Scoliosis - what is it and how can physiotherapy help?
Patients often present to physiotherapy with a diagnosis of mild scoliosis and not much more information on what it is, how it has come about and what can be done to help with ongoing management. If this sounds like you or a loved one, let's dive right in!
What is scoliosis?
Scoliosis is an umbrella term for spinal conditions that impact the normal curvature of the spine. Scoliosis may occur at any time, whether it be during adolescence or detected later in a person’s lifespan, however typically doctors or therapists diagnose the condition between 10 and 15 of age. The prevalence is 3% of the population with a higher incidence in females. Cases may vary from mild to quite severe, which of course means that the treatments for the condition vary wildly. Physiotherapy is beneficial for all cases of scoliosis however depending on the severity other modalities such as bracing and surgery may be required. Females are 8 times more likely to progress to a curve magnitude that requires treatment.
Types of Scoliosis:
Scoliosis can be classified by aetiology or origin.
Idiopathic scoliosis makes up about 80 percent of diagnosed cases and is diagnosed when all other causes are excluded. The term “idiopathic” essentially means that the cause of the condition is not verifiable.
Congenital scoliosis results during an embryos development and results in malformation of one or more vertebrae and may occur in any location of the spine. The vertebral abnormalities cause curvature and other deformities of the spine because one area of the spinal column lengthens at a slower rate than the rest. Because these abnormalities are present at birth, congenital scoliosis is usually detected at a younger age than idiopathic scoliosis.
Neuromuscular scoliosis encompasses scoliosis that is secondary to neurological or muscular disease such as spinal muscular atrophy, cerebral palsy and spina bifida. This type of scoliosis generally progresses more rapidly than idiopathic scoliosis and often requires surgical treatment.
How do I know if I have Scoliosis?:
Signs and Symptoms:
There are several signs that may indicate the possibility of scoliosis. It is wrongly assumed that there needs to be pain for scoliosis to be suspected. This is incorrect as the actual condition itself is very rarely a cause of pain. A recent study indicated at the time of diagnosis of idiopathic scoliosis, 23% of patients had back pain. However 10% of these patients were found to have other pathology that was the cause of this pain. This indicated that if a patient with diagnosed idiopathic scoliosis has more than mild back discomfort, a thorough evaluation for another cause of pain is advised.
Some potential signs that may encourage you to seek professional advice include:
Shoulders are uneven – one shoulder blade higher or one shoulder blade may stick out
Head is not centred directly above the pelvis
One or both hips are raised or unusually high
Rib cages are at different heights
Waist is uneven
The appearance or texture of the skin overlying the spine changes (dimples, hairy patches, colour abnormalities)
The entire body leans to one side
Following a clinical assessment, if your practitioner suspects some form of scoliosis diagnostic imaging will need to be performed, typically an x-ray. On the images, the spine may appear as an “s” or “c” in shape. Medical experts assess the severity of this condition by measuring the angle of the curvature (Cobb angle). For a scoliosis diagnosis, a Cobb angle of at least 10 degrees must be present in the patient, a curve is considered significant if it is greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment.
Treatment - How can physiotherapy help?
As mentioned above the severity of the condition will dictate the most appropriate treatment, however the benefit of physiotherapy is that it’s relevant at all stages. Bracing and surgical management may need to be explored if a more significant deformity is present. When referred to a physiotherapist for management at any stage, a thorough assessment at your initial appointment will help to tailor an individualized plan that considers your goals and condition severity. Treatments often incorporate range of motion and breathing exercises to help address any functional or sporting limitations as well as strength training (particularly around the trunk musculature) to minimise the impact of the condition.
If you suspect scoliosis in yourself or a loved one, always seek professional advice early. Early detection means treatment options are explored to minimise the negative impact this can have on the quality of your life now and into the future.
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!