Managing Scoliosis with Physical Therapy

Scoliosis is a condition that affects the normal shape of the spine, altering a person’s back alignment and posture and causing a lateral “s” or “c”-shaped curve in the spine. The abnormal curvature of the spine can place stress on the surrounding muscles and joints, causing loss of strength and flexibility in the spinal and back muscles over time. Physical therapy is an effective, non-invasive treatment method to manage scoliosis, stabilize the scoliosis curve, improve postural alignments, enhance neuromuscular control and muscular strength, and improve overall function in individuals with scoliosis.

Scoliosis doesn’t normally cause pain, but pain can develop due to the abnormal curve of the spine placing stress on the surrounding muscles and joints, causing changes in body alignment, posture, and movement patterns. The muscles that support the spine can become imbalanced and lose strength and flexibility over time.

Common signs of scoliosis can include:

• Uneven shoulder height

• Uneven hip height

• Uneven waistline

• Bony bump on one side of the back

• Appearance of a difference in leg length

• Pain in areas around the spine like the shoulder, pelvis, or hip

• Pain with specific movements and activity

• Sense that the two sides of the body don’t line up/are not symmetrical

Physical therapy is a relevant treatment option during all phases of scoliosis. It is particularly effective when scoliosis is diagnosed early on, but also plays an important role in improving function when combined with bracing as well as regaining strength and mobility after surgery.

The aim of physical therapy management of scoliosis is to decrease the side-to-side curvature, slow down the curve progression of the spine, improve breathing function and muscular balance, decrease pain and stress on the back, and improve posture.

Physical therapy management for scoliosis can include:

• Manual therapy: using joint and soft tissue mobilizations, the therapist uses manual therapy to help restore motion to joints and muscles restricted by scoliosis and gently retrain movement patterns.

• Modalities: to manage pain, the therapist may use ice, heat, electrical stimulation, or deep heat ultrasound to relieve back pain.

• Patient education: the therapist provides education on the effect of scoliosis on the body as well as movement strategies to manage the condition and activities of daily living.

• Range of motion exercises: the therapist guides the patient through gentle range of motion exercises, particularly of the spine.

• Targeted strengthening exercises: the therapist specifically targets muscles of the spine to address any muscular imbalances in the back as well as strengthening other body parts that have been weakened by scoliosis like the hips and shoulders.

• Functional training: the physical therapist teaches proper movement patterns and body mechanics and retrains the body for optimal movement and function.