Scoliosis is a spinal disorder that often occurs in childhood and adolescence where the spine curves to one side or the other resembling the letter ‘S’ or ‘C’, observable when looking from the back or front.
There are many causes for scoliosis but most of the time, it is unknown for an individual. It could be genetic, neuro-muscular disorder or having poor posture. Scoliosis commonly occurs in young females (most commonly detected between ages of 10 to 18 years) but can also be evident in some males.
Scoliosis may result in pain or restricted movement due to imbalances in the muscles and restrictions in certain parts of the joints. Most of the time, it is painless, but has to be carefully monitored to identify if it worsens over time.
A healthy spine is aligned well, meaning that the curves are in the proper places and when viewed from the back, there is no imbalance seen. Imbalances can look like one side of the shoulder or hip is higher than the other.
THORACIC scoliosis affects the mid-back more than any other parts of the spine. ‘Thoracic’ refers to the 12 spine segments that start from the base of the neck to the mid-back, and scoliosis there means that it curves to either the right or left. When this happens, you will see one shoulder look higher than the other side, and the shoulder blade will look like it ‘pops’ out away from the rib cage.
Lumbar Scoliosis involves the ‘Lumbar’, which refers to the 5 spine segments in the lower back, and is the part of the spine right above the hips. It is evident when you see one side of the hip hiking higher, and there may be a difference in leg length.
‘Thoraco-Lumbar‘ is the junction where your mid back meets your lower back. With scoliosis in this area, you may see a combination of hip and shoulder height differences, and a person may have more pain in both the mid back and lower back.
Combined Scoliosis is the most common type of scoliosis, as our spine often tries to compensate to balance itself. When there is a scoliosis in the mid back, our lower backs may also develop a curve to counter-balance the difference, and vice versa.
Non-surgical care for scoliosis involves chiropractic treatment and scoliosis-specific physiotherapy.
Chiropractic care comes into play when there are restrictions in the spine. As scoliosis causes the spine to curve to either the right or the left, this may cause some compression of the spine segments and stiffness, making it difficult to move out of the position.
Scoliosis-specific rehabilitation means that the physiotherapist provides body awareness training and active exercises that are specific to the type of scoliosis that the patient has. Not all curves are the same, and there are different angles of curve, rotation, and severity.
An exercise programme that is tailored for the curve is important to ensure that the patient knows how to effectively do the exercises at home and prevent worsening of the scoliosis. Sometimes, we use spinal orthotics (Scoliroll) to help passively stretch out the curve.
This depends on the cause of scoliosis. Idiopathic scoliosis is non-preventable as it is determined by structural genetics, but functional scoliosis which is caused by muscle imbalances and poor posture can be prevented. It is very important for those with idiopathic scoliosis, especially around the ages of 9-18 years, to monitor their curve progression and to undergo rehabilitative care to manage it, as they are still growing and the chances for it worsening is highest at this age.