What is scoliosis?
Scoliosis is a medical condition where an abnormal sideways curve develops at some point along a person’s spine. The word literally means “bending".
What causes scoliosis?
The exact cause is often not known, however, about 33% of children whose parents have scoliosis will develop scoliosis, so it’s partially genetic. Bodily accidents, prior to and during an adolescent’s growth spurt, can also create conditions that could, essentially, cause scoliosis. Even postural stresses, such as carrying a backpack that’s greater than 10-15% of a child’s weight, could lead to curvature of the spine.
How is scoliosis recognized?
Some signs to look for may include:
- The head isn’t quite centered over the rest of their body (the body seems to lean to one side).
- Shoulders could appear uneven, or a shoulder blade or collar bone may stick out.
- The rib cages might be at different heights.
- With arms hanging loosely at the side, there may be more space between the arm and the body on one side.
- The waist is uneven or a hip could be raised up.
- Unsteady or irregular walking, or limited mobility.
- There’s evidence of pressure sores due to imbalance.
- There could be back, shoulder or neck pain.
- There’s a family history of scoliosis or other significant back problems.
Scoliosis is usually confirmed through a simple physical examination by a medical practitioner such as a physical therapist. The exam involves standard bending tests along with measurement of those movements. Grade school screenings can sometimes detect scoliosis before it develops into a more serious condition.
If further diagnostic information is needed after an initial exam, then an imaging technique (such as x-rays) might be used as a next step.
The Scoliosis Research Society recommends that girls be screened twice, at 10 and 12 years of age (grades 5 and 7), and boys once at 12 or 13 years of age (grades 8 or 9).
What are the results if not treated at an early age?
Although scoliosis is not life threatening, if it isn’t detected and treated at a younger age it can become much more difficult to deal with as a young adult and throughout a person’s life.
Ignoring signs of scoliosis could lead to pain if the spine curves abnormally and substantially affects the nearby muscles and joints. These changes, especially during adolescence, may alter a person's alignment, posture and movement patterns, causing irritation and pain.
Muscles that usually support the spine could become imbalanced with scoliosis, leading to a loss of flexibility and strength.
Waiting too long to detect scoliosis could result in surgery, or the curvature may become a permanent condition with fewer options to choose from as time passes. Extreme forms of untreated scoliosis could ultimately affect the lung or heart.
Untreated scoliosis in a person’s younger years can show up later in life when an injury occurs or with muscle stress that complicates the underlying scoliosis. Even workplace posture in mid-life can become a factor that reveals previously undiagnosed scoliosis. At these later stages, treatment is increasingly difficult.
Elderly people with scoliosis may experience greater back pain due to spinal arthritis or disc disease. And severe curvature can, over time, affect the nerves of the spine, creating a danger of paralysis.
Any preexisting curvature worsens as a child grows and their body matures, so early detection is important.
Why is physical therapy important with regard to scoliosis?
Physical therapists act as first responders to scoliosis, in terms of detecting and treating the condition. Early intervention offers the best chance to manage scoliosis effectively.
Many patients and their parents inquire about treatment options other than bracing and surgery, which can be invasive and expensive. Each patient’s situation is different, so it’s best to keep an open mind
A physical therapist knows what to look for and how to test for scoliosis. Because the tests are easy to perform, there is virtually no downside to testing — only the time it takes to do them. A trained eye, however, is necessary in definitively identifying scoliosis and creating an appropriate treatment plan.
Physical therapists are skilled at identifying symptoms and helping individuals of any age to restore and maintain mobility so they can function at their personal best with a high quality of life.
Physical therapy can provide care during any of the phases of scoliosis treatment, including bracing or post-surgery. An effective physical therapist analyzes movement patterns of the whole body, noting any limitations caused by changes in the spine, and addressing other symptoms, such as pain and muscle imbalances.
Your physical therapist will work closely with you or your child, and will develop a customized plan tailored to the type and severity of the scoliosis as well as specific patient goals that you’ve agreed upon. Progress is closely monitored with each session.
Ongoing education is always an important part of physical therapy. Your physical therapist will provide all the information you require about scoliosis and the effects of it on the body.
How does physical therapy treat scoliosis?
An experienced physical therapist will work with a person to develop strategies that are specific that person’s situation and all other factors that have been observed by the physical therapist.
For mild conditions, specific exercises may be recommended along with monitoring by the therapist. The assessment and strengthening of spinal muscles is important since it is those muscles that are restricted or cramped, and therefore pulling in ways that offset the spine. Because stretching helps to lengthen and maintain muscles at their normal length, specific physical therapy exercises help a person strengthen, support and restore normal spine function.
For more moderate conditions, especially for individuals engaging in sports and exercise, treatment strategies may include bracing. There are many different bracing techniques, but the important thing to remember is that each approach must be uniquely fitted for an individual’s specific physical circumstances. Proper bracing can hold the curve and prevent it from progressing to the point where surgery is recommended.
If a physical therapist is unable to treat a person’s particular condition, then discussion of surgical solutions would be part of the conversation.
In general, a physical therapist helps people who have experienced an injury, illness or physical condition regain or maintain the ability to participate in everyday activities, providing assistance through assessment, intervention, and ongoing evaluation of the scoliosis. This helps a person manage the condition so they can participate in their regular daily activities without significant disruption.