Scoliosis

Scoliosis is a condition in which a person’s spine is curved from side to side and appears as an “S” or a “C” on an x-ray film. The condition may be idiopathic (meaning the cause is unknown) or it may be congenital (result of certain vertebral anomalies at birth). It may also develop as a result of a neurological disorder such as cerebral palsy and spina bifida. Scoliosis occurs and worsens, most commonly in adolescents. It affects more girls than boys. There is no cure for this condition and it may become painful in adulthood.

The goal of physiotherapy in treating adults, therefore, is to address back pain, posture and muscle strength. Heat, electrical stimulation and massage have been proven helpful in alleviating the pain of scoliosis. In addition, soft tissue manipulation may help improve alignment and flexibility but cannot halt the progression of the disease. Exercises to strengthen muscles also form part of the physiotherapy program. Aquatic exercises are especially helpful as the buoyancy of the water helps improve flexibility, posture and balance and relieve pain.

In idiopathic adolescent scoliosis, therapy may focus on bracing to prevent progression of the disease. A custom-fitted brace may be appropriate, which fits from the armpits to the hips. The child or parent is taught to put on and take off the brace and is given a wearing schedule, usually 22-23 hours a day.

For the child whose scoliosis is the result of a neurological disorder, therapy is much more complex. Special seating and/or mobility devices may be needed. Training in posture, coordination and gait may be necessary as well as exercises to promote flexibility and strength. The child may also be fitted with a brace and will be trained in the normal wearing procedure.

Scoliosis presents many challenges both to the patient as well as the physiotherapist; however with proper diagnosis and treatment, one can lead a reasonably pain-free and independent life.