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Physical Therapy for Scoliosis

What is Scoliosis? 
Scoliosis is a condition involving an excessive lateral curvature of the spine. Scoliosis affects ~2-3% of the general population and is usually diagnosed in childhood or adolescence.

Scoliosis can be classified based on the three primary etiologies: congenital, neuromuscular or idiopathic. 

  • Congenital scoliosis occurs due to an inherited malformation of one or more of the vertebrae, which may cause the vertebra to grow at different rates, altering the normal spinal curvatures.
  •  Neuromuscular scoliosis occurs secondary to neurological or muscular disease, such as cerebral palsy, muscular dystrophy or spinal cord injury. 
  • Idiopathic scoliosis comprises the majority of scoliosis diagnosis, and occurs without a known cause. 

Mild cases of scoliosis are often asymptomatic. However individuals with scoliosis can develop symptoms. Physical therapists play an important role in managing these symptoms, and helping individuals with this condition improve their function and quality of life. 

Clinical signs and symptoms of potential scoliosis include:

  • Excessive sideways curve of the spine
  • One shoulder blade higher than the other
  • Sideways posture
  • Spine pain
  • Difficulty breathing (in severe cases) 

Diagnosis of Scoliosis
Scoliosis is diagnosed through a thorough physical examination and medical imaging. The physical examination includes observation and active movement of the spine at the cervical, thoracic, and lumbar level in order to differentiate between altered posture or scoliosis. 

Medical imaging, including an X-ray, spinal radiograph, MRI or CT scan, is used to confirm the presence of structural curvatures of the spine.   The severity of scoliosis is determined based on the amount of curvature (measured in degrees), also known as the Cobb angle. The Cobb angle is a standardized measurement of the amount of curvature, which categorizes the severity of the condition:

  • A Cobb angle of 10° is the minimum measurement used to delineate scoliosis. 
  • A Cobb angle between 15°-20° is considered mild, and may not require targeted treatment. However, the condition is monitored to determine potential progression of the curvature and if future treatment is necessary. Physical therapy can be helpful in mitigating potential progression through structured exercise programs. 
  • A Cobb angle between 20°- 40° often requires physical therapy and medical intervention such as bracing. The type of treatment and brace is determined based on an individual’s symptoms, his/her lifestyle and severity of the curve. 
  • A Cobb angle between 20°- 40° may require surgical intervention. The most common surgical technique is a spinal fusion. 

Treatment
A multidisciplinary approach is used to help treat sympathetic scoliosis. From a physical therapy perspective, treatment will focus on a combination of manual therapy and exercise to improve spinal mobility and flexibility. In addition to spine-directed interventions, treatments may be provided at neighboring body regions to increase mobility to compensate for decreased spine range of motion. Like all conditions we see at Sparks Physical Therapy, treatment will be individually tailored based on your specific goals. 

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