Muscular spasm causing a functional scoliosis

Patient

Q: Hello, I've been having issues with my left shoulder; it keeps making a cracking and popping noise when I adduct and abduct my shoulder and sometimes when I move it up and down. My acromion also is visibly more prominent on the left side as well. My left ribs are not exactly straight compared to the right side (which seems to have a more smoother look) and they protrude out more, it is especially visible when I breath in and out. When I twist to the left side, it seems as though my breath is stopped halfway to fill up whereas when I twist to the right I can take a full breath. There is also an issue with my spine, in the thoracic spine to be specific I believe, I have taken an x-ray for it and the results say "you have evidence of a muscle spasm that causes an abnormal curve". My doctor did not believe all these symptoms were that big of a deal, so she just waved me off pretty much, she didn't even bother to look at my shoulder when I asked her. The problem is, I keep getting on-and-off numbness and tingling down my lower right back, and numbness, tingling, and sometimes nerve pain in my left arm. I am afraid I have nerve compression and I do not want nerve damage. This has been ongoing for several months now, gradually getting worse.

Doctor

A:    A scoliosis is a lateral or sideways curve in the spine that is apparent when viewing the spine from behind. A mild degree of scoliosis is common, occurring in up to 50 per cent of the population. Scoliosis generally does not require any specific treatment. However, severe scoliosis does indeed need treatment. Scoliosis occurs mainly in the thoracic and thoraco-lumbar regions. There are two basic types of scoliosis: structural and functional. In the structural scoliosis the mechanics of the curve are such that rotation of the vertebrae occurs in combination with lateral curvature, and this usually produces a protuberance of one side of the rib cage, seen best when a person bends forward. In your particular case it seems that the prolonged muscular spasm is causing a functional scoliosis, this misalignment is probably affecting the function of the cervical spine and also the shoulder. In the functional scoliosis, fixed rotation does not occur, and the curvature is usually non-progressive. This type of scoliosis is classified into postural, which disappears on forward bending, and compensatory, which is most commonly due to a short leg. I strongly recommend you to get a comprehensive evaluation by an Orthopedic Surgeon in order to determine the cause and repercussion of what it seems a postural, functional problem and proceeds with the adequate treatment.

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