Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. In the last few of our physiotherapy articles we have been concentrating on the hand but in this article for the ThreeSpires Physiotherapy blog I thought it would be good to look at a condition that affects the spine and generally begins in childhood/adolescence but has consequences for the whole of life: scoliosis. Also to remind anyone who is not a regular reader of this physiotherapy blog: we are a home visit physiotherapy service based in Lichfield and offering services in Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.

What is Scoliosis?

Scoliosis is a condition where the spine curves to the side rather than going straight up vertically. Usually the curves of the spine are forwards and backwards and you can feel this on yourself or someone else. Whereas with scoliosis the spine has curved to the side rather than the usual forward and backwards.

What Causes Scoliosis?

Even though doctors have been aware of scoliosis for a long period, the actual cause of scoliosis is still not well understood and in the majority of cases (approx 80%) there is no clear cause of scoliosis and in this case it is called idiopathic scoliosis. In idiopathic scoliosis the patient will have received an array of tests to rule out underlying causes and these will have all come back as negative. In which case doctors will then call this a case of idiopathic scoliosis. In other cases there can be an underlying cause such as a neuromuscular condition like cerebral palsy or muscular dystrophy which has caused the muscles of the back not to support the spine properly. If scoliosis begins in older age then it is usually caused by degeneration and wear of the spine, possibly through osteoporosis and some parts of the spine collapsing.

What are the Symptoms of Scoliosis?

Although scoliosis can begin at any age it most commonly starts between the ages of 10 and 15 during which period the spine will begin to shift to one side. If a person has scoliosis there spine will be curved to the side at some point most commonly in the thoracic area (mid/upper back) and this can present with shoulders sticking out, hips out to one side or a bump forming in the back. Scoliosis can cause back pain but not always and symptoms are variable. The most important thing with scoliosis (especially in children) is to get a diagnosis early so that the condition can be managed well and it is important that you see a doctor to get an x-ray which will help to confirm the diagnosis.

What are the Treatments for Scoliosis?

Treatment for scoliosis depends upon the age at which it develops, severity of curvature and a judgement as to whether it is likely to get worse over time. In children there are several treatment options:

Treatment for Children with Scoliosis:

 

1. Monitoring: initially if the scoliosis is judged to not be too severe and the consultant feels that it may not develop further then simply monitoring and checking the progress of the curve will be the preferred treatment. Often with very young children the curve in the spine will grow out over time and therefore in some cases a wait and see approach will be the best option.
2. Bracing: In some children it may be necessary for them to wear a cast or a brace to prevent their scoliosis worsening as they grow. This will be done in consultation with a surgeon and will be worn until everyone is confident that the scoliosis has stabilised.
3. Physiotherapy: usually as part of treatment for scoliosis patients will be referred to a physio who will prescribe exercises and stretches to help strengthen muscles and improve mobility.
4. Surgery: there are two main surgical options for children whose scoliosis is more severe and is rapidly worsening and a specialist spinal surgeon will be involved in assessing which option is most appropriate.  If they are young enough they can have rods inserted alongside their spine to help the spine grow straight. These rods are generally extendable and should grow/elongate with the child as they grow. However if they are older it may be necessary to use spinal fusion to stop their scoliosis worsening.

 

Treatment for Adults with Scoliosis

1. Physiotherapy: the appropriate exercises, strengthening and stretching programme is in general the first line of treatment for an adult with scoliosis. A physiotherapist will be able to assess the physical needs of the patient and prescribe exercises designed to strengthen the muscles of the spine and promote mobility.
2. Injections: in some patients with scoliosis, pain is a severe problem and for these patients a steroid injection may be helpful.
3. Surgery: for adults surgery is much less common and is only considered if the scoliosis is significantly worsening or pain is not under control. In severe cases where the scoliosis is worsening and other methods have failed then surgery will be considered. This will usually be spinal fusion of selected segments.  

 

How Can Physiotherapy Help with Scoliosis?

Whether it is an adult or a child it is important that once you have had a diagnosis of scoliosis that you seek help from a physiotherapist. Physiotherapy can help with strengthening muscles that have become weak, lengthening and stretching tight muscles and tendons and generally reducing the symptoms of scoliosis. Having an assessment with a physiotherapist will help you decide upon a good management plan that will allow you to best manage the condition.

If using our physiotherapy service this will involve having one of our physiotherapists visit you at home to conduct the initial assessment of usually 1hr. During this initial assessment our physiotherapist will discuss your condition with you, take a past medical history and go through goals, targets and what you would like to work towards. Next they will conduct a full physical assessment of your scoliosis, how it is affecting movement, balance, strength and mobility. Afterwards in conjunction with your goals and the results of the physical assessment they will devise an exercise and management plan that will help you with your scoliosis. At ThreeSpires Physiotherapy we have both adult and paediatric physiotherapists who will be able to help manage your or your child's scoliosis.

Okay, I hope that you have found this article about scoliosis helpful. If you have any questions, would like more information or want to know if our physiotherapists can help with your scoliosis then please get in touch. For anyone reading: we are a home visit physiotherapy service, based in Lichfield but serving anywhere within a 20 minute drive including areas such as Sutton Coldfield, Tamworth, Cannock, Burton and Rugeley. We offer a wide range of services including paediatric physiotherapy, post-operative rehabilitation, neurological physiotherapy and neck and back pain relief. If you need further information or would like to book an appointment we can be contacted on 0788 428 1623 or via enquiries@threespiresphysiotherapy.co.uk