Scoliosis is an abnormal curvature of the spine, typically affecting 2% of the population. When looking from the side, the human spine has normal curves but when looking from behind, the spine should appear straight. With a patient with scoliosis, the spine appears curved from behind.
Scoliosis affects females 2x more than males with the most common cause is idiopathic or of unknown origin. Idiopathic scoliosis is typically noted beginning at 10 years of age when growth spurts begin prior to puberty. Other forms of scoliosis include functional scoliosis, neuromuscular scoliosis, and degenerative scoliosis.
Functional scoliosis includes when the spine itself is normal but a curve forms because of another musculoskeletal dysfunction such as a leg length discrepancy or myofascial trigger points. Neuromuscular scoliosis begins early on in the formation of the spinal bones which is common in those individuals with birth defects, muscular dystrophy, and cerebral palsy. Degenerative onset scoliosis is developed later on in adulthood and is caused by arthritic changes in the spine.
Treatment of scoliosis is determined on the severity of the curve. Each case of scoliosis is different and therefore there is no standard treatment. However, a combination of exercise such as the Schroth Method, bracing, and postural retraining have been noted to be effective. If the scoliotic curve is less than 25 degrees typically no treatment is required and reexamination is done every 4 to 6 months. For a curvature between 25 degrees and 40 degrees a back brace is used along with physical therapy interventions with reexaminations done every 4 to 6 months to monitor the curvature. Curves more than 45 degrees may need to be evaluated for surgical intervention
Achieving the best possible posture is important for the stabilization and correction of the spine. Physical therapy is a key aspect in developing patient specific treatment plans. Postural correction must not only be achieved in exercise but incorporated into daily activities. Curvatures for scoliosis typically form “C” shaped curves or “S” shaped curves. It is important to remember when doing exercises to help with “S” shaped curves to avoid exercises that adversely affect one of the curves while trying to correct the other. Therefore, seeking guidance from a skilled physical therapist is very important. Physical therapy interventions for patients with scoliosis are designed to halt the progression of the curvature of the spine and lengthen the spine. In a patient with scoliosis with muscular imbalances (or muscular weakness) and asymmetrical loads to the spine can only continue to make the curvature worst, therefore it is important on beginning a treatment plan early.
Remember, the goal of all treatment plans for a patient with scoliosis is to reduce pain if present, improve posture, halt the progression of the curvature, and reverse abdominal curvatures. It is important for your child to be screened early during their elementary school years!