Spinal Disorders and Scoliosis
The spine both carries the trunk and protects the spinal cord across the neck, upper back and lower back. Symptoms in this region range from pain and postural change to nerve compression and curvature. This page sets out which condition is covered under which heading and how assessment proceeds.
Conditions Covered Under This Heading
- Lumbar disc herniation — pain radiating into the back and leg, sciatica
- Cervical disc herniation — pain radiating into the arm, numbness, loss of hand dexterity
- Spinal stenosis — leg symptoms that shorten walking distance
- Scoliosis — curvature in children and adolescents, degenerative curvature in adults
- Osteoporotic vertebral compression fractures
How Does Assessment Proceed?
The first step with spinal symptoms is to establish whether the pain is mechanical or nerve-related. This distinction directly determines the treatment plan.
- History: site and radiation of pain, aggravating and relieving movements, walking distance, numbness and weakness, bladder and bowel symptoms.
- Neurological examination: muscle strength, reflexes, sensation, gait and balance.
- Imaging: a standing X-ray shows alignment; MRI is the basis for assessing the disc, nerve root and spinal cord. Imaging is not needed in every patient or on the first day of symptoms.
- Additional tests: nerve conduction studies, bone density measurement or laboratory tests where needed.
A common error is to treat an MRI finding as a reason for treatment on its own. Disc protrusion is seen in a significant proportion of people with no symptoms at all, and this proportion rises with age. The decision comes from assessing symptoms, examination and imaging together.
Treatment Approach
For the great majority of spinal problems the first approach is not surgical. Where there are no red-flag findings and no progressive neurological loss, the following steps are followed:
- Staying active — prolonged bed rest is not recommended
- Pain management; the choice and duration of medication determined by the physician
- Physiotherapy and an exercise programme targeting the trunk and hip muscles
- Reviewing daily life and working arrangements
- Injection treatments in selected cases
Surgery is considered where there is progressive weakness, findings of spinal cord compression, cauda equina syndrome, or resistant symptoms restricting daily life despite an adequate period of treatment. The method is planned according to the site of compression, spinal alignment, bone quality and the patient’s requirements. Outcomes vary from person to person.
Scoliosis Follows a Different Path
In spinal curvature the decision rests on three factors: the degree of the curve, the patient’s age and remaining growth potential. A curve may progress in a growing child, whereas the same degree is generally stable once growth is complete. Follow-up intervals are therefore planned according to growth. For detail see the Scoliosis page.
Daily Advice for Spinal Health
- When lifting, bend your knees, keep the load close to your body and do not twist while lifting
- Stand up and move every 30–45 minutes
- Bring the screen to eye level; do not look down at a phone for long periods
- Work the trunk and hip muscles regularly
- Weight control and stopping smoking have a favourable effect on disc health
When Should You Seek Assessment?
- If pain radiating into the arm or leg has lasted several weeks
- If numbness is spreading or weakness has started
- If your walking distance is becoming progressively shorter
- If you have noticed asymmetry of the shoulders or waist in your child
- If pain interrupts your sleep at night
When to Seek Medical Help Without Delay
- Loss of bladder or bowel control, or an inability to pass urine
- Numbness around the anus and inner thighs (cauda equina syndrome)
- Weakness developing in both arms or both legs at once
- Rapidly worsening hand dexterity and disturbance of walking
- Night pain together with fever, weight loss or a history of cancer
- Severe spinal pain after significant trauma
These findings require urgent assessment. Outside office hours, go to the nearest emergency department.
Frequently Asked Questions
Should I have an MRI straight away for back pain?
If there are no red-flag findings, imaging is generally not needed in the early period. Most back pain settles within weeks. MRI is requested where there is progressive weakness, red-flag findings, or symptoms that persist despite an adequate period of treatment.
I have a disc herniation — can I do sport?
In the acute phase, movements that increase pain are avoided; activities such as walking and swimming are generally recommended early. Return to weight training is planned gradually and technique matters.
Should I wear a brace?
If needed, it is used for a short period and on medical advice. Prolonged use can weaken the trunk muscles, so continuous use is generally not recommended.
Will my movement be restricted after spinal surgery?
This depends on the method used and how many levels are involved. Movement decreases in a region that has been fused; daily activities can generally be maintained. Expectations are discussed in detail before surgery.
Does my child’s school bag cause scoliosis?
No. A heavy bag can cause back pain but is not the cause of idiopathic scoliosis. Scoliosis is a structural curvature and does not develop from postural habits.
My pain has gone — can I stop the exercises?
Continuing the programme for a period after the pain has settled is recommended. The strength of the trunk and hip muscles is among the modifiable factors affecting the likelihood of symptoms returning.
Academic Work
Assoc. Prof. Bertan Cengiz, MD has scientific work published in national and international peer-reviewed journals in the field of spinal surgery and spinal deformity and related areas. The publication list and verifiable academic sources are available on the Publications page.
Related Pages
- Lumbar Disc Herniation
- Cervical Disc Herniation (Neck Hernia)
- Spinal Stenosis (Narrowing of the Spinal Canal)
- Scoliosis (Curvature of the Spine)
- The First 48 Hours of Back Pain: What to Do and What to Avoid
The information on this page is for general guidance and does not replace an in-person medical examination. Diagnosis and treatment require a physician’s clinical assessment. Outcomes of any treatment or surgical intervention may vary from person to person; no guarantee of a specific result or timeframe is given on this page.