Adult-onset Secondary Scoliosis can be caused by:
Anatomically shortened (or lengthened) leg acquired after:
- Leg growth plate fracture
- Pelvic, hip or leg fracture with loss of original leg length or
- Joint replacement—which is becoming much more common.
Although more commonly diagnosed in adulthood, an anatomically shortened leg may occur in childhood.
- Iliolumbar and/or Sacroiliac Ligament sprain injury acquired from the regular “wear-and-tear” stress and strain of day-to-day, year-to-year weight-bearing. The sprain injury results in Sacroiliac Joint misalignment and, ultimately, partial dislocation with sacral base unleveling.
- Regular wear-and-tear stress-strain-and-sprain is the most common cause of Scoliosis in adults—seen in 99% of lower back pain cases to one degree or another. Onset of symptoms can be associated with or aggravated by a traumatic event, such as a car or bicycling accident.
Symptoms of acquired SIJ misalignment and adult-onset Scoliosis include:
- Low back pain (LBP), often radiating to the buttock, groin and/or leg on the same side as the LBP.
- This referred pain is generated by the sprained SI Joint ligament(s)—such ligament pain is NOT caused by nerve impingement. In fact, ligamentous referred pain often mimics the neurologic pain of true “sciatica.” Occasionally, true ligament pain may be accompanied by a true neurologic pain component due to a coincidental nerve impingement—such a combination resembles the “perfect clinical storm.” And, it takes an experienced diagnostician to differentiate the two.
Compensatory short leg syndrome with:
- Weakened leg abduction on the same side as the short leg
- Compensatory, total vertebral column, S-shaped Scoliosis with the lower concavity facing away from the side of the SI Joint dysfunction (i.e., on the short leg side)
- Supinated ankle and foot
Compensatory long leg syndrome with:
- Dropped shoulder on the long leg side.
- Hesitation limp on the long leg side
- Pronated ankle and foot.
- Lower lumbar (L3-4-5) rotatory misalignment and/or upper thoracic (T6-7) costovertebral rotatory misalignment with upper thoracic “hump” formation with associated pain between the shoulder blades (intrascapular), more prominent on the long leg side.
All of these same symptoms and signs can, also, be observed in Early-onset Secondary Scoliosis.