Scoliosis: Non-Surgical Treatments

What is Scoliosis?

Scoliosis is a condition in which the spine is curved toward either the right or left side. Thus, the upper back seems to be rounded, the lower back appears to curve inward (swayback), and one shoulder and/or hip looks higher than the other.

Prevalence and Demographics

About 80% of scoliosis cases occur in people 10 to 18 years of age, and the condition is far more common in girls. While most cases among both genders are mild and require no treatment, girls are more likely to progress significantly without treatment.

Diagnosis

For a diagnosis of scoliosis to be made, a curve must measure 11º or more; a curve less than that is labeled spinal asymmetry and is unlikely to get much worse. However, a pediatrician or an orthopedic surgeon can monitor it with visual inspections and x-rays to be sure it does not move in that direction.

Treatment Options: An Overview

Bracing: A brace is the most common treatment for children who have scoliosis spine curvatures of 25º to 40º and who have not finished growing. The brace will not correct the curvature but will keep it from worsening.
Surgery: Surgery is an option for more severe cases, in which the curves are 40º to 50º or more. Spinal fusion, which joins vertebrae permanently, is effective but is not used for children whose bones are not fully grown because growth will no longer be possible in the fused area. Thus, fusion is often performed for older adolescents. Metal implants and bone grafts are utilized to straighten the curve, although a zero-degree curvature is not possible.
Physical Therapy: While physical therapy alone cannot cure scoliosis, exercise helps maintain good muscle tone and a healthier heart and lungs, and it may reduce discomfort. We will be glad to work with your physician to design an exercise program to augment the benefits of a brace or surgery in the treatment of this condition.

Impact on Health

Scoliosis does not usually cause back pain, but in severe, uncorrected cases, it can compromise overall health because there is less room in the chest cavity for the heart and lungs to function properly.

Is There a Way to Fix Scoliosis Without Surgery?

Scoliosis can be a daunting diagnosis, especially when considering the prospect of surgery.

Fortunately, non-surgical approaches can be effective, depending on the severity of the curvature and the patient’s overall health.

Let’s delve deeper into these options to understand how they work and their potential benefits.

Bracing

For many people, especially children and adolescents who are still growing, bracing is a common non-surgical treatment. The primary goal of a brace is not to correct the existing curve but to prevent it from worsening. This is crucial during the growth spurts that occur before the bones are fully matured.

There are different types of braces, such as the Boston brace and the Wilmington brace, each designed to fit specific types of spinal curves. These braces are custom-made and need to be worn for most of the day to be effective.

Although bracing doesn’t usually correct the curve, it can significantly halt its progression, making it a valuable option for managing scoliosis.

Physical Therapy

Physical therapy can be an important adjunct to bracing and other treatments. While it doesn’t cure scoliosis, it helps manage symptoms and improves overall function.

Physical therapists design personalized exercise programs aimed at strengthening the muscles around the spine, improving posture, and increasing flexibility.

Lifestyle Adjustments

In addition to bracing and physical therapy, making certain lifestyle adjustments can be beneficial.

Maintaining a healthy weight, practicing good posture, and engaging in regular, moderate exercise can support spinal health and overall well-being. Activities like swimming and yoga can be particularly helpful, as they promote strength, flexibility, and balance.

Does Physical Therapy Work for Scoliosis?

Physical therapy is a common and effective approach for managing scoliosis, even though it does not cure the condition outright. The primary benefits of physical therapy for scoliosis are related to symptom management, improving physical function, and preventing further progression of the curve.

Here’s a closer look at how physical therapy can be beneficial:

Benefits of Physical Therapy

Improved Muscle Strength: Strengthening the muscles around the spine helps support the curved areas and can reduce discomfort.
Enhanced Flexibility: Stretching and flexibility exercises can help improve range of motion and reduce muscle tightness.
Better Posture: Physical therapy often includes exercises to improve posture, which can make the spine appear straighter and reduce the visual impact of scoliosis.
Pain Management: While scoliosis itself may not always cause pain, related muscle imbalances and poor posture can. Physical therapy can help alleviate pain and discomfort through targeted exercises and manual therapy techniques.

Specific Physical Therapy Exercises For Scoliosis

Here are some specific exercises that physical therapists may use to help manage scoliosis:

Rotational Exercises: These exercises help counteract the rotational aspect of scoliosis. They focus on improving spinal alignment and can help reduce the curve’s progression.
Strengthening Exercises: Core strengthening exercises are crucial for providing support to the spine and improving overall stability.
Stretching and Flexibility Exercises: Stretching exercises target tight muscles and help improve overall flexibility. They are often tailored to the specific needs of the individual.
Breathing Exercises: Techniques like those used in the Schroth Method focus on improving breathing mechanics and posture, which can help manage scoliosis symptoms.

Physical therapy works best when it’s part of a comprehensive treatment plan that may include bracing or other non-surgical interventions.

It’s important to work closely with a physical therapist who specializes in scoliosis to develop a personalized exercise program that addresses your specific needs and goals.

Did you know you have Direct Access* to Physical Therapy? No referral, no problem!

At What Point Is Surgery Needed for Scoliosis?

Surgery for scoliosis is generally considered when non-surgical treatments have not been effective, or when the curvature of the spine is severe and progressive.

Deciding to proceed with surgery involves careful consideration of various factors, including the severity of the curve, the risk of progression, and the impact on the patient’s overall health and quality of life.

Indications for Surgery

Severe Curvature: Surgery is often considered when the spinal curve exceeds 40º to 50º. At this stage, the risk of the curve worsening and causing additional health problems becomes significant.
Progressive Curve: If scoliosis is worsening despite non-surgical treatments, surgery may be recommended to prevent further progression.
Functional Impact: If scoliosis is causing significant functional problems, such as difficulty breathing or chronic pain, surgery might be needed to improve quality of life.
Age and Growth: Surgery is typically recommended for older adolescents or adults whose spines have stopped growing. For younger patients, non-surgical treatments are usually preferred to avoid interfering with growth.

Types of Surgical Procedures

Spinal Fusion: The most common surgical procedure for scoliosis is spinal fusion. This involves joining two or more vertebrae together using bone grafts and metal implants to create a single, solid segment of the spine. This procedure helps to stabilize the spine and prevent further curvature.
Rods and Screws: During spinal fusion, surgeons often use metal rods and screws to hold the spine in the correct position while the bone grafts heal.
Anterior and Posterior Approaches: Surgery can be performed from the back (posterior) or the front (anterior) of the spine, or sometimes a combination of both. The choice of approach depends on the specifics of the curvature and the patient’s anatomy.

Post-Surgery Considerations

After surgery, patients typically undergo a period of recovery and rehabilitation. This may include physical therapy to restore movement, strength, and flexibility. The recovery process varies depending on the individual and the extent of the surgery, but most people can return to their regular activities over time.

Final Thoughts

Managing scoliosis can be a journey, but physical therapy is a powerful tool to help you along the way. At The Jackson Clinics, we’re here to provide personalized support that can make a real difference in your comfort and quality of life.

If you’re ready to take action, check out one of our 18 locations to get started today. Let’s work together to create a plan that gets you feeling better and moving more comfortably.