Scoliosis

Physiotherapy for scoliosis may help relieve pain, improve spinal mobility, and prevent worsening of lateral spinal curvature. Your physical therapist can strengthen muscles that support your spine and improve your postural awareness.

Understanding Scoliosis: More Than Just a Curve

What is scoliosis exactly? It’s a three-dimensional spine deformity that goes beyond simple bad posture. The spine may curve in a C-shape (single curve) or S-shape (double curve), affecting the body’s overall balance, gait, and, in severe cases, even respiratory function.

Recognizing scoliosis symptoms early can be crucial for effective treatment. Common signs include:

• Uneven shoulders or hips
• One shoulder blade protrudes more than the other
• A visible rib hump when bending forward
• Clothes hanging unevenly
• Back pain (more common in adults with scoliosis)

While the exact cause of most scoliosis cases remains elusive, factors such as genetics, neuromuscular conditions and degenerative diseases can play a role. Regardless of the cause, early intervention is key to managing the condition effectively.

If you are experiencing any of these symptoms, it’s important to consult our physiotherapist promptly. Our team at HelloPhysio can assess your condition and provide an accurate diagnosis.

Diagnosing scoliosis is often straightforward. A physiotherapist can often observe a lateral curvature simply by looking at your back. Asking you to bend forward at the waist can help confirm the diagnosis, as this position accentuates any spinal curvature and rotation. This may cause one side of your rib cage to appear more prominent — a “rib hump” — which is a telltale sign of scoliosis.

If scoliosis is suspected, an X-ray may be ordered to examine the alignment of your spine. The imaging reveals the position of the vertebrae and allows for precise measurement of the curvature. Some individuals have an “S”-shaped curve, where the lower (lumbar) spine curves one way and the middle (thoracic) spine curves in the opposite direction. Others may have a “C”-shaped curve, with the lumbar and thoracic spine curving in the same direction.

As the spine curves laterally, the vertebrae may also rotate slightly. Additionally, many patients with scoliosis experience a straightening of the thoracic spine’s normal curvature.

Using the X-ray, our expert physiotherapists can determine the type and severity of the curve, measured by the Cobb angle. Cobb angles range from 10 degrees (mild) to over 60 degrees (severe).

There are several treatment options available for scoliosis:

• Mild Cases (Cobb angle less than 20 degrees): These may simply require regular monitoring and specific exercises.
• Moderate Curves (Cobb angle between 20 and 40 degrees): Bracing may be recommended to prevent further progression. Physical therapy exercises are often advised to improve posture and strengthen spinal muscles.
• Severe Cases (Cobb angle over 40 degrees): Surgery may be necessary to stabilize and correct the spinal alignment.

Many individuals with mild to moderate scoliosis benefit significantly from physical therapy, which helps manage the condition and enhance their quality of life.

Physical Therapy Evaluation for Scoliosis

If you’ve been referred to physiotherapy for scoliosis, your first session will typically involve a comprehensive initial evaluation. During this appointment, your physiotherapist will engage in a detailed discussion with you to gain a thorough understanding of your condition. They’ll inquire about:

• Your Pain Levels: Where you experience pain and how it affects your daily activities.
• Your Diagnosis: Specific details about your scoliosis, such as the type and severity.
• Previous Treatments: Any interventions you’ve tried so far to manage your scoliosis.

They will also review your medical history and note any medications you’re currently taking. It’s beneficial to bring any recent X-rays or imaging studies to your appointment, as these provide valuable insights into the curvature of your spine. If you use a brace, bring it along as well.

Assessment and Measurements

After the initial interview, your physiotherapist will conduct various assessments to evaluate your physical status. These may include:

• Postural Assessment: Observing your posture to identify any imbalances or deviations.
• Range of Motion Tests: Measuring the flexibility of your spine and limbs.
• Strength Evaluation: Testing the strength of muscles, especially those supporting your spine.
• Balance Tests: Assessing your stability during different movements.
• Pulmonary Function Assessment: Evaluating your breathing capacity, as scoliosis can impact lung function.
• Functional Mobility Examination: Observing how you perform everyday activities and movements.

During this evaluation, expect to be actively moving, so wear comfortable clothing for easy movement.

Goal Setting and Treatment Planning

With a clear understanding of your condition, your physiotherapist will collaborate with you to set personalized goals and develop a tailored treatment plan. Common objectives for managing scoliosis through physical therapy include:

• Pain Management: Implementing techniques to reduce discomfort and improve quality of life.
• Improving Spinal Alignment: Exercises and therapies aimed at enhancing spinal positioning and reducing curvature progression.
• Strengthening Muscles: Building strength in the muscles that support your spine to provide better stability.
• Enhancing Postural Control: Training to maintain proper posture during daily activities.
• Increasing Range of Motion: Stretching and mobility exercises to maximize flexibility in your spine and extremities.
• Improving Breathing and Lung Function: Respiratory exercises to enhance diaphragm function and overall pulmonary health, which may be affected by spinal curvature.

Starting Your Treatment

Treatment often begins during the initial appointment. Your physiotherapists will likely introduce you to a specific home exercise program that fits your needs. Performing these exercises daily is crucial, as they complement the therapies you’ll receive during your clinic visits and play a significant role in your progress.

Moving Forward

Consistent participation in your physical therapy program is key to effectively managing scoliosis. Regular sessions with your physiotherapist, combined with diligent practice of your home exercises, can lead to significant improvements in:

• Pain levels
• Spinal alignment
• Muscle strength
• Posture
• Flexibility
• Breathing capacity

By taking an active role in your treatment, you can control your scoliosis better and enhance your overall well-being.

Physical Therapy Exercises for Scoliosis

Incorporating regular exercise into your daily routine is crucial if you have scoliosis. The primary goals of scoliosis-specific exercises are to:

• Improve Breathing: Enhance lung function and capacity, which can be affected by spinal curvature.
• Increase Postural Awareness: Help you become more conscious of your posture to correct imbalances.
• Strengthen Spinal Support Muscles: Build strength in the muscles that support your spine, providing better stability.
• Reduce Joint Pain from Muscular Imbalances: Alleviate discomfort caused by uneven muscle tension and stress on joints.

While these exercises may not decrease or reverse the curvature of your spine, they are designed to help you gain better control over your posture and halt the progression of scoliosis. Ultimately, scoliosis treatment through physical therapy aims to prevent the condition from worsening and decrease or eliminate the need for surgical intervention.

Benefits of Early Physiotherapy Intervention

Most patients with scoliosis benefit from attending physiotherapy sessions once or twice a week for four to six weeks. After this initial period, regular follow-up appointments are important to monitor progress and advance your exercise program. Your physiotherapist will work with you to develop a customized follow-up plan that suits your specific needs.

For many people, managing scoliosis is a lifelong commitment. If your spinal curve is less than 20 degrees, you can often manage the condition effectively with exercises alone. If your curve exceeds 20 degrees, you may benefit from bracing in addition to daily spine-specific exercises. Should your curve progress beyond 50 degrees, surgery might be considered to help stabilize your spine.

If you suspect you have scoliosis, please contact our team at HelloPhysio to explore conservative management options.