Physiotherapy exercises for scoliosis

Physiotherapeutic measures – in particular targeted exercises to strengthen the chest, abdominal and back muscles – can often stop a worsening of the scoliosis…

Scoliosis Care: Latest Research and Treatment Modalities

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Scoliosis: Diagnosis and Examination

If scoliosis is suspected, it is always advisable to see an orthopedist. Typical signs during the physical examination are an asymmetrical shoulder stand, waist triangles of different sizes (distance between the loosely hanging arms and the torso) and possibly a “rib hump” due to the twisting, i.e. a protrusion of the ribs on one side of the back. In order to distinguish real scoliosis from a mere bad posture, the doctor checks whether the curvature of the spine can be compensated for by movements of the patient (active) or, if necessary, by correcting the posture (passive). In the so-called Adams test – bending forward with straight knees – scoliosis shows asymmetrical muscle bulges in the neck and lumbar area.

If the suspicion of scoliosis has been substantiated, an X-ray is taken (frontal and lateral spine). Using the X-rays, the doctor can determine the Cobb angle and the curvature pattern, also identify possible malformations or vertebral deformations and, in young people, also the skeletal maturity – i.e. the expected residual growth.

If scoliosis is detected, regular check-ups are necessary, sometimes in children every three to six months – the frequency depends on the severity, growth phase and also on the type of therapy.

Treatment options for scoliosis

Treatment of scoliosis should begin as soon as possible after diagnosis. Very good results can be achieved in children and young people before growth is complete. In the case of mild scoliosis, physiotherapy is the first choice and is often sufficient. In slightly more severe cases, children are additionally prescribed a corset. In some cases, an operation is unavoidable.

Physiotherapy exercises for scoliosis

Physiotherapeutic measures – in particular targeted exercises to strengthen the chest, abdominal and back muscles – can often stop a worsening of the scoliosis, sometimes even reduce the curvature. In addition, breathing therapy is usually useful, it relaxes muscles and soul and promotes lung function. Tense muscles can also be loosened using procedures such as manual therapy.

It is important to maintain the measures and exercises long enough to ensure the success of the treatment. Movement therapy should also be carried out as an accompaniment to treatment with a corset and after surgical measures.

The scoliosis corset – a companion in childhood and puberty

With a Cobb angle between 20 and about 45 degrees, children are usually given a custom-made corset (“Chêneau corset”), a type of plastic armor. It straightens the torso through breathing. This so-called orthosis has to be worn for a few months or years – often around the clock, except for showering. Unpleasant for many, and certain sports are not possible with it. But good results speak for this therapy. Adults benefit less as their bone growth is complete. However, orthoses are sometimes used for them too, for example for stabilisation.

Surgery for scoliosis

If the conservative therapies are not sufficient, an operation can be considered – but at the earliest from the age of ten. In Germany, around 1,000 adolescents are operated on for scoliosis every year. Surgery is indicated for severe scoliosis if the curvature progresses quickly, if there is a risk of wear or stiffening due to spondylosis (remodeling of the vertebral bodies) or if the function of internal organs is restricted.

While adults have sections of the spine that are aligned and then stiffened, children need special systems that don’t restrict the spine from growing. These are, for example, titanium rods that are attached to the ribs and vertebrae – they have to be lengthened in a small operation every four to six months. Newer forms of these rods have a small remote-controlled motor and “growing rods”. Another modern procedure is spinal stapling, which specifically slows down the growth of the spine in individual areas (only in lighter cases).

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