While scoliosis affects millions of people and considered a common condition, it should never be neglected as it can lead to potential complications. Mild scoliosis with less than 10 degrees curvature and scoliosis that occur after adolescence are usually self-limiting and non-debilitating. Due to this, they may go unnoticed or asymptomatic; thereby, not requiring aggressive managements. However, more severe curvature of the spine may require more aggressive managements as they may lead to significant back pain as well as affectation of the organs inside the thorax. In this line, several managements are needed to help people with scoliosis achieve optimum level of functioning.
The specific treatments for scoliosis depend on the severity of the curvature as well as the maturity of the skeletal system. Common treatments for scoliosis include:
- Physical Therapy
Physical therapy is one of the initial treatments for scoliosis. For scoliosis with less than 20 degrees curvature, conventional physical therapy techniques are usually employed while the Schroth method is the specific technique used for patients with scoliosis exceeding 30 degrees.
- Occupational Therapy
People with moderate to severe curvature of the spine may also suffer from impairments in their ability to perform activities of daily living. In such cases, occupational therapy may help regain optimum level of functioning. Occupational therapy involves the performance of activities that cannot be performed properly by patients. This may include productivity, leisure and self-care activities. During occupational therapy, patients may also use other supportive modalities such as braces to allow the person to perform optimally without significant back pain.
- Chiropractic care
Chiropractic care is an alternative and complementary management for scoliosis. Most chiropractors employ spinal manipulations to help the spine return to its normal position. Chiropractors also employ traction, exercises and other managements to help the spine assume its normal alignment.
Casting is commonly employed to progressive infantile scoliosis cases as well as to juvenile scoliosis. The cast involves a plaster jacket to correct the curvature early. Research has already indicated that casting may help to permanently correct infantile scoliosis cases. The casting includes plaster casts involving elongation, derotation and flexion to help the spine achieve a straight alignment.
Bracing is employed to patients who are still on their way to bone maturity. When the bones are not yet fully developed, the spine may assume more severe curvature that may require surgery in the long run; thereby, bracing helps patients stay away from surgery as much as possible. Although braces are usually employed for younger patients, they can also be used by adults to relieve significant back pain. Curvature of the spine may also pull the surrounding muscles causing pain and spasms. With braces, the back is held in a neutral potion relieving pressure and tension on the soft structures of the back.
For curves greater than 50 degrees, surgery is employed to prevent the high risk for progression. Surgery is also employed to patients with cosmetically unacceptable curves such as those who have evident shoulder asymmetry. For those with organ affectation such as difficulty of breathing, surgery helps relieve pressure on the lungs. A completely straight spine may be hard to achieve, but most cases have been significantly improved following surgery. Spinal fusion is the technique used. Spinal fusion involves merging the vertebrae together to become rigid in order to prevent further progression of the curvature. As with any other surgical procedures, spinal fusion may lead to possible complications; hence, more conservative managements are preferred. In this line, managing scoliosis early may help avoid surgery in the long run.
The overall goal of scoliosis treatments is to prevent the further progression of the curvature and to promote optimum level of functioning with lesser pain.