EN 
NL Scoliosis
Our spine is not naturally straight. There is a natural curvature forward (lordosis) and backward (kyphosis). Scoliosis involves lateral curvature in the back. In most cases it is an S-shape, in some cases it is a C-curve. Because our head will always occupy a straight position, it looks like standing straight. Scoliosis also involves a twisting of the vertebrae. These then position themselves so that a kind of spiral staircase is created, as it were.
Cause of scoliosis
In more than 80% of all cases, there is no identifiable cause. We then call this idiopathic scoliosis. Treatment depends on the person's age. For this reason, there are 3 different types of categories:
- Adolecent scoliosis: 10-18 years
- Juvenile scoliosis: 3-9 years
- Infantile scoliosis: 0-3 years
Congenital scoliosis: Congenital scoliosis is a congenital abnormality. It involves vertebrae that are only half constructed or where several vertebrae grow together. Congenital scoliosis often involves abnormalities in different parts of the spine. The abnormalities arise as early as during pregnancy. Exactly why these abnormalities arise is still unclear.
Neuromuscular scoliosis: In some conditions or syndromes, the control of various muscles is impaired. This often involves a disorder of the nervous system such as spina bifida or Duchenne disease.
How is scoliosis diagnosed?
Diagnosing a scoliosis and its severity is done with an X-ray. In practice, we see that there are usually several more steps prior to this examination. Often, a patient comes to the physiotherapist with back problems. Sometimes these have just arisen, in other cases they have been present for some time. A smaller scoliosis (<20 degrees) is not always immediately noticed by healthcare providers because it is then simply not easily visible from the outside. This also means that sometimes people are not diagnosed until relatively late, as wide-fitting clothes further conceal the abnormality. The physiotherapist may notice during the physical examination that a deformity is present in the back. To assess this, he or she is asked to bend forward with the back in a standing position. An abnormal position (bulge) of the back may then become visible. We call this a gibbus. A gibbus occurs because the ribs turn with the scoliosis and then the scapula changes in position.
Treatment of scoliosis
The orthopaedist will initially determine what kind of treatment is most appropriate. This is done using the aforementioned Cobb's angle. The degree of deformity thus determines further policy. Making the scoliosis disappear unfortunately does not work.
For scoliosis between 10-20 degrees, observation combined with physiotherapy is chosen.
Between 20-40 degrees, wearing a brace may be prescribed to stop progression, in combination with a physiotherapy programme.
In case of a scoliosis of 40> degrees, surgical intervention can be considered. Various surgical techniques are available for this.
In the latter case, spinal fusion is often used, in which several vertebral levels are joined together, preventing further growth.
Surgical intervention or conservative treatment
The orthopaedist makes an initial decision on what kind of treatment is most appropriate. This is done using the Cobb's angle mentioned earlier. The degree of deformity thus determines further policy. Making the scoliosis disappear unfortunately does not work.
- For scoliosis between 10-20 degrees, observation combined with physiotherapy is chosen.
- Between 20-40 degrees, wearing a brace may be prescribed to stop progression, in combination with a physiotherapy programme.
- In case of a scoliosis of 40> degrees, surgical intervention can be considered. Various surgical techniques are available for this.
In the latter case, spinal fusion is often used, in which several vertebral levels are joined together, preventing further growth.
The different stages in the treatment of complaints with scoliosis
Successful rehabilitation consists of several stages and steps. Good back strength, stability and control are necessary to get back to your daily activities without complaints.
During an acute phase:
In this phase, we mainly focus on reducing complaints. Sometimes the complaints play up again, resulting in pain with a possible decrease in mobility of the spine. In addition to mobilising exercises, we may opt for treatments using muscle techniques or other techniques from manual therapy.
Strength and stabilisation phase:
In this phase, strength is built up. The greater the load capacity is in relation to the daily load, the less likely complaints will arise. We also do stabilising exercises. In between, we also work on general fitness.
Gradations of scoliosis
We classify a scoliosis into different degrees, depending on the severity of the deformity. In addition, this also helps in determining the right treatment policy. The Cobb's angle can be used for this. Different gradations are distinguished;
- an angle of up to 10 degrees
- an angle of 15-20 degrees
- an angle of 20-40 degrees
- an angle of 40> degrees
Making an appointment at FysioFitaal
We work from multiple locations in Tilburg, always close by for professional and accessible physiotherapy. Fill in the contact form and we will contact you soon. Together, we will work on your recovery!
