Scoliosis refers to abnormal curvatures and rotations of the spinal column, that are commonly diagnosed in childhood or in early adolescence. The spinal column is a collection of bones that make up the skeletal components of the neck, part of the ribcage, the lower back, and the back of the pelvis. These skeletal components are responsible for protecting the vulnerable spinal cord, for moving relative to each other to support the movement of other structures like the skull and other segments like the limbs and the segments of the trunk, for bearing the weight of the upper half of the body in addition to any external loads, and for adapting to the body's different postural and performance needs. Abnormal curvatures and rotations of the spinal column have the potential to affect muscular strength and balance, as well as the nerves and arteries that support the spine and other structures.
Scoliosis occurs in two to three percent of the population, and commonly develops and is diagnosed in infancy or early childhood. The primary age of onset for scoliosis is between 10-15 years old, and while the occurrence of the condition is equal for both genders, females are eight times more likely for their scoliosis condition to progress to a level of severity that requires treatment. Scoliosis can also occur in adults, occurring in almost one in ten adults over the age of twenty-five and increasing to almost seven tenths of adults over the age of 60, and this increase is typically associated with age-related degeneration of the spine. Scoliosis can arise over the course of a person's life and can also be congenital, arising from changes that occur during the foetal stage of development that cause some parts or areas of the spine to develop at different rates and thus cause curvature. Scoliosis can also occur as a result of neuromuscular abnormalities such as those that occur in cerebral palsy, dystrophy, and spina bifida, and these scoliosis presentations typically progress more rapidly as well as require surgical treatment more often.
Scoliosis can be diagnosed visually by assessing the symmetry and posture of an individual, through radiology to detect curvature in the spine that might be obscured by body fat or musculature, or in the course of assessing a different condition like back pain. Scoliosis has been found to have occurred in 23-percent of patients presenting for back pain, in one study. Following diagnosis of scoliosis, the severity of the curvature of the spine is assessed and rated in terms of severity by the number of degrees of curvature. The greater the number of degrees of deviation as a result of spinal curvature, the more invasive the treatment required. A spinal curvature of minimum ten degrees is necessary to diagnose scoliosis, while severe scoliotic bends of more than fifty degrees may require surgery. Because of the potential of spinal curvatures to involve the ribcage and therefore the heart and the lungs, assessment and review of a patient's exercsise and respiratory capacity may be necessary.
Most people with scoliosis present with spinal curvature of such mildness that bracing or surgery is not necessary. In children and in adolescents, regular monitoring may be necessary as changes in the child's anatomy over time may increase or change the amount of muscular strain, as well as changeing the curvature of the spine. More severe scoliosis that either presents as significantly curved or which appears to be progressing may require surgery, and this surgery is typically spinal fusion of two or more of the bones of the spine with metal prosthetic components installed by a surgeon and whose interventional effects are consolidated by timely physical therapy.
In the clinic, physiotherapy is useful in the management of all forms of scoliosis so long as it is applied correctly, and where necessary in combination with other forms of management. Mild scoliotic curves may be managed with basic, non-invasive physical therapy to minimise discomfort while maintaining cosmesis. This treatment may consist of physical exercises, manipulation and soft-tissue work, as well as management of the condition through appropriate referral and review. If the scoliosis is so severe that surgical management is necessary, physiotherapy works in conjunction with the overall intervention to support good outcomes after surgery and to minimise risks of acute complications.
Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future.
At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.