Patient case study

Sophie’s story: three sore spots, one chainWhat a standing EOS scan showed about her pelvis, spine, shoulder and neck

Back
Shoulder
Neck
Pelvic imbalance
Compensating spinal curve

Three painful areas looked like three problems. They were one problem, corrected three times.

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Real ScanAlign patient
Her own scan video
About 12 minutes to read

Sophie · Scan video Watch Sophie’s scan

Sophie’s own scan video, shared with her permission.

The short answer

Why did Sophie’s back, shoulder and neck all hurt?

Why did Sophie’s back, shoulder and neck all hurt? Her standing EOS scan showed her pelvis was not sitting level, and her spine had curved to compensate so that her head stayed over her feet. That curve keeps you upright, but it loads muscles and joints unevenly all the way up, which is how one problem at the pelvis can be felt in three separate places. Her plan changed from treating each painful area on its own to working on pelvic alignment and load from the ground up.

Patient: Sophie
What hurt: Back, shoulder and neck
The pattern: Three areas, each treated on its own
Plan before the scan: Treating each painful area separately
Scan: EOS full-body standing scan, front and side views
Key findings: Pelvic imbalance and a compensating spinal curve
Plan after the scan: Pelvic alignment and load from the ground up
Where: ScanAlign, 19 Harley Street, London

Before the scan

Three painful areas, three separate plans

Sophie had pain in three places: her back, her shoulder and her neck. Each one had been looked at and treated on its own, which is the usual way these things are handled. Three areas, three conversations.

Treating the painful area often helps, and for a while it did. But relief in one place did not settle the others, and nothing explained why someone would have three separate problems at once.

It is a common experience. Treatment that helps but does not hold usually means the thing causing the strain has not changed, only the strain itself has been eased.

Three painful areas is unlucky. Three painful areas in one chain is a pattern.

How it builds

One uneven base, corrected all the way up

Each stage adds to the one before it. Select a stage to build the picture up from the base, the way the body does.

Pelvis not level
Spine curves to compensate
One shoulder higher
Neck holds the head level

Illustration, not drawn from Sophie’s images. Simplified and exaggerated for clarity. Which side sat higher is not part of her published summary, so the direction shown is illustrative.

The pelvis sits off level

Your pelvis is the base your spine stands on. It is designed to sit level. When one side sits higher, nothing above it can sit square either, so the correcting starts straight away.

The spine curves to compensate

The spine does not simply lean over. It curves back the other way, so your head stays above your feet and your eyes stay level. That curve is doing a job. It is also loading one side of each joint more than the other.

One shoulder ends up higher

The rib cage and the shoulders ride on the spine, so when the spine curves, they move with it. A shoulder that sits higher changes how the whole arm and shoulder blade work.

The neck finishes the job

Whatever correcting is left falls to the neck, because your eyes need to be level to move around safely. The neck muscles hold that position all day, which is why the top of a chain like this is so often where the ache turns up.

Read the chain from the top and it looks like three problems. Read it from the bottom and it is one problem being corrected three times. That is why the body works as a chain, not as a set of separate parts.

What the scan found

Two findings, and one depends on the other

The second finding is the body’s answer to the first. That is the part worth holding on to, because it changes where a plan should start.

A pelvis out of balance

The two sides of her pelvis were not sitting level, which is sometimes called uneven hips.

What it is
The pelvis is the junction of the body. The spine sits on top of it, both legs hang below it, and almost everything you do passes through it. It is built to sit level and square.

Why it mattered for Sophie
An uneven base is the first link in her chain. It decides the angle the spine starts from, and everything above it has to work around that angle.

What the standing scan shows
A standing image shows both sides of the pelvis at once, so their heights can be compared directly rather than estimated by hand or by eye.
A spine curving to compensate

Her spine had curved to make up for the uneven base and keep her head over her feet.

What it is
A compensating curve is the spine correcting for something below it. It is the body doing its job, not the body failing. It is different from scoliosis, where the curve is in the structure of the spine itself and is usually twisted as well as bent.

Why it mattered for Sophie
The curve is what carries the problem upward. It is the reason her shoulder and her neck were involved at all, even though nothing had happened to either of them.

What the standing scan shows
The whole spine is captured standing, head to feet, in one image. That matters here, because a curve and the pelvis that drives it have to be seen together to make sense. A full spine X-ray taken standing is the usual way to measure it.

The difference it makes

The same three areas, read two ways

Nothing in the middle column is wrong. It is what most people get, and it helps. The third column is what a whole-body picture adds on top of it.

Where it hurt	Looked at on its own	Seen as part of one chain
Lower back	Local treatment to the sore muscles and joints, aimed at easing the pain where it is felt.	The lower back sits directly on the pelvis. If the base is not level, the back bends to make up the difference, every hour of the day.
Shoulder	Work on the shoulder joint and the muscles around it, aimed at movement and pain.	When the spine curves, the rib cage and shoulders go with it, and one shoulder can end up sitting higher. Our guide on uneven shoulders explains what that looks like.
Neck	Treatment to the neck itself, often alongside advice on posture at a desk.	The neck does the last bit of the correcting, tilting so your eyes stay level. That is why it can ache even when nothing happened to the neck. It is sometimes described as a cervical tilt.

The middle column is the usual approach, not a comment on Sophie’s own care. The point is what the third column adds.

Watch the scan

Watching Sophie’s scan: what to look for

The video walks through Sophie’s real EOS images, front and side. You do not need any medical training to follow it. These three things are worth watching for, and they come in the order the body builds them.

What to look for in the video

Check the level of the pelvis in the front view.
Follow the spine up from the pelvis and watch how it curves to keep the head centred.
Compare the height of the two shoulders.

Scan images can look unfamiliar at first. That is normal. The written report that comes with every scan explains the findings in plain English. Replay Sophie’s video

What a standing EOS scan shows

Whether the two sides of your pelvis sit level
The curves of your whole spine, front and side, under your own weight
Whether one shoulder sits higher than the other
How your head sits over your pelvis and your feet
The shape of your joints and the space inside them while they carry weight

What it does not show

Discs and nerves in detail
Cartilage, muscles, tendons and ligaments in detail
Inflammation and other soft-tissue causes of pain

For these, MRI is usually the better tool. A standing scan answers a different question: how the parts line up and share load when you are upright.

After the scan

How Sophie’s plan changed

Before

Treating each painful area separately

After the scan

Addressing pelvic alignment and load from the ground up, with targeted support

The change was where to start. Rather than three plans for three areas, the work began at the base: getting the pelvis and the way load travels through it right first, with targeted support for the areas that had been compensating. Our guides on pelvic tilt exercises and posture exercises explain the general approach.

That does not mean the sore shoulder and neck get ignored. They still need help, and easing them is worth doing. It means they are treated as part of a chain rather than as three unrelated faults, so the relief has a better chance of lasting.

It also gives whoever treats her something concrete to work from. A physiotherapist, osteopath or chiropractor can plan around a measured picture of how she stands rather than around a description of where it hurts. If you are unsure who to see, our guide comparing physiotherapy, osteopathy and chiropractic may help.

ScanAlign is a diagnostic imaging clinic. We show you what is going on and explain it clearly. Treatment is planned by the specialists you choose, with the findings in hand.

Why standing matters

Why a standing scan made the difference

A compensating curve only exists while you are holding yourself up. It is the body correcting for a base that is not level, and that correcting stops the moment the weight comes off.

Lying down takes that weight off. Muscles relax, the spine settles into the table, and a curve like Sophie’s can soften or disappear. That does not mean the pain only happens when you stand. Plenty of people hurt lying down too, and night-time back pain is common. It means the cause often sits in how you are aligned and loaded when upright and carrying your weight, even if you feel it at other times.

An EOS scan is a full-body weight-bearing scan in 15 seconds, unstitched and non-magnified, with front and side views captured at the same time. It uses about 90% less radiation than a standard X-ray, around ten times less.

Lying down: MRI and CT

The load comes off

Muscles relax and the body settles into the table. A tilt, and the curve that corrects for it, can soften or disappear. These scans are excellent for discs, nerves and soft tissue.

Standing: EOS

Your real working position

Pelvic level, spinal curves and shoulder height show as they are when you carry your own weight. Head to feet in one image, front and side together.

An honest note about MRI. EOS shows bones, joints and alignment. If your problem is mainly discs, nerves or soft tissue, MRI is usually the better tool, and we will tell you so on your free call. See how EOS compares with MRI, CT and X-ray.

Seek urgent help first if you have new numbness, weakness in your arms or legs, or loss of bladder or bowel control. Contact your GP, NHS 111 or A&E.

Your story

Do your painful areas have separate plans?

Which of these sound like you?

Tick any that apply. Nothing is saved or sent.

I have more than one painful area, each with its own treatment
Treatment helps one area, but the others carry on
The pain seems to move around my body
I have been told one shoulder or hip sits higher than the other
My clothes hang unevenly, or one strap always slips
No one has looked at how those areas connect, from head to feet

Tick any that sound like you.

Talk it through on a free call

Questions to ask your specialist

Whoever is treating you, these questions join the painful areas up instead of taking them one at a time.

Could my back, shoulder and neck pain be connected?
Does my pelvis sit level when I am standing?
If my spine has a curve, is it compensating for something below it?
Should we be starting at the base rather than at the painful areas?

Good clinicians welcome these questions. If you are not sure who to ask, our guide on when to see a specialist can help.

How a story like Sophie’s starts

A free video consultation
Tell us what has been going on and what you have tried. No GP referral is needed, and we will say honestly whether a scan is likely to help.
Your standing scan at 19 Harley Street
You stand naturally, with light undressing, and the scan captures you from head to feet. Read what to expect on the day.
A clear written report
A plain-English report of your findings, with a summary you can take to your GP, physiotherapist or specialist.

Questions

Questions people ask after reading Sophie’s story

Can a problem in my pelvis cause neck pain?

It can. If the pelvis is not level, the spine curves to keep your head over your feet, and the neck makes the final adjustment so your eyes stay level. Holding that position all day is work, and work that never stops can ache. It is not the only cause of neck pain, which is why it helps to see the whole chain rather than guess.

Is a compensating curve the same as scoliosis?

No, although they can look similar in a picture. A compensating curve is the spine correcting for something below it, such as an uneven pelvis. Scoliosis is a curve in the structure of the spine itself, usually with rotation as well as a sideways bend. Telling them apart matters, because they are managed differently.

Why does treating each painful area separately only help for a while?

Because it changes the symptom rather than the loading. If the base is still uneven, the body goes back to correcting in the same way as soon as it is upright again, and the same areas take the same strain. Local treatment is still useful. It just works better alongside a plan for the cause.

Are uneven shoulders always caused by the pelvis?

No. A dominant arm, carrying a bag on one side, an old injury or a difference in the spine itself can all do it. What a standing scan adds is the ability to see whether the shoulders are level relative to the pelvis and the spine, instead of judging them on their own.

Can a compensating curve be reversed?

It depends on what is driving it. A curve that exists to correct for something below it can often change when the thing below it changes, which is why the plan starts at the base. Structural curves behave differently. Our guide on postural versus structural curves explains the distinction, and how long posture change takes is a fair summary of the timescale.

Should I bring my scan to a physiotherapist, osteopath or chiropractor?

Yes, whoever you are already working with. The report is written in plain English and is yours to share. If you want a fresh view on findings you already have, our guide on asking for a second opinion covers how to go about it.

Is the EOS scan safe?

Yes. EOS uses about 90% less radiation than a standard X-ray, around ten times less. You stand in an open scanner, with no tunnel and no injections. There is more detail on our safety page.

How much does it cost?

Prices are on our cost page. The first video consultation is free and there is no obligation to go ahead.

Keep reading

Guides linked to Sophie’s findings

Your story

More than one painful area, like Sophie?

If you are managing two or three sore spots with separate plans, a free video consultation is the easiest way to find out whether a standing scan could show how they connect.

Book a free video consultation Call 020 7935 0001

Sophie’s story, first name and scan video are shared with her permission. Individual findings and care plans vary, and this story does not predict your results.

This page is general information and not a diagnosis.

ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital’s CQC licence.