Understanding Scoliosis: Symptoms, Diagnosis and Treatment

Understanding Scoliosis: Symptoms, Diagnosis and Treatment

Understanding Scoliosis: Symptoms, Diagnosis and Treatment

04 September 2023  | Article is written by Nur Athika Binti Azhar (Physiotherapist, BP Healthcare), Reviewed by Dr Lee Wang Loong (Chief Medical Officer, BP Healthcare)

Defining Scoliosis

Scoliosis is a form of a common spine problem that is often diagnosed during adolescents. Patients diagnosed with scoliosis have a spine that bends sideways and even rotates transversely (perpendicularly), with a curvature degree exceeding 10°.

Types of Scoliosis

Work-Related Musculoskeletal Disorders (WRMSDs) are defined as injuries of the musculoskeletal system, affecting the tendons, ligaments, muscles, nerves, and discs. Neck pain is one of the common forms of WRMSDs.

  • Idiopathic scoliosis

The most common type with no known cause. Commonly noticeable during early adulthood.

  • Congenital scoliosis

Rare type and commonly noticed during infants.

  • Neuromuscular scoliosis

Referred to as myopathic scoliosis and often affects people with neuromuscular conditions like cerebral palsy or muscular dystrophy.

  • Degenerative scoliosis

Often later in life when the joints and spine start to degenerate

Signs of Scoliosis

Common physical signs:

  • Uneven shoulder/ hip level on upright
  • A visibly curved spine
  • Body leaning on one side
  • Different rib cage level
  • Uneven leg lengths
Progressive signs:
  • Frequent lower back pain especially after prolonged standing or sitting
  • Breathing difficulty (due to rotated spine)
  • Back stiffness
  • Numbness over legs (due to severely curved spine that causes pinched nerves)

Diagnosis of Scoliosis

Clinicians assess the extent of the condition by conducting physical evaluations and using diagnostic tools such as X-rays to calculate the Cobb angle which is the standard measurement used to quantify and assess the severity of spinal deformities. If this angle exceeds 45°, the condition is viewed as severe and requires intensive treatment.

Source: Health Central
Treatment of Scoliosis

There are various treatment options for these curved and twisted spine conditions. Depending on the severity and spine maturity, the experts will propose suitable treatment and management

For growing children with a curvature between 25° – 40°, the treatment options suggested are usually the customized bracing, accompanied by physiotherapy. This is to stop the curvature from progressing.

Those suffering with progressive curvature will require surgery to prevent any risk of spinal deformity, usually followed by physiotherapy to maintain the post-surgery ‘realigned’ spine.

Source: Peds Ortho

Managing Scoliosis with Physiotherapy

The goal of physiotherapy is to avoid the curvature progression and avoid the need for surgery. The common methods and techniques that is included in physiotherapy are:

  • thermal therapy
  • electro modalities like Transcutaneous electrical nerve stimulation (TENS) or Electrical muscle stimulation (EMS)
  • manual physiotherapy techniques like soft tissue releases

To complement these physiotherapy techniques, some management routines may include corrective, strengthening and stabilization exercises. These can help maintain the spine curvature and breathing exercises, if necessary.

The rehabilitation program period and frequency normally varies for those with scoliosis, depending on the severity. Some may be required to attend physiotherapy sessions once a week to 2-3 times per month for a year, with a home exercise program.

Those with idiopathic scoliosis would require physiotherapy visitation every 6 months or annually to monitor the progression of the curvature until the spine matures. X-ray investigations would also be required for idiopathic cases during the maintenance visits to check on the progression of the Cobb angle.

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