What is Scoliosis and How Can Physio Help?

To understand scoliosis and find out how physiotherapy can help, you’ve come to the right place. In this article, our physiotherapists will explain the essentials of scoliosis, including its causes and symptoms, and how physiotherapists play a crucial role in diagnosing, educating, and treating you for this condition.

You’ll also find key info about the various types of treatments available and the effective modalities we recommend to manage your symptoms.

Whether you or a loved one has been diagnosed with scoliosis, or you’re simply curious about how physiotherapy can help conditions affecting the spine, this guide is designed to provide you with the knowledge and confidence to take the next steps. Read on to learn more about scoliosis and how physiotherapy at One Body London can make a significant difference to your quality of life.

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.

Scoliosis Treatments

First, let’s talk about surgery. The most common type of surgery for scoliosis is spinal fusion, and it’s usually reserved for structural scoliosis. Surgery is only recommended for adolescents with severe cases to prevent the scoliosis from worsening. If we think that surgery is the best option for you, we’ll let you know during your initial physio assessment and diagnosis.

Besides surgery, here are the treatments we rely on.

Bracing

Braces are a way to prevent scoliosis from progressing. By literally bracing the back, we can help growing bones form correctly. These braces fit underneath your clothes and aren’t visible at all. You may be encouraged to wear the brace day and night, but it can be removed for short periods for physical activities. Braces aren’t an option for scoliosis cases in adults.

Manual Therapy

Manual therapy is a hands-on technique, often massage. Our physiotherapists use manual therapy to strengthen your muscles, reduce tension, and alleviate pain. We’ll focus on loosening soft tissue and improving joint mobility to promote better spine alignment.

Postural Training

This training focuses on increasing awareness of your posture, teaching you how to position your body correctly during all kinds of daily activities. Through guided practice, our physiotherapists help you develop the strength and habits needed to support your spine, reduce strain, and prevent further curvature. It’s simple but effective!

Pain Management

Manual therapy, postural training and exercises can go a long way to easing any pain or discomfort you might be feeling. However, your physiotherapist can also give you advice on heat therapy, using ice packs, or considering other ways to reduce pain and inflammation.

Exercises

Exercises are designed to reduce discomfort, improve functionality, and prevent further curvature of your spine. We’ll focus on mobility in the spine, flexibility in the surrounding tissues, and muscle imbalances. Building core strength, lengthening tight muscles, and helping you stay aware of your posture throughout the day are some of the goals we may focus on.

There are two main methods of treating scoliosis through exercise. These are the Schroth method and SEAS method.

Schroth Method

The Schroth method is a specialised exercise approach for treating scoliosis that focuses on elongating and derotating the spine to improve posture and function. It has been around since the 1920s and we still use it today.

The Schroth method involves:

• Individual Exercises: A key part of this method is focusing on each patient’s unique spinal curvature. The treatments are then designed around you.
• Breathing Techniques: We will incorporate specific breathing patterns to aid in spinal correction. It’s easy to forget that the curvature of the spine can also impact lung capacity. Diaphragmatic breathing can help you optimise your lung function.
• Postural Awareness: Emphasises awareness and correction of your posture during daily activities. Self-awareness is a key part of the Schroth method.
• 3D Approach: Arguably the defining aspect of the Schroth method is the 3D approach. This addresses the three-dimensional nature of scoliosis by targeting rotational, sagittal, and frontal planes (your physio will explain this to you in detail).

This method is always therapist-guided: instruction and guidance from a trained Schroth therapist are essential. Explore all our therapists’ qualifications and experience at One Body to get started.

Scientific Exercise Approach to Scoliosis (SEAS)

Another method is the Scientific Exercise Approach to Scoliosis (SEAS). This treatment method utilises specific exercises to stabilise and correct spinal deformities in scoliosis patients. It’s mostly used for conservative cases rather than severe cases.

The SEAS method involves:

• Custom Exercise Programs: Just like the Schroth method, it’s key to start by customising the treatment to the individual’s spinal curvature and needs.
• Self-Correction: Focuses on teaching patients to actively correct their posture.
• Functional Exercises: By focusing on exercises that fit into daily activities, it is easier for you to stick with them at home.
• Monitored Progression: The exercises are adjusted over time to match your progress. This is not just part of the SEAS method but a key aspect of physio!

The SEAS method is most well-known for being evidence-based: like much of physiotherapy, it is grounded in scientific research and clinical evidence.

See a Physiotherapist for Scoliosis Today

Not to brag, but One Body London is an excellent choice for scoliosis treatment, offering convenient clinic locations throughout the city. Our therapists are highly trained and experienced in managing scoliosis cases, ensuring you receive the best care tailored to your needs. 

We pride ourselves on providing personalised treatment plans and comprehensive support. Plus, we accept all private health insurances, making it easier for you to access the quality care you deserve.

Explore our London physiotherapy services today to get started.

FAQs

Rebecca Bossick CEO/Clinical Director

Rebecca is the director of One Body, the founder of the established clinic Physio LDN and a highly regarded professional in the physiotherapy field. Her advanced skills have attracted a diverse clientele, including professional athletes and celebrities such as UFC fighters, singers, ultra-endurance athletes, and England rugby players. Rebecca specializes in complex pre- and post-operative conditions, receiving numerous referrals from London’s top consultants and trainers. Her expertise is also sought by large businesses for corporate physiotherapy and ergonomic workplace assessments. With a BSc Hons in Physiotherapy and certifications as a member of the Chartered Society of Physiotherapy (MCSP), an Acupuncturist (MAACP), a Cosmetic Acupuncturist Consultant, and a trained Sports Massage Therapist, Rebecca brings a wealth of knowledge and experience to her practice. She is also a qualified Steroid Injection Therapist.

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