Physical Therapy Management of Scoliosis Resulting in Bilateral Shoulder Pain in an Older Factory Worker: A Case Report

Background: Adolescent Idiopathic Scoliosis (AIS) affects as many as 4 in 100 adolescents. The efficacy of conservative treatments has been closely examined in younger age groups, but little research exists examining conservative management of AIS as adolescents age into adulthood and beyond. Considering the aging population, including those with conservatively managed AIS, is at risk for pain and dysfunction resulting from degenerative changes of spinal alignment, a need for this research exists in order to properly manage cases of peripheral joint dysfunction rooted in spinal deformity. Case Description: A 61 year old male presenting with bilateral shoulder pain also has a history of AIS. Through adolescence, his AIS was managed by observation only and he encountered few issues. His shoulders began hurting more frequently with age until he sought medical attention. This patient was working full time as a factory worker throughout this episode of care. Intervention: Physical therapy to treat shoulder impingement including manual therapy, neuromuscular re-education, therapeutic exercise, and therapeutic activity. Intervention evolved from targeting shoulder pain to increasing spinal mobility and postural control as symptoms improved. Outcome: Improvement of 29.5% as measured by QuickDASH. Patient expressed satisfaction with his recovery and opted to discontinue therapy. Discussion: AIS can continue to alter function and cause pain into adulthood. These symptoms can be treated with physical therapy by implementing interventions targeted at both the spine and the primary symptom location.