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Physical therapy for 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 sort of spiral staircase is created.
The fast facts:
- A scoliosis cannot occur based on your preferred posture
- Scoliosis occurs on average in only 3% of the population
Gradations of scoliosis
We classify a scoliosis into different degrees depending on the severity of the deformity. This also helps in determining the appropriate treatment policy. For this, the Cobb's angle can be used. We distinguish between different degrees;
- an angle up to 10 degrees
- an angle of 15-20 degrees
- an angle of 20-40 degrees
- an angle of 40> degrees
Cause of scoliosis
In more than 80% of all cases, there is no identifiable cause. We then call this an idiopathic scoliosis. Treatment depends on the age of the person. For this reason, there are 3 different types of categories:
- Adolecent scoliosis: 10-18 years of age
- Juvenile scoliosis: 3-9 years of age
- Infantile scoliosis: 0-3 years
Congenital scoliosis: Congenital scoliosis is a congenital abnormality. It involves vertebrae that are only half constructed or that 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 disorders 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 physical therapist 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 noticed immediately by health care providers simply because it is not easily visible from the outside. This also makes that sometimes people are not diagnosed until relatively late, because wide-fitting clothing conceals the abnormality even more. The physical therapist 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. A deviated position (bulge) of the back may then become visible. We call this a gibbus. A gibbus occurs because the ribs rotate along with the scoliosis and then the scapula changes in position.
Treatment of scoliosis
The orthopedist will initially determine what kind of treatment is most appropriate. This is done using the previously mentioned Cobb's angle. Thus, the degree of deformity determines the further policy. Unfortunately, making the scoliosis disappear is not possible.
- For scoliosis between 10-20 degrees, observation is chosen in combination with physical therapy.
- Between 20-40 degrees, a wearing a brace may be prescribed to stop progression, combined with a physical therapy program.
- With 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 attached together, preventing further growth.
Surgical intervention or conservative treatment
The orthopedist initially makes a decision about what kind of treatment is most appropriate. This is done using the Cobb's angle mentioned earlier. Thus, the degree of deformity determines the further policy. Making the scoliosis disappear unfortunately does not work.
- For scoliosis between 10-20 degrees, observation is chosen in combination with physical therapy.
- Between 20-40 degrees, a wearing a brace may be prescribed to stop progression, combined with a physical therapy program.
- With 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 attached together, preventing further growth.
The different stages in the treatment of complaints with scoliosis
Successful rehabilitation consists of several stages and steps. Good strength, stability and control of the back is necessary to be able to resume your daily activities without complaints.
During an acute phase:
In this phase we focus mainly on reducing the complaints. Sometimes the complaints return which results in pain with a possible decrease in mobility of the spine. In addition to mobilizing exercises we can opt for treatments using muscle techniques or other techniques from manual therapy.
Strength and stabilization phase:
In this phase there is a build-up in strength. The greater the load capacity is in relation to the daily load, the less quickly complaints will occur. We also do stabilizing exercises. In between we work on the general condition.
Rehabilitation at Physio Fitaal
For physiotherapy for complaints of scoliosis, you have come to the right place at Fysio Fitaal. Our specialists guide you in this process as best as possible and motivate where necessary. Fysio Fitaal works with specialists in the field of back rehabilitation. Through the combination of expertise, extensive facilities and passion for physiotherapy you have come to the right place.
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