Scoliosis and Physical Therapy

What is Scoliosis?

Scoliosis is an abnormal sideways curvature of the spine. It is indicated by the side-to-side “C” or “S” shape of that curve. Normally, the spine has a natural curve at the top of the shoulders and in the lower back. While everyone has these slight curvatures, if the angle of the curve measures 10 degrees or more, it is deemed scoliosis.

Scoliosis can be visibly evident as an uneven look of the shoulders, hips or waist. The vertebrae of the spine may also be rotated, which results in one shoulder blade or the trunk muscles appearing more prominent.

Scoliosis affects more females than males (two percent of the female population has scoliosis versus one-half percent of the male population). More than 80 percent of people with scoliosis have idiopathic scoliosis (no known cause), the majority of whom are adolescent girls. Scoliosis in this category is based on the age at which it develops, and is divided into three groupings.

  • Idiopathic scoliosis – under three years old
  • Juvenile idiopathic scoliosis – between three and 10 years of age
  • Adolescent idiopathic scoliosis – ages 10 to 18

A cause can be identified for an estimated 20 percent of scoliosis cases (i.e. those not idiopathic). These are different types of scoliosis, including:

  • Congenital, in which spinal deformities are apparent at birth
  • Neurological, when nerve abnormalities affect muscles in the spine

Other categories of scoliosis include:

  • Structural, in which the curvature of the spine is permanent and is caused by injury, disease or birth defect
  • Nonstructural, in which the curvature is temporary and can be corrected

Another relevant and common type of scoliosis is degenerative. While the overall adult population is reported to have an incidence of scoliosis ranging from two to 32 percent, one study showed that in the elderly, that rate jumps to 60 percent. This form of scoliosis is caused by an arthritic condition (spondylosis) of the spine. Some other causes of degenerative scoliosis include osteoporosis, vertebral compression fractures and disc degeneration.

Scoliosis can result in the following:

  • Back pain
  • Muscle imbalance
  • Uneven shoulder, hip or waistline height
  • Pain in the surrounding areas of the spine (shoulder, hip, pelvis)
  • Pain with activity or with certain movements
  • Compromised breathing

Causes

Although it is not always the case that those who develop idiopathic scoliosis have a family history of the condition, it does increase the risk.

Common causes of scoliosis, other than idiopathic are:

  • Birth defects (e.g. spina bifida)
  • Genetic conditions (e.g. Down syndrome, Marfan syndrome)
  • Neurological abnormalities
  • Neuromuscular conditions (e.g. cerebral palsy, muscular dystrophy)
  • Spine injuries or infections
  • Tumors

Physical Therapy for Scoliosis

The prognosis for an individual with scoliosis depends on how severe the problem is, and how early it is diagnosed and treated. While there is no cure for scoliosis, the symptoms can be treated and reduced.

Physical therapy is one of the main ways to manage scoliosis symptoms, as well as to maximize functional capacity.

There are a number of areas in which physical therapy can help those with scoliosis. These include:

  • Improving mobility and flexibility
  • Improving posture
  • Preventing the spine curvature from progressing
  • Recovering from scoliosis surgery
  • Relieving pain
  • Strengthening involved muscles

These benefits are achieved through some of the following physical therapy techniques:

Strength exercises. These are often exercises to strengthen supporting spine muscles (such as in the shoulders, back and hips) that have weakened due to the spine’s positioning.

Range-of-motion exercises. These are designed to provide flexibility, especially in targeted areas in which movement limitations may exist.

Manual therapy. Restoring joint and muscle tissue motion that has been restricted by scoliosis may be done with hands-on work, in which physical therapists specialize. This is done to help facilitate movement patterns.

Modalities. There are additional treatments that may help achieve physical therapy goals. These include such modalities as ice, heat, ultrasound and/or electrical stimulation.

Education. Physical therapists are experts in assessing and providing education on proper movement patterns. They can also provide information on scoliosis and its impact on the body.

Types of Physical Therapy for the Treatment of Scoliosis

There are a number of physical therapy techniques that are used especially for the treatment of scoliosis. An excellent review of many of them is published in a 2016 article entitled, Physiotherapy scoliosis-specific exercises—a comprehensive review of seven major schools. The article appears in Scoliosis and Spinal Disorders, a journal that encompasses all aspects of spinal deformities and disorders.

At Spinal Rehabilitation and Wellness Center, we are experts in providing customized physical therapy as part of our multi-disciplinary approach. For more information or to schedule an appointment, contact us today.