What we Treat / Scoliosis

Scoliosis

Scoliosis is a lateral or sideways curve in the spine that is apparent when viewing the spine from behind. Most cases of scoliosis are mild, but severe scoliosis can be disabling. A mild degree of scoliosis is common, occurring in up to 50 per cent of the population. Scoliosis generally does not require any specific treatment unless it becomes painful or tight. However, severe scoliosis does indeed need treatment. Scoliosis occurs mainly in the thoracic and thoraco-lumbar regions. There are two basic types of scoliosis, structural and functional. In the structural scoliosis the mechanics of the curve are such that rotation of the vertebrae occurs in combination with lateral curvature, and this usually produces a protuberance of one side of the rib cage, seen best when a person bends forward. This is the worst type of scoliosis, and it can be progressive. In the functional scoliosis, fixed rotation does not occur, and the curvature is usually non-progressive. This type of scoliosis is classified into postural, which disappears on forward bending, and compensatory, which is most commonly due to a short leg.

Causes

While the causes for most types of scoliosis are unknown, hereditary factors have thought to have an effect on it. Some less common types of scoliosis may be caused by:

• One leg being shorter than the other - curvature of the spine can develop due to problems elsewhere in the body, such as one leg shorter than the other or muscle spasms in the back.
• Neuromuscular disorders - such as Cerebral Palsy, birth defects affecting the development of the spine and muscular dystrophy can cause scoliosis. Congenital scoliosis, where the curve is present from birth is much more severe and needs more aggressive treatment than other forms of scoliosis.
• Arthritis in the spine - This degenerative scoliosis occurs in older adults due to the weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs.

Symptoms

Signs and symptoms of scoliosis may include uneven shoulders or waist, one shoulder blade that appears more prominent than the other or one hip higher than the other. If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing.

Treatment

The most important part of the management of scoliosis is the early detection of its presence, as early management may prevent the need for surgery. The management of a scoliosis is determined by the extent of the scoliosis. A number of methods are used to decide upon the most appropriate treatment. In most instances a mild scoliosis requires no specific treatment. Advice in regard to posture and exercises may be offered.

In the majority of functional scoliosis, our Physios can give advice regarding:

• Posture;
• Strengthening of muscles and correction of muscle imbalance;
• Strapping;
• Ergonomics;
• Exercise.

Exercises can be prescribed to maintain curve status. If a brace is required, an exercise programme will also be prescribed, but if not required, instruction regarding review of the scoliosis and exercises will be provided.

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