Treatment: How to relieve scoliosis?

The treatment of scoliosis depends on a certain number of factors such as bone age, the amplitude of the major curve of the spine, expressed in degrees and called the Cobb angle, scalability…

Scoliosis 2022

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Symptoms

Scoliosis does not cause any particular spinal pain. “Contrary to what one might think, patients with scoliosis do not have more spinal pain than the general population (for the most numerous cases).” says Jérôme Madeira. The main symptom is the more or less visible spinal deformation that can lead only in the most extreme cases to a loss of vital respiratory capacity, neurological damage or even psychological disorders. Most often parents report during the consultation that the child is standing “crooked”, with an asymmetry in the posture.

Diagnostic

Only a doctor can make the diagnosis. He first performs a clinical examination to rule out scoliosis. In order to diagnose scoliosis, he mainly seeks to observe a hump (a deformation of the rib cage visible by a “bump” in the back) by asking the patient to lean forward after taking care to horizontalize the pelvis (test of Adam). He observes the trunk as a whole: more or less accentuated physiological curvature, balance of the shoulders, balance of the trunk, unequal lengths of the lower limbs… The doctor can then request an X-ray in order to have a more precise image of the spinal deformity and to adapt the treatment accordingly.

Treatment: How to relieve scoliosis?

The treatment of scoliosis depends on a certain number of factors such as bone age, the amplitude of the major curve of the spine, expressed in degrees and called the Cobb angle, scalability… Treatment depends on each individual . Scoliosis is a personal situation, the treatment must adapt to the specificities of each one. There is a therapeutic palette for the treatment of scoliosis ranging from conservative treatment (physiotherapy, corset, etc.) to surgery. These treatments can be combined with psychological care if necessary. “Each scoliosis is unique because each patient is unique, says Jérôme Madeira. However, the earlier the scoliosis is detected, the better the treatment will be.” And to add: “The key to successful care is joint work and good intelligence between physiotherapist, doctor, surgeon, patient and family.”

Orthopedic treatment: wearing a corset or not?

The effectiveness of corset treatment no longer needs to be demonstrated: in many cases, it makes it possible to avoid surgery. This efficiency depends on many parameters. The final result is based on reducibility in the brace: it is therefore the radiological angulation in the brace that determines the effectiveness. An angular correction of more than 50% in corset is desirable. The corset must be adapted to the patient in its shape, type, exposure time, etc. Brace treatment is most often combined with physiotherapy and physical activity to increase the patient’s chances of avoiding surgery and having the best possible functional and aesthetic result.

Physiotherapy: what exercises to do and what movements to avoid?

Unfortunately, physiotherapy does not stop the progression of progressive scoliosis but does reduce it. It is useful alone (in the least risky cases) or in addition to a corset and after surgery. There is a large body of evidence showing the benefit of physiotherapy specific to scoliosis. “The physiotherapist can show you exercises specific to scoliosis, explains Jérôme Madeira Indeed, the exercises to be performed are very specific to each patient and each type of scoliosis”. He will regularly reassess the patient and perform exercises.

The role of the physiotherapist does not lie solely in carrying out specific exercises, he is the health professional who will most often be seen by the child and the family. “In this capacity, underlines Jérôme Madeira, he often plays a role in the link between the family and the doctor, he also monitors that the corset is always adapted to the patient and he participates in the acceptance of the treatment. In all cases, there is no bad movement, we can never repeat it enough, emphasizes Jérôme Madeira. He nevertheless specifies that “during the corset treatment phase, there may be adjustments to be made in terms of movements in order to optimize its effect.”

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