SCOLIOSIS

Scoliosis is a 3-dimensional deformity of the spine. It is diagnosed when there is sideways bending of the spine greater than 10 degrees, accompanied by rotation of the spine. It is estimated that 2-4% of the global population has scoliosis.

What are the signs of scoliosis?

A scoliosis will display visible effects such as:

• Shoulder asymmetry in which one shoulder appears higher than the other.
• Leg length discrepancy where one leg may appear longer than the other.
• A shift of the body to the right or the left can occur
• Waistline asymmetry in which one hip appears to be higher than the other.
• There may be a bony prominence on the back or at the ribs secondary to the rotational aspect of scoliosis.

Scoliosis in Adolescents

Adolescent Idiopathic Scoliosis (AIS) refers to scoliosis that occurs in late childhood or adolescence.

• It is a 3-dimensional deformity of the spine occurring in healthy pubertal children
• Onset is between 10 – 18 years of age.
• There is no known cause.
• It is the most common spinal deformity.
• It affects females more than males.

How does scoliosis affect a young person?

• It is primarily a cosmetic issue, but there can be potential psychological impact on a child’s growth. This is a phase that they might start to pay more attention to their physical appearance.
• As the child grows, there may be far-reaching health issues in adulthood if the scoliosis exceeds a certain angle and is left untreated, such as:
  • Increased spinal curvature and cosmetic deformity
  • Development of back pain
  • Decreased quality of life as a secondary consequence
• There can be muscle imbalances and reduced flexibility in the spine due to its curvature. Often, the back and lower limb muscles are weaker or tighter on one side more than the other. This may affect a child’s ability to participate or excel in sporting activity.
• In rare cases, a person with severe scoliosis may also develop heart or breathing issues due to the distortion and increased stiffness of the rib cage.

What are the treatment options available?

• Depending on the individual case and severity of the curve, scoliosis treatment includes:
  • Observation
  • Exercises
  • Bracing
  • Surgery

Treatment is prescribed depending on the risk of progression of the spinal curvature, which is associated to potential growth in the adolescent, as scoliosis tends to progress with periods when there is a rapid or significant change in height. Medical specialists managing patients with scoliosis will need to monitor the spinal curves regularly to ensure it does not progress into adulthood.

How can a physiotherapist help?

• A trained physiotherapist can prescribe appropriate and customized exercises depending on the severity of the scoliosis and the risk of progression.
  • Physiotherapy management programmes will include one or more of the following:
    • Physiotherapy Scoliosis Specific Exercise (Schroth)
    • Posture awareness
    • Pain management and Stretching / Strengthening exercises
    • Activity recommendations (e.g. Swimming)
  • A physiotherapist can also discuss the bracing options if necessary.

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