What is Scoliosis and How Can Physio Help?

Understanding Scoliosis

Scoliosis is a condition where the spine curves sideways in an “S” or “C” shape. This curvature can occur at any part of the spine but is most commonly found in the thoracic (mid-back) or lumbar (lower back) regions.

As a result, the shoulders or the hips may be unaligned, and the curvature will be most visible when viewed from the back or front. Here’s a quick diagram to help you visualise what is happening to the spine in a case of scoliosis.

There are two types of scoliosis. The first is functional scoliosis where the curvature is a result of an underlying condition that impacts your body’s ability to function. For example, this could be muscle imbalance. The second is structural scoliosis where the spine itself is curved due to the bone structure or surrounding tissues.

The easiest way to tell the difference is to move into different positions – if moving your body can momentarily fix the curvature, it’s functional scoliosis. If your spine is curved no matter how you move or sit, it is structural scoliosis.

Causes

There are four groups of causes for scoliosis.

• Idiopathic: The most common type is idiopathic scoliosis (80% of cases). It typically develops during adolescence and is more prevalent in girls than boys. If your condition is described as idiopathic, it’s just doctor-talk for “we don’t know what caused it.”
• Neuromuscular: This type is associated with conditions that affect the muscles and nerves, such as cerebral palsy, muscular dystrophy, or spinal cord injuries. Put simply, an imbalance in muscle support can lead to a curved spine.
• Degenerative: Degenerative scoliosis occurs in older adults due to the wear and tear of the spine over time. It can result from conditions like osteoporosis or degenerative disc disease, which cause the spine to weaken and curve.
• Congenital: This type is present at birth and results from malformations in the spine as it develops in the womb. These malformations can cause the spine to grow unevenly, leading to a noticeable curve.

We’ll explain which types of physio can help best below.

Symptoms

The good news is that scoliosis doesn’t always present with back pain. In fact, scoliosis rarely presents with moderate pain. Many cases are entirely pain-free, while others may experience mild discomfort or muscle aches. 

If you are experiencing moderate to intense pain, it could be caused by an underlying condition. Whatever the cause, you do not have to suffer. Visit a physiotherapist or your doctor to find out what’s going on.

But in most cases, scoliosis manifests through visual signs rather than pain:

• Uneven Shoulders: One shoulder may appear higher than the other or one shoulder blade might protrude more than the other.
• Asymmetrical Waist: Your waist may look uneven, with one side appearing more prominent.
• Tilted Hips: Your hips might be uneven, causing one to appear higher.
• Visible Curve: In some cases, we might be able to see a visible curve in the spine when you bend forward.

Emotional Toll

Doctors tend to focus on physical symptoms and pain, if present. But as physiotherapists, we take a holistic approach, and we know that scoliosis can have a huge impact on quality of life.

For our younger patients, it is totally normal to feel self-conscious and insecure. Studies have found that adolescents with scoliosis have higher rates of anxiety and depressive symptoms. You can get support for dealing with social exclusion or academic challenges too. Physiotherapy can also go a long way to helping you understand your body and regain confidence.

For our older patients, we commonly see scoliosis resulting in reduced mobility and independence. This loss of freedom can greatly impact your mental health and quality of life. Again, physiotherapy can help you work on mobility and manage your condition to stay independent for as long as possible.

But before we get into treatments, we’ll explain how the process starts with a diagnosis.

How Physiotherapists Can Help

At One Body London, our physiotherapists are dedicated to providing comprehensive care for scoliosis. Our approach includes thorough assessment, accurate diagnosis, and ongoing education and support to help you manage and improve your condition.

The journey begins with a detailed functional examination to assess your posture and spinal alignment. During this assessment, our physiotherapists will listen to all of your concerns. Every case of scoliosis is different, and we want to make sure we truly understand you. This helps us create a treatment program that’s as effective as possible.

Assessment and diagnosis include:

• Examining Your Posture: We observe your standing and sitting posture, noting any asymmetries or visible curvatures.
• Evaluating Movement: We assess your range of motion and how your spine moves during different activities.
• Measuring Progression: We can help determine the cause (structural vs functional) and use a scoliometer or Cobb angle alongside scans from your doctor.

Next, education. This is a crucial component of our physiotherapy program. We believe that understanding your condition helps you take an active role in your treatment. Our physiotherapists will help you understand what scoliosis is, how it affects your body, and what to expect. We also offer ongoing support and reassurance, addressing any questions or worries you have.

Depending on the type and cause of your scoliosis, you have several treatment options. For idiopathic, congenital, and degenerative scoliosis, treatments are usually targeted at improving your quality of life, reducing symptoms, and helping you effectively manage the condition. For neuromuscular scoliosis, these treatments are focused on treating the underlying cause, too.

Whatever path you go down, our goal is to help you understand why certain treatments are recommended and make informed decisions about your care.