Scoliosis: Setting the Record Straight

Kim’s Korner

We all know how important posture is but there are times when standing straight is just not possible due to abnormal curves in the spine, known as scoliosis.  Our back has natural curves when viewed from the side but, when viewed from the back, it is straight. Scoliosis is a condition that presents either a ‘C’ or ‘S’ shaped curve from the back.  Scoliosis can be structural; either present at birth (congenital due to a genetic condition or appear in the teenage years (idiopathic) where the cause is unknown. Depending on the severity of the curve and the integrity of internal organs, it may be managed conservatively with a brace, exercise and posture re-education or, in extreme cases, surgery may be indicated.  Scoliosis can also appear later in life (known as environment) and is often due to poor posture and weakness or the ageing process; this is more easily corrected with exercises.

Often scoliosis goes undetected but careful assessment of posture can reveal problems. Some of the most common signs are:

• Uneven shoulders

• Rotation of the ribcage

• One shoulder blade more prominent than the other

• One hip higher than the other

• Uneven waist curves

Physiotherapists are healthcare professionals concerned with improving function and reducing pain. They are specialists with in-depth knowledge of human anatomy and physiology, which makes them well placed in treating injuries, neurological and musculoskeletal conditions and movement dysfunction.

Whether scoliosis is congenital, idiopathic or due to abnormal daily postures, physiotherapy can help. Although there may be slight differences to treatment approach, the underlying principles are the same:

• Strengthen weak muscles

• Create body balance through flexibility and strengthening exercises

• Posture re-education

• Balance and proprioception exercises

Your therapist will undertake a thorough assessment and identify postural abnormalities and muscle imbalances, and strength and flexibility issues.  The aim of treatment will be to prevent further postural changes and reduce pain. This is done by creating an individual rehabilitation programme for you that may include:

• Electrotherapy: by means of electrical current the ability to reduce pain and also stimulate muscles.

• Flexibility training: stretching muscles that are tight.

• Muscle strengthening: ensuring that weak muscles are identified and exercised.

• Muscle balance training: muscles work in groups and often there is an imbalance.  These muscles will be identified and functional exercises introduced that will ensure correct muscle activity and movement.

• Postural re-education and advice: your therapist will give you advice on how to sit correctly and how to position objects in your environment to ensure that you are not over-using certain muscles or sitting in awkward positions.

• Balance and proprioception exercises; to ensure that your body can react to changes in movement and direction.

• Core stability exercises: strengthening these muscles will not only make you stronger but can help relieve pain.

In some cases of mild to moderate scoliosis the doctor may suggest a brace, the purpose of whih is not to correct the curve but to stop it getting worse. If the curve is severe, it can affect a person’s breathing and put pressure on other internal organs. In these cases surgery may be suggested. Surgery is a long and complex process. Depending on the goal of surgery there are three common surgical procedures:

• Fusion: the spinal curve is corrected as much as possible and metal rods are inserted to hold the spine in place.

• Growing systems: if the curve is severe and the child young, a system of rods is inserted which are adjusted, every 6-12 months, to take into account the growth of the spine. Once the spine has reached its full development, a spinal fusion may be done.

• Fusionless: with new technology and research, a new method is gaining in popularity.  The technique requires putting constant pressure to the side of the curve, reducing growth on that side but allowing the other side to continue to develop at its normal rate.

If you notice an abnormal curve in your spine, contact your doctor today and remember, even mild cases require exercise and advice to achieve optimum posture. Speak to a physiotherapist to see how they can help.

Kim Jackson is a UK-trained physiotherapist with over 20 years’ experience. She specializes in musculoskeletal pain and dysfunction, including back pain and sciatica, stroke and other neuro conditions plus sports physiotherapy, having worked with local, regional and international athletes and teams treating injuries and analyzing biomechanics to improve function and performance.  She is registered with the Allied Health Council and is a member of PASL. She currently works at Bayside Therapy Services in Rodney Bay,

www.baysidetherapyservices.com