Scoliosis is a condition that causes an abnormal sideways curve of the spine, often appearing as an S or C shape. The best physical therapy treatment for adults with scoliosis includes exercises to reduce pain. Your physical therapist will show you breathing techniques with exercises to improve your posture. You will also strengthen weak areas around the spine, including the abdominals. You will work on stretches for areas surrounding the spine that have muscle tension, such as the lower back, trunk, and hips. Physical therapists will educate patients on the best ways to relieve pain, modify activities to help achieve goals, and keep up with helpful exercises.
Your spine is the base of support for your entire body. Consisting of 33 small bones (called vertebrae) stacked on top of one another, the spine allows you to bend and twist your trunk as you perform your daily activities. Your spine helps you bend over to pick something up off the floor or twist to reach something in the backseat of your car.
Your spine has natural curvatures at the neck, upper back, and lower back. These curves are part of normal posture and absorb mechanical shock during movement. They occur in the sagittal plane, or the plane of movement that splits your body into right and left halves. Scoliosis is a condition affecting the spine’s lateral (sideways) curvature. This can affect posture and alignment throughout the body. While scoliosis can occur at any age, it is more frequently diagnosed in adolescence, with an average prevalence of 2%–3% in children under 16.
Depending on severity, scoliosis can affect a wide range of daily activities. Limited spinal mobility may lead to difficulty with bending and twisting, while changes in alignment and posture may affect walking and standing. While some people diagnosed with scoliosis may experience pain due to the effects on surrounding muscles and joints, research has shown no link between mild to moderate scoliosis and back pain.
Physical therapy can treat scoliosis and help improve your quality of life. With Direct Access, you don’t need a referral from your primary care provider to get started today. Keep reading to learn more about physical therapy for scoliosis and how we can help you get back to doing what you love.
In the majority of cases, the cause of scoliosis is unknown. When this happens, it is diagnosed as idiopathic scoliosis, which comprises about 80% of all cases. Adolescent idiopathic scoliosis, which is diagnosed during puberty, is the most common type of scoliosis.
Developmental issues during pregnancy may result in spinal birth defects affecting the development of the spine. This can lead to congenital scoliosis as areas of the spine grow at uneven rates. This is usually detected at a much earlier age than idiopathic scoliosis.
Neuromuscular scoliosis is a type of scoliosis that can develop secondary to several medical conditions that affect the spine and surrounding tissues. These medical conditions include muscular dystrophy, spina bifida, and cerebral palsy. The curves associated with neuromuscular scoliosis typically develop earlier than in idiopathic scoliosis and can involve the entire spine.
Certain risk factors, including age and sex, can increase the chance of developing scoliosis. Adolescents, aged 10-18, constitute the majority of cases of scoliosis. Females are more likely than males to develop scoliosis, and females are more prone to progression and the need for treatment.
Scoliosis also has a strong genetic link. Individuals with a family history of scoliosis are more likely to develop the condition.
Common scoliosis symptoms include:
Scoliosis typically does not cause pain. If there is pain or discomfort, this is due to the spinal curve’s impact on the surrounding muscles and tissues. Over time, the muscles around the spine may also weaken, causing imbalances that affect strength and flexibility.
Detecting scoliosis as early as possible is important to prevent the curve’s progression. Contact your physical therapist if you notice physical signs of scoliosis, such as uneven shoulders or a rib hump, in yourself or your child.
Remember the strong genetic link with scoliosis—if there’s a family history of scoliosis, you can contact your physical therapist for a screening. You won’t need a referral to be seen by a physical therapist; Direct Access allows you to make appointments directly with your physical therapy office.
Your physical therapist will evaluate you for scoliosis by performing a physical examination and functional assessment. During your physical exam, they will assess your posture, range of motion, strength, and balance. For your functional assessment, you’ll be asked to perform specific movements or replicate activities that are difficult or cause discomfort.
After your physical therapy evaluation, if your physical therapist suspects scoliosis, they will refer you to a doctor for X-rays. Scoliosis cannot be diagnosed visually. X-rays are needed to measure the Cobb angle, a measurement used to determine the severity of curvature.
Several factors must be considered when determining treatment options for scoliosis. Your physical therapist will consider the maturity of your spine and whether it is still growing. An adolescent with scoliosis will likely experience growth and change in the spine as they age. This will affect the decisions around your treatment options.
Your physical therapist will also review the severity of the curve and its location. They will consider how your spinal curves affect your daily life. After assessing these factors, your physical therapist will discuss the treatment options best suited to your case.
Regular Observation
Many times, treatment is not necessary for mild cases of scoliosis. However, if your physical therapist is concerned about progression, they may want to schedule regular screenings. This could mean every four to six months for adolescent patients until the spine has reached maturity. For adult patients, appointments can be made less frequently unless symptoms worsen.
Braces
Bracing is an effective treatment option for patients who have not reached skeletal maturity. Your physical therapist will help you manage your brace and regularly check for fit. Consistently wearing a brace has been shown to stop curve progression in about 80% of children with scoliosis. There are many different options for bracing, and your physical therapist can help you decide which is best for you.
Physical Therapy
Physical therapy is an effective, conservative treatment option for scoliosis. An experienced physical therapist can help you and your child develop a plan to address any issues and reach functional goals. The treatment plan may include scoliosis exercises for physical therapy, hands-on treatment, functional training, and education. With Direct Access, you can make an appointment for you or your child to be screened for scoliosis today – no referral needed.
If you are considering surgery as a treatment option for scoliosis, talk with your physical therapist first. They can provide additional conservative treatment recommendations to address your concerns without surgery.
However, there are circumstances when surgery may be warranted. In an adolescent, if the spinal curve is greater than 40 degrees with signs of progression, surgery may be recommended to halt progression and minimize spinal deformity.
Some adults who underwent scoliosis surgery as adolescents may be candidates for revision surgery, especially if their surgery was more than 20 years ago. In general, adults with curves greater than 50 degrees with nerve damage could necessitate surgery.
There are several different surgical procedures to address scoliosis:
Spinal fusion: A spinal fusion involves placing a bone graft between two vertebrae in the curved area of the spine, straightening the curve. Rigid metal rods are placed on the straightened spine to ensure the spine heals correctly. This creates a solid bond between two or more vertebrae, eliminating any movement in those sections.
Vertebral body tethering: Vertebral body tethering involves placing screws along the outside of the spinal curve along the side of the vertebrae. A tether is attached to the screws and tightened, guiding the spine to straighten as it grows. Unlike a spinal fusion, vertebral body tethering preserves spinal mobility, allowing movement.
Osteotomy: An osteotomy is a technique used in conjunction with spinal fusion when the fusion isn’t enough to correct the curvature. In an osteotomy, pieces of the vertebrae are cut and removed to allow the spine to be realigned. Once straightened, the spine can be fused in proper alignment.
After a thorough examination, your physical therapist will develop a treatment plan personalized for you or your child. They will prescribe exercises to reduce pain and strengthen weak areas of the spine, including core and back muscles. If your physical therapist has assessed a muscular imbalance, they will teach you corrective exercises targeting specific back, hip, or shoulder muscles.
Your physical therapist may also prescribe stretches to target your hips, back, or shoulders. These exercises aim to restore function and improve quality of life. Your physical therapist will ensure you know how to perform them properly and provide detailed instructions for home.
The Schroth method is a specialized scoliosis therapy program designed to address three-dimensional spinal curvature through strengthening, stretching, and breathing techniques. Your physical therapist may use this method or another specialized program like the Scientific Exercises Approach to Scoliosis (SEAS).
The primary goals of physical therapy sessions are to improve mobility, strengthen the body, and alleviate pain. Your physical therapist will also show you how to improve your own health with a home exercise program and education. Your treatment plan will also incorporate your personal functional goals, helping you live a fulfilling, active life.
Scoliosis doesn’t have to slow you or your child down. You can still be athletic and high functioning after a scoliosis diagnosis. For example, Usain Bolt, the Fastest Man in the World, and world deadlift holder Lamar Gant both have scoliosis and have competed at top levels.
There are many benefits of pt for scoliosis with an individualized treatment plan based on your or your child’s needs. Using the proper scoliosis-specific exercises, your physical therapist can help you strengthen the muscles around your spine and restore a more symmetrical posture. This translates to less discomfort and improved overall movement patterns with functional activities.
Physical therapists can specialize in specific methods for treating scoliosis. For example, the Schroth Method is a comprehensive treatment designed to correct a spinal curvature in three dimensions. Because the spinal curvature is unique to each person, the Schroth exercises are tailored to your individual case. With consistency and commitment to the program, patients can stop the progression of their curvature.
A strong patient-physical therapist partnership, also called a therapeutic alliance, is essential for success during your physical therapy treatment. There must be a collaboration between the patient and therapist, with the patient taking an active role in their rehabilitation. Your physical therapist will help empower you to take ownership of your treatment plan and celebrate your successes. A strong therapeutic alliance also leads to improved communication between you and your physical therapist, ensuring you’re working towards the goals that are important to you.
Scoliosis can range from mild to severe. In more severe cases, there may be pain, breathing problems, or visible deformities.
Scoliosis is a progressive condition, meaning it worsens over time. Treatments are geared towards managing symptoms and slowing the progression.
No, scoliosis cannot be prevented. Most cases of scoliosis are idiopathic, meaning the cause is unknown.
It’s never too late to start a scoliosis treatment program. Treatments in adulthood can focus on slowing progression while improving quality of life.
Yes, PT can help address the asymmetries caused by scoliosis and help you or your child work towards functional goals.
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