Scoliosis is a type of condition that alters the spine’s shape, affecting your posture and trunk alignment. The condition makes the spine turn and moves to the side. Scoliosis could occur at any moment in your life, but it is not uncommon at the adolescent stage. Credible sources suggest that 2 to 3 percent of the general population suffer from scoliosis. Out of the population, females are known to be more susceptible to scoliosis than males.
The condition has stages, from mild to severe. Regardless of the condition stage, you want to seek a physical therapist’s help. They will offer the necessary treatment depending on the severity of your condition. For example, severe scoliosis levels could require you to undergo surgery.
At Suarez Physical Therapy, we manage the condition using a team approach to ensure no stone remains unturned. We work together with other medical experts and your loved ones, too, until your condition is resolved. Contact us today if you or someone you know is seeking a qualified physical therapist for scoliosis treatment in Las Vegas, NV.
Overview of Scoliosis
According to the Scoliosis Research Society, scoliosis is a three-dimensional condition that you could have when your spine becomes curved sideways and rotates. As mentioned above, scoliosis makes your trunk alignment and posture change, which you cannot correct by standing in an upright posture. On an x-ray, your spine could look like a ‘C’ or an ‘S’ shape. Your physician determines scoliosis severity by measuring the curvature angle, also known as the Cobb angle. If the Cobb is at least 10 degrees, your physician could consider diagnosing scoliosis and referring you to physical therapy for treatment.
The most common type of scoliosis is adolescent idiopathic scoliosis (AIS). The condition is primarily diagnosed in patients aged between 10 and 18 years. According to science, there is no identifiable cause. However, about 35% of children suffering from AIS have a history of the condition in their family.
How Scoliosis Feels
According to medical research, scoliosis is a painless condition; however, you could experience discomfort and pain while the spine curves or when it alters the surrounding joints and muscles. These changes affect your movement patterns, posture, alignment, hence, causing pain and irritation. In addition, muscles supporting the spine could become imbalanced because of scoliosis, causing flexibility and strength loss. If you have the condition, you could note the following:
- Pain with specific activity and movement
- Pain in the regions near the spine, for instance, hip, pelvis, and shoulder
- Sensing that the two sides of your body are not aligned
- An uneven waistline
- Imbalanced hip height
- Imbalanced shoulder height
Causes of Scoliosis
Often than not, Scoliosis has no cause. In that case, the condition is referred to as idiopathic scoliosis. About 3% of the world’s population suffers from idiopathic scoliosis. Experts link the cause to genes, but the cause could be beyond genetics too.
Types of Scoliosis
Common Scoliosis Curve Types
A curve that appears bent backward in a “C “shape, involving a bending of the spine to the right, is called dextroscoliosis. A scoliosis curve on your back protruding to the left side in a regular “C” shape is called levoscoliosis. Common scoliosis curve types are:
- Right Lumbar Curve — the curve type inclines to the right side, beginning and ending on the lower back.
- Right Thoracic Curve — this curve type bends to the right side of your upper back or the thoracic region.
- Double Major Curve - entails the left lumbar curve on the bottom and the right thoracic curve on top. Therefore, your abnormality could be less pronounced because these two curves balance each other out.
- Right Thoracolumbar Curve — a scoliosis curve that bends to the right side, beginning in the thoracic/ upper back and ending in the lumbar/ lower back.
You could suffer from many other scoliosis curves like the left thoracic curve or triple curves.
Idiopathic Scoliosis Types
Scientists categorize idiopathic scoliosis by age at which deformity developed. The categories include:
- Adolescent idiopathic scoliosis. A type that patients develop from 10 to 18 years old.
- Juvenile idiopathic scoliosis. Susceptible patients range between 4 and 9 years old.
- Infantile idiopathic scoliosis. Infants who develop this condition range from birth to 3 years old. The cause of this scoliosis type is unknown.
Credible studies have shown that out of all idiopathic scoliosis, 80% of these are adolescent scoliosis. During adolescence, growth is rapid. Therefore, you should monitor your child’s skeleton development to detect abnormalities early enough.
Congenital Scoliosis - A scoliosis type caused by spinal bone deformity during the early development of a baby inside the uterus.
Symptoms of Scoliosis
If you have a mild curve, you and anybody with an untrained eye could hardly notice it. But if the curve extends, many signs or symptoms are conspicuous.
Early Signs of Scoliosis
Many times, scoliosis is noticed when another person comments about your body posture. For example:
- Sideways curvature when naked. You could notice your child’s back has a sideways curvature while they are on the beach or pool.
- Clothes hanging unevenly or fitting awkwardly. You could notice that your child’s blouse or shirt appears uneven.
You want to have a newly discovered asymmetry checked even if it appears minor because it is easier to treat if identified early.
Moderate or Severe Scoliosis Symptoms
According to experts, scoliosis curves extend past the mild stage in approximately 10% of patients with idiopathic scoliosis. However, if the curves continue progressing, the deformity is more visible to people surrounding you. Examples of symptoms you could notice at the mild or severe scoliosis stage are:
- Low self-esteem - even if the scoliosis curve affects you, your loved ones and friends could easily overlook this symptom. For example, teenagers who want to fit in with their peers could have self-esteem issues. They could be stressed when their appearances are different, outfits appear uneven, or other people can see their back braces, limiting activity and being uncomfortable.
- Cardiovascular complications - if your rib cage turns significantly, it results in reduced spacing for your heart to efficiently pump blood. As a result, you could develop conditions that will have you have many trips to your doctor.
- Breathing Difficulties - like cardiovascular complications, a twisted spine and rib cage could reduce the lung space. Your ribs could press against the lungs, causing breathing problems.
- Reduced range of motion - your spine is built to allow flexibility and movement. If it twists, it could cause rigidity; hence, lowering flexibility and the spine’s ability to bend.
- Change in gait or walking - when your spine bends and twists significantly, it could misalign the hips. If your hips are out of alignment, how you walk or your gait could change. The compensating you do to keep balance because of the uneven legs or hips could cause muscle fatigue. For example, someone could notice that one hand grinds against the hip while walking the other does not.
- Pain - if your condition is severe, the back muscles could experience painful spasms. Local inflammation could develop near the strained muscles, causing pain. Because of higher loads, the facet joints and intervertebral discs could begin to degenerate.
Even if scoliosis could cause death, the odds of reaching such a severity level are low. You have to undergo surgery before the deformity reaches such severe stages.
Idiopathic Scoliosis Signs and Symptoms
The early stages of abnormalities hardly show symptoms. For example, all lateral or sideways curves of 10 degrees and beyond along the spine are considered scoliosis. This is because you could fail to detect small curves even on spine x-rays. However, as the curve extends to 20 degrees or above, the odds are that you could notice abnormalities like the body tilting to one side or clothes hanging unevenly.
Medical experts say that young adults and adolescents with idiopathic scoliosis will hardly feel pain. Nevertheless, the abnormality could cause trunk imbalances and extra problems, which could lead to muscle spasms. Trunk imbalances cause not only muscle spasms but also pain.
Back Pain Symptoms and Controversy
Many controversies exist out there concerning back pains caused by scoliosis. Research has shown minimal results that link scoliosis to back pain. If you suffer from scoliosis and experience back pain, your physical therapist should identify other underlying conditions that could be linked to the pain.
Many idiopathic scoliosis patients say that they feel the condition causes back pain. However, most recent studies have linked back pain with scoliosis curves more than normal spine curves.
Diagnosis of Scoliosis
In children, pediatricians, physical therapists, and school nurses detect scoliosis during a school screening or physical examination. The primary aim of the program is early detection and treatment. A therapist’s visit involves a comprehensive medical history review or particular questions regarding the current conditions and background health history.
The physician and physical therapist will assess the spine at various points and check for flexibility, swelling, strength, and tenderness. Your child could be requested to briefly show the activities that cause or points that feel pain and difficulty. The physical therapist will identify your child’s signs and symptoms that the scoliosis curve causes.
If you or the child sees a physical therapist before a doctor, you could be referred to an orthopedist for a radiography session to determine if it is indeed scoliosis. Scoliosis could often be confused with other conditions like ankylosing spondylitis, juvenile disc disorder, and Scheuermann’s disease.
Adam’s Forward Bend Test
Adam’s forward bend test is the initial step of diagnosing scoliosis. The test’s primary aim is to identify abnormal rotation in the spine. Adam’s forward bend test needs a physician or physical therapist to observe you bending forward from the waist at an angle of 90 degrees with your arms stretched toward the ground. Your knees should be straight. When at this position, many symptoms are conspicuous in the body trunk or the spine. These signs and symptoms include:
- One leg looks shorter than the other
- The trunk of the body tilts towards one side
- The waist looks uneven
- One hip looks to protrude more than the other
- Your rib cage could look higher on one side. This condition is called a rib hump.
- Your shoulder blade looks slanted, or one should appear higher than the other.
This particular test could be useful to detect spine curves located in the mid-back or upper back, where scoliosis usually develops. However, this test does not help detect abnormal curves in the low back as it does not involve rotation of the rib.
Measuring Spine Rotation Using Scoliometer
Adding to the forward bend test, your clinician could use a scoliometer/ inclinometer to measure the angle of trunk rotation (ATR). Then, when you are still bending forward, the physical therapist could place the inclinometer flat on your back on the positions where the asymmetry is most conspicuous.
As a rule of thumb, if your clinician records ATR of 5 degrees and above, they could schedule a follow-up or refer you for radiographs at an imaging facility who could take images of the back for a precise scoliosis diagnosis. You could also need X-ray imaging to measure the curve degree to determine if indeed it’s scoliosis. Once scoliosis is identified, the patient will be referred to an orthopedic spine physician for review of the X-ray’s and, along with physical therapy, prescribe other treatment strategies to implement.
Cobb Angle Measurement
The Cobb angle describes the lateral scoliosis curve. The physician could identify the angle by drawing a perpendicular line on an x-ray from the spine’s twisted vertebra above the apex of sideways scoliosis and another perpendicular line running from the most-twisted vertebrae below the apex. Cobb angle forms where these two lines meet, usually at 10 degrees.
Risk Factors for Scoliosis to Progress
Following are factors that could increase your risk for scoliosis to worsen:
- A curve in the thoracic spine - the odds of this curve progressing is higher when compared to a curve on the lower back.
- Female gender - females are more likely to suffer from mild to moderate or severe scoliosis than males.
- Skeletal growth - Your scoliosis curve could progress and worsen. If your skeletal growth is not contained early, it has a risk of growing.
Prevention of Scoliosis
Studies have shown that you cannot prevent scoliosis. However, more studies are occurring concerning treatment types of ceasing scoliosis progression like bracing. Studies have shown that bracing is effective at curtailing spinal curves progression. The main goal of physical therapy is to manage signs and symptoms and optimize the functional capacity of every individual. As mentioned above, the team approach method is the best when treating scoliosis.
Treatment of Scoliosis
Scoliosis treatment options include surgery, bracing, and physical therapy. Your physical therapist determines the ideal treatment depending on your age, the severity and scoliosis type, and guidelines that the Scoliosis Research Society advises. The therapist could offer care in one of the scoliosis treatment phases, such as during the acute, post-surgical and chronic bracing phases.
How Your Physical Therapist Could Help
Your physical therapist could offer care in one of the scoliosis treatment phases like post-surgically or bracing. First, the therapist will evaluate your body’s movement patterns and posture, identify any problems with spine changes and symptoms like muscle imbalances and pain. Next, you or your child will work with the physical therapist to create a personalized treatment plan according to your goals, curve severity, and scoliosis type. Next, the physician will keep monitoring your progress within the treatment course.
A physical therapist could offer the following treatments:
- Range-of-Motion Exercises - a physical therapist will develop a treatment plan - a range of motion program - to prevent limitations or increase your body’s range of motion when you experience limited movement.
- Strength Training - your therapist will create a treatment plan to strengthen muscles around the spine or in other body parts that are weak due to the spine’s position change. These body parts include shoulders, back, neck, and hips.
- Manual Therapy - your physical therapist could use their hands to restore motions to joints and muscle tissue limited because of scoliosis. In addition, they use their hands to retrain and guide movement patterns.
- Modalities - Many other treatments like ultrasound, electrical stimulation, heat, and ice could help reach physical therapy goals. Your physical therapist could choose appropriate modalities for the exact cause.
- Functional Training - physical therapists are proficient in evaluating movement patterns, offering education regarding proper movements patterns, and retraining your body for optimum movement.
- Education - consult with your physical therapist to offer scoliosis and its effects on your movement and body.
When Idiopathic Scoliosis Needs Treatment
Following are treatment options for idiopathic scoliosis:
- Observation — doctors usually observe you if your curve is below 20 degrees. Your physical therapist will recommend you have x-rays taken every four to six months to observe the scoliosis progression.
- Bracing — if your curve shows progress above 25 degrees, the doctor usually recommends you wear a back brace until your skeleton is fully matured. The primary purpose of bracing is to prevent the scoliosis curve from worsening and lowering the chances of undergoing surgery.
- Surgery — if the above treatment options cannot work, your therapist could recommend that you undergo surgery. Today, the most common surgery type for idiopathic scoliosis is a posterior spinal fusion. The surgery type could help correct your problem with fewer levels of fusion. Posterior spinal fusion preserves more back mobility too.
Studies have shown that over 90% of the adolescents with idiopathic scoliosis do not undergo surgery nor wear back braces.
Find a Physical Therapist Near Me
We evaluate and treat the medical conditions of patients who visit Suarez Physical Therapy with abnormal spine curves fast and effectively. Within a few days, we could diagnose the medical condition and develop an ideal treatment plan. Many of our scoliosis patients recover without undergoing treatment. However, we could recommend surgery if other available conservative treatment options, along with physical therapy fail. If you seek quality spine treatment in Las Vegas, NV, and want to schedule an appointment with us today, reach us at 702-368-6778.