The word Scoliosis literally means ‘bent”. In medical terminology, Scoliosis means a sideways bending of the spine. Scoliosis often develops when a child is growing. Sometimes it is present at birth. Scoliosis is most common in girls.
There are many different causes of Scoliosis; One of the ways in which various types of Scoliosis are classified is as per the cause. The most common variety is Idiopathic Scoliosis, i.e., developing without apparent cause. Or a cause may be present such as a genetic problem causing abnormal shape of spinal bone units (called vertebrae). This is called congenital scoliosis.
Scoliosis may be of different grades of severity ranging from mild (a curve of 20 degrees or less), or moderate ( a curve between 20 to 50 degrees). A curve is severe when it measures more than 50 degrees. These abnormal curves may be located in various parts of the spine ( upper spine or lower spine).
The treatment of Scoliosis depends upon the type of Scoliosis, the severity, and the age of the child
NON SURGICAL treatment of scoliosis is possible when the scoliosis deformity is small, and the child still has many years of growth left.
In India, very few centers offer non-surgical treatment for scoliosis. At our center, the most effective non-surgical treatments for scoliosis are:
Specialized custom braces.
Scoliosis specific exercises.
In our center, we follow Schroth method of scoliosis specific exercises.
Dr Sarup monitors the children undergoing non-surgical scoliosis treatment very closely. He has frequent interactions with his team of specialist orthotics and physical therapy specialists in order to regulate and optimize the treatment. Children and adolescents undergoing the non-surgical treatment for scoliosis have x-rays taken at regular intervals to monitor the scoliosis deformity. Every patient is given a tailor-made program depending upon the characteristics of their scoliosis and their age.
Important points about the non-surgical treatment:
Bracing:
Bracing is the most important part in the non surgical treatment of Scoliosis. There is now very good research evidence that bracing is effective in a child or an adolescent.
Brace treatment is effective if modern principles of bracing are followed. In this, brace design and customization play a major role.
Every child or adolescent undergoes physical exam, x-rays, markings and then a brace is ordered. Once ready, the brace undergoes a few modifications to fine tune the brace fitting. Then the patient has to wear the brace in a dedicated manner.
In order for the brace to be effective, the child needs to wear the brace for 20 hours every day. Children, and especially adolescents, are often worried about the brace being awkward when being worn. However, once they start wearing the brace and find it comfortable, they are happy to wear the brace. Also, the brace is hardly visible when worn under a loose T shirt.
The brace holds the spine in a corrected position which allows mounding of the spinal curve into correction as the child grow
Physiotherapeutic Scoliosis Specific Exercises:
At our center, we follow the Schroth method of exercises. This method relies on the following principles to make the non-surgical treatment of scoliosis effective;
Deformity improvement through postural corrections. The therapists build muscle memory to make these corrections a daily habit.
Address muscle asymmetry. In scoliosis, muscles on one side of the body are often bigger and stronger compared to the opposite side. The scoliosis specific exercises are designed to achieve muscle symmetry thereby reducing abnormal internal muscle forces on the spine. This also helps with correction in the long term.
Rotational angular breathing. In this technique, patients are taught to use their breathing to rotate the spine and promote the reshaping of the rib cage. All patients with scoliosis have deterioration of their breathing capacity. This specialized technique improves the breathing capacity of scoliosis patients.
Schroth therapy is considered amongst the best methods of physiotherapy in the non surgical treatment of Scoliosis.
This therapy by itself can be used in older patients with scoliosis to improve their posture and breathing. In growing children where scoliosis improvement is the goal, the exercises are always combined with brace treatment in order to make the non-surgical treatment of Scoliosis effective.
I often see many other treatment modalities being often recommended to patients with scoliosis. These most commonly are;
Acupuncture
Yoga
Pilates
Ayurvedic treatments
Massages
Homeopathy
Psychic healing
In my experience and to my knowledge, none of these treatments are known to be effective in the non-surgical treatment of scoliosis.
For non-surgical treatment of Scoliosis to succeed,
The scoliosis curve has to be mild or moderate and not severe.
That the child has scoliosis needs to be detected early before the curve progresses and growth comes to a stop
The child or the adolescent needs to wear the brace meticulously and tirelessly for two to three years.
The parents need to bring the child to our specialist center regularly for therapy.
If these measures are followed, there is a very high chance of spinal curve not progressing and even regressing. Surgery can be thereby avoided except in severe cases.
My advice to parents is to keep checking your adolescent or pre-teen girl child for scoliosis and ask your children’s orthopaedic to do the same at every check up till age 14 years. A simple clinical test called the Adam’s test can be carried out. It takes less than 3 minutes and will detect early scoliosis. In this test, you can stand behind the child with the child’s back exposed or the child wearing a tight T shirt. Ask the child to bend down and touch the toes. A child who has scoliosis will be seen to have an abnormal bulge or asymmetry of the spine. This test can be done very easily done at home. See a doctor immediately for any suspicious bulge on the back.
If your child has been detected as having Scoliosis, the most important points to remember are:
Consult a specialist:
It’s crucial to seek treatment from a qualified orthopedic doctor or physical therapist experienced in scoliosis management.
Early diagnosis is key:
Early detection allows for timely intervention and potentially better treatment outcomes.
Individualized treatment plan:
The best treatment approach will vary depending on the severity of the curve, the patient’s age, and overall health.
Early non-surgical treatment of Scoliosis is effective.
