Scoliosis

Scoliosis in Children and Teens

Idiopathic Scoliosis affects 3% of all children, and is typically identified when a child is 8-10 years old (Juvenile Idiopathic Scoliosis), or 12-14 years old (Adolescent Idiopathic Scoliosis). As the child’s skeleton is still growing, there is a higher risk of progression and therefore it’s more urgent to seek treatment as soon as your child is diagnosed with scoliosis.

Idiopathic Scoliosis may present as:

• uneven shoulders
• a shoulderblade that appears to stick out
• uneven waist or hips
• a ‘bump’ on the back when the child bends forward

If you suspect your child has scoliosis, bring him/her to your family doctor for a proper assessment. Your doctor may request an X-Ray to confirm if a spinal curve is present.

If your child receives a positive diagnosis of scoliosis, it is important to seek conservative treatment early to try to prevent progression of the curve. The ScoliClinic physical therapists can help you navigate the system to determine which treatments are most appropriate for your child.

Generalized guidelines for treatment for adolescents with scoliosis are determined by curve magnitude and stage of skeletal growth:

• 10°-30°: Scoliosis exercises, and monitoring
• 30°-50°: Scoliosis exercises, bracing
• 50°+: Scoliosis exercises, possibly surgery

Physical therapy for scoliosis at The ScoliClinic is based on the Schroth Method Principles. This approach treats each child’s spinal curve in a 3-dimensional manner, and our Schroth-trained physical therapists work closely with these children and teens to make an age-appropriate, individualized home exercise program that can be done at home.

Although many teens are diagnosed with scoliosis, it can feel like an isolating experience for you and your child. We’ve created group classes that function as a space for teens of similar age and skill level can meet other teens in the same situations and exercise together on a regular basis.

The goals of conservative treatment for kids and teens with scoliosis are:

1) Improve esthetics via postural correction
2) Treat/prevent spinal pain symptoms
3) Treat/prevent respiratory dysfunction
4) Slow the curve progression

For children and teens who are still growing, a brace may be indicated to help slow curve progression. Our Schroth-trained physical therapists work closely with Certified Orthotists who make the 3-dimensional braces to ensure the correction forces of the brace and exercises are similar.

Scoliosis in Adults

Research is showing that scoliosis is significantly more common in the adult population than in children – up to 60% of all adults have some form of scoliosis (Schwab et al, 2005).

If you were diagnosed with idiopathic adolescent scoliosis when you were a child, your spinal curve has likely remained into your adulthood. If you are experiencing any symptoms/signs such as back pain or postural asymmetries, these may intensify in adulthood.

Some cases of scoliosis are classified as denegerative or de novo scoliosis. This can be caused by a previously-stable adolescent-onset scoliosis that progressed late in adulthood, or by structural changes of the spine that occur with aging such as asymmetrical osteoporotic fractures, disc degeneration, or facet arthrosis (Ledonio et al 2013).

Adults with scoliosis may experience back pain, stiffness, or difficulty at work or while doing activities that they love.

The ScoliClinic’s physical therapists will review your X-Ray (if available), perform a detailed assessment, and discuss your goals to create a customized home exercise program that is best suited to your needs.

Treatment guidelines for adults take a wider range of factors into consideration, to determine the most effective combination of curve-specific Physiotherapy, custom spinal bracing, and surgery:

• How many curves are present?
• What’s the size of the curves?
• Is there discomfort, pain, or other symptoms?
• Are the curves stable? Is there progression / structural changes despite skeletal maturity?

Scoliosis-Specific Physiotherapy and Massage Therapy can be helpful at any stage, depending on your goals.

Goals for scoliosis treatment in adults are determined by YOU. Common goals we hear are:

1) Address back pain and discomfort by stabilizing your spine through curve-specific strengthening
2) Improve posture and esthetics
3) Prevent further degeneration of the curve
4) Increase your education on movements to avoid, and modifications to your daily activities
5) Improve your respiratory efficiency

A custom brace may be helpful to support you for short periods as you perform certain daily activities. Your ScoliClinic Physiotherapist can discuss if bracing may be appropriate for you, and can connect you with a Certified Orthotist trained in 3-dimensional scoliosis bracing.