Scoliosis Of The Spine - Physiotherapy Treatment
What is scoliosis? Very simply put, scoliosis of the spine describes a curving of the spine
, with the curve moving away from the center (or sideways, in other words). The presence of scoliosis is felt by pain in the upper or lower back, and fatigue and is noted by uneven shoulders and hips, as well as a spine that visibly curves laterally.
Treatment of the condition depends upon the degree of the curve. In youngsters with less than 20 degree curve, no treatment is generally recommended, though the condition should be checked about every 6 to 8 months. If curves worsen to the 25 degree or greater mark, braces are often recommended that help to slow the progress of the condition. There are numerous different braces available, including a Charleston brace, a Wilmington brace and a Boston brace. The braces all look and function somewhat differently; and while none of them reverse the curve that is there, they do work to straighten the spine, and they can be adjusted over time.
In cases where the curve has progressed to 40 degrees or more, surgery is often recommended. Surgery generally involves fusing the bones together and holding those bones in place with one or more metal rods. Braces are often worn after surgical procedures as well.
Causes
There are several primary causes of spinal scoliosis. Some cases are caused by neuromuscular issues such as poor muscle control or muscle weakness. These issues are often, in turn, caused by diseases such as muscular dystrophy, spina bifida, polio and cerebral palsy. These are called neuromuscular scoliosis.
Congenital scoliosis is present at birth and is cause by poor formation of the spine, or fusion of the ribs, during the baby's development period while in the womb. This type of scoliosis is found equally in girls and boys.
Idiopathic scoliosis, as the name suggests, does not have a known cause, and emerges from a straight spine. This is the most common form and is most commonly found in adolescents, and most often in girls.
Testing is done by visual examination of the spine, shoulders and hips. Shoulders and hips will often be tilted when scoliosis is present. The patient will also be tested for reflexes and strength. Findings can be verified through X-ray.
The patient might be tested with scoliometer, which is a device for measuring the degree of curve in the spine. An MRI might also be ordered.
The prognosis is dependent on the degree of the curve, its cause, and where in the spine it is located. The more severe the curve, the more likely it is to worsen over time, after the body has stopped growing naturally. Less severe cases, which can be treated with braces, often get better over time, with a minimal of long-term lasting implications. Some will have a heightened risk for lower back pain as they age.
Patients with neuromuscular scoliosis are often confronted with larger issues than just the scoliosis, and the objectives of treatment for the scoliosis, therefore, are different.
Across all of these categories, treatment can cause complications as well. One of the primary ones associated with treatment is the emotional challenges of wearing a brace through the teenage years. Psychological counseling is frequently recommended.
Physical complications can include arthritis in the lower back as an adult, respiratory problems, spinal cord or nerve damage, post-surgical spinal infection. In cases where surgery aimed to fuse bones, one other complication is that the bones simply do not fuse.
Exercises for Scoliosis
The primary objective of exercise for scoliosis is to strengthen the muscles in the lower back, shoulders and upper back. To do this, the abdominal muscles are also an area of focus.
One exercise involves the use of a stability ball. You sit on the ball with your left foot up on its toes and your right hand outstretched with you middle finger and thumb together and pointing down. Now, slowly lift your foot off the ground and extend and lift your arm. Hold the position for five seconds and slowly return to the rest position. Take about 30 seconds to rest and the repeat 10 to 20 times.
Another also involves the ball. Get on your knees in front of the ball and lean forward until your stomach is on the ball and the ball is supporting your weight. Then move backward slowly until your back is parallel to the ball, with your arms raised and straight out (and also parallel with the ball). Hold the position for about five seconds. Rest and repeat for 10 to 20 repetitions.
Next sit on the ball with your feet flat on the ground. Make sure you spine is straight. Take a small weight in one of your hands, and drop that weight and hand behind your head. Use the other arm to stabilize if necessary as you move the weight up and down 10 times. Rest and repeat this three times.
Next, stand with your arms at your sides, facing your legs, and small weights in each hand. Pull your arms straight up your body, till your elbows are just slightly higher than your hands. Then return your hands to the rest position. Make sure to pause before continuing. Do this to the count of ten, and with short rests in between, do 10 repetitions.
by: Johnathan Lim
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