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When Back Pain Needs a Specialist

When Back Pain Needs a Specialist

A friend recently mentioned her teenager has been diagnosed with scoliosis. And then you notice an elderly relative is having difficulty standing up straight. In fact, he can’t stand up straight anymore. What is affecting each of these individuals at very different periods in their lives?

Scoliosis and common forms of adult spinal deformity can have a painful impact on one’s quality of life, according to Rajiv Saigal, MD, a Washington Township Medical Foundation (WTMF) neurological spine surgeon. Treatment options are available for both, Dr. Saigal says— especially if the issues are identified early.

Dr. Saigal will discuss scoliosis and other spinal issues at a Health & Wellness seminar, Tuesday, Feb. 20. The 11 a.m. online seminar, “Scoliosis and Spinal Deformity: What Is It and What Can Be Done About It?” can be viewed on facebook/Washington Hospital and youtube/whhsinHealth. During the seminar, Dr. Saigal will review treatment options and discuss when surgery is recommended.

Scoliosis (curvature of the spine) occurs when the spine, rather than growing in a straight line from the neck to the bottom of the back, develops a curve. The curve is often in a “C” shape from side to side.

Scoliosis is frequently first identified in adolescent children as they enter their growth spurt, either through a regular exam by the child’s pediatrician or when the child is playing organized sports and a coach notices it. Such exams focus on uneven hips or shoulders or other physical signs of uneven spinal alignment. Additional signs of scoliosis can include complaints of pain or wakefulness during the night interrupting sleep.

According to Dr. Saigal, for those with a spinal curvature of less than 25 degrees, symptoms are mild and typically do not require surgery. Exercises to strengthen the core muscles may be sufficient, and occasionally a back brace is recommended. Bone density is often tested and supplements may be recommended.

A minority of younger patients develop a “significant” curvature of 25 degrees or more and may require surgery. “The important thing is to monitor the curvature through regular physician visits,” he says. Many curvatures stabilize at under 25 degrees, but they still should be monitored.

In older people, spinal curvature and other spinal deformities can be debilitating and require surgery. In addition to curvature, spinal deformities can be caused by tumors, trauma such as an accident or fall, or degeneration of the spine from aging.

If you—or someone you know—suddenly can’t stand up straight any longer, a specialist should evaluate the condition. Dr. Saigal emphasizes, “Such curvatures in older adults can cause balance problems and lead to falls, which then can lead to worsening health issues.”

Patients also experience balance issues with spinal curvature but often compensate by rotating their knees or pelvis, which is why the physical exams of young people focus on uneven hips or shoulders as telltale signs of spinal curvature.

Before deciding on a medical career, Dr. Saigal received a PhD in engineering. “I studied biomechanics and became interested in spinal issues and how to correct and compensate for them. Medicine became the vehicle to combine what I had learned as an engineer to help individuals deal with spinal curvatures and other deformities. “The body is a complex biomechanics structure and fixing spine deformities can help solve or prevent issues occurring elsewhere in the body,” he explains.

To learn more about the minimally invasive options associated with spine treatment, visit For more information or to register for the upcoming, “Scoliosis and Spinal Deformity: What Is It and What Can Be Done About It?” seminar, visit