Scoliosis – A bend in the back


What is it?Picture of scoliosis in spine

Scoliosis is the medical term for a curved spine. It is a relatively common condition that, unfortunately, is often misunderstood and over-emphasised. It is estimated that scoliosis is present in about 2-3% of the population. Of this number 20% are congenital (meaning present from birth) and 80% are idiopathic (meaning it develops spontaneously during life, for no know reason). Many people will live with a scoliosis their whole life and have very little problems and function normally.

There must be a bend in the spine of over 10° for it to be classified as a scoliosis.  Any less than this and it is classified as a simple curve in the spine. Radiologists can measure the angle, called a Cobb angle accurately on x-ray.

 

Who gets it?

Sometimes a scoliosis develops at a very young age, and sometimes it can develop later in life. On occasion, when a person has an episode of back pain, they can temporarily look as if they have a scoliosis but this will usually be less than 10° so not an official scoliosis, and will resolve when their back pain does. Some people can develop a scoliosis later in life as an adaptation to other longer term pain or conditions.

 

How we can treat it

Scoliosis spine

What a scoliosis looks like when someone bends over

For scoliosis’ of 10-45° exercise is a large part of treatment. Curves of over 45° MAY need surgery. In moderate cases (curves of 20-40°) some children/adolescents may wear a brace as well as treated with exercise. But in curves of 10° to approximately 25° exercise is the main form of treatment.  It is particularly useful to get children and teenagers treated, as sometimes the curves can increase with growth if not addressed.

Exercise can reduce curves by up to 32%, research has shown. And those in exercise programmes have 24-48% fewer spinal fusions (surgery that puts metal work along the spine to keep it straight) than those not in exercise programmes (Rigo, 2003)

 

 

Elongating the spine is the first thing you want to do in the management of a scoliosis. Using wedges and supports so that gravity is acting to normalise the curves in the spine is important first, and then strengthening/lengthening exercises depending on the directions of the curves in the spine.  Hands on therapy like massage and myofascial release can also be beneficial to help lengthen the shortened areas of the spine.

It is important that the principles of elongation, lengthening and strengthening exercises are prescribed very specifically and correctly for the curves of individual scolioses. This needs to be done gradually and gently as it can feel quite intense for the patient at first.  A lot of Pilates exercises are very good for people with a scoliosis.  If you would like an individualised home exercise programme or some treatment please book in here.

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