Polio survivors and leg-length variations

DEAR DR. ROACH: I had polio when I was 11 years old, many years ago, and miraculously, recovered enough to live a normal life. When I was in my 40s, I developed constant back pain and visited a renowned orthopedist. When I told him I’d had polio, he rolled up a paper towel and placed it under my right heel. He told me that “all people with polio have some degree of scoliosis.” The pain went away almost immediately.

He gave me a prescription for a 1⁄4-inch heel pad (to take to a shoemaker) and to wear it in my right shoe all the time. The doctor said that for over 30 years, my back muscles have been straining to force my body to stand straight, causing the pain. I also was advised to do a set of floor-stretching exercises, which I did every morning. I am now 85 years old and never had back pain again. — E.R.

Poliomyelitis is a devastating complication of poliovirus with no proven treatment. The virus may damage many of the nerves of the body, including those to the muscles necessary to breathe (hence, the iron lung).

Scoliosis is a common complication of poliomyelitis, but it is not universal. Scoliosis may develop years after the acute infection along with muscle weakness as part of post-polio syndrome.

One possibility of apparent scoliosis in your case is of a leg-length discrepancy (one leg longer than the other), which is exceedingly common in polio survivors. When one leg is longer than the other, it may lead to changes in the body to compensate. Over time, this causes hip and back pain and scoliosis due to functional changes of the spine. I suspect you had a leg-length discrepancy that the orthopedist addressed. It’s also possible there is both some scoliosis and some leg-length discrepancy.