Therapy / treatment of scoliosis - what can be done?

Therapy for scoliosis

The Therapy of Scoliosis (Scoliosis therapy) depends on the age of the patient and the severity of the scoliosis. The best therapeutic success with scoliosis therapy occurs during the growth phase in childhood.

Is the spine only easily affected by scoliosis (Curvature below 20 °), physiotherapy may be sufficient to strengthen the back muscles. Is the Curvature of the spine more severe (over 20 °), the vertebrae must also be loaded with the help of various corsets in order to avoid consequential damage. Wearing a corset for scoliosis therapy has to be persisted, which is especially difficult for children.
In principle, the corset must always be worn, they say 23 hours a day. So it should only be removed for washing. This type of scoliosis therapy must be continued until the growth is complete.
A corset fixes the torso and prevents the shoulder and pelvis from twisting against each other. It works on the principle: pressure and relief. A complementary physiotherapy for scoliosis therapy must not be dispensed with under any circumstances.

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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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  60311 Frankfurt am Main

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Further information about myself can be found at Dr. Nicolas Gumpert

At severe scoliosis one has to think of an operative therapy. In order to optimally prepare for the operation, a traction method should be used in advance. Then the spine is stiffened through a procedure called spinal fusion. Patients generally find this stiffening to be less restrictive. For stiffening, screws are screwed into individual vertebrae and connected to one another with rods. A corset treatment is not necessary in this case.

Several steps are necessary to surgically straighten scoliosis:
The spine must not only be straightened in its lateral curve, but rotation and torsion must also be compensated. Various surgical procedures are available:
Ventral and dorsal procedures. With the ventral approach, the approach is chosen from the front, with the dorsal approach, from the rear. In the latter case, the vertebral arches (the rear part of the vertebral bodies) and their backward protrusions are exposed. If the ventral access is chosen, the spine must be prepared through the abdominal cavity. As with any surgical procedure, this operation is also dangerous. The more severe the extent of the scoliosis, the riskier the operation. Possible complications, in addition to the general risks such as bleeding and infection, can be, for example: Damage to the spinal cord through pressure, tension or displacement, circulatory disorders up to (temporary) paraplegia. The straightening of the spine brought about by the operation can unfortunately also regress and the metal implants can tear out. Here are just a few of the possible complications.

Exercises for scoliosis

Exercises to promote the back and support muscles are useful. The exercises should be based on the type of spinal curvature. This is guaranteed above all with physiotherapy. Breathing exercises and relaxation techniques can also be helpful.

Read more about this at: Breathing exercises to relax - that really helps!

Below are three general exercises that can be used at home. However, it would be better to see a physical therapist to learn more specific exercises.

• Starting position: four-footed stance (supported on knees, shins and palms)

The left arm and right leg are stretched out and then bent at the elbows and knees until the two joints below the body touch. When stretching at the beginning, make sure that the back and neck form a straight line with the head. The exercise can be repeated as often as you like. Then the exercise should be repeated just as often with the right arm and left leg.

• Starting position: Lie on your stomach, arms stretched forward, palms facing the floor, legs stretched out

The aim of this exercise is to activate the muscles of the entire body. The muscles become tense. The tense arms and head should be raised towards the ceiling. The position should be held for five to ten seconds. Then lay down the body and arms again in a relaxed manner.

• Starting position: standing straight, leaning your back against a wall, both arms relaxed at the sides of your body

In this exercise, the left arm is stretched over the head to the right and the upper body is angled to the right. This creates a stretch on the left side of the torso. The position is held for about ten seconds and then repeated on the other side. It is important that your back is straight towards the wall and your shoulders remain open.

In general, sporting activity in leisure time can help to cope with the disease (muscle training, but also psychological components). For example: swimming, cycling, jogging or yoga.

Please also read our article about Pilates or Autogenic training

Exercises on the exercise ball / Pezziball according to Schroth

Overall, it is difficult to perform Schroth exercises (including on the exercise ball / Pezzi ball) only with the help of a written declaration.
Schroth therapy is about identifying bad posture together with a therapist. Mirrors are used here. In order to correct the bad posture, certain exercises are carried out. The conscious perception of the body and the individual components (muscles, ligaments, tension, stretching) is very important. During the therapy, certain exercises for at home are worked out and instructions are given as to which rules must be followed.

Performing the exercises without practical guidance is therefore unfortunately not very promising. If you are interested in such a therapy, your doctor or orthopedic surgeon can be consulted.

Treatment in adulthood

It is difficult to make a general statement about the therapy, as many factors such as the burden of symptoms, consequential damage and dynamics play a role.

A corset is often used in the treatment of scoliosis in adolescent patients. However, this is not common in adult patients. Adult patients usually have a permanent curvature of the spine and vertebral bodies.

This can result in some consequential damage:

• limited mobility
• premature signs of wear and tear (arthrosis of the facet joints)
• Breathing problems
• other problems caused by a different spatial order of the internal organs

These consequential damages are usually the focus of treatment. Physiotherapy can help improve mobility and provide relief from breathing problems. If the dynamics deteriorate, a corset or an operation can be useful.

Incidentally detected scoliosis in adults with a low degree of curvature do not necessarily have to be treated if it does not worsen and there is no symptom burden, but should continue to be observed.

Read more on this topic at: Facet syndrome

Physiotherapy for scoliosis

In physiotherapeutic treatment, the focus is on strengthening and stretching the muscles and maintaining mobility.But breathing can also be disturbed by the curvature of the spine. Therefore, additional breathing or relaxation exercises can be helpful.

Trained therapists can use different treatment concepts (Schroth, Dorn, Vojta, etc.) and exercise equipment depending on the patient and degree of severity. The exact misalignment (thoracic / lumbar spine, etc.) should be discussed. Self-help exercises are also learned during therapy. In general, the curvature should be prevented from advancing, but a (complete) correction cannot usually be achieved, as is the case with corset treatment.

Osteopathy for scoliosis

Osteopathy as the sole therapy cannot usually provide sufficient relief. However, it can be used in addition to other treatments. The advantage is the conservative approach. This means that no operations or interventions are carried out.

Osteopathy not only regards the spine as a critical point, but also holistically other (resulting) functional restrictions of the entire body and tries to gently resolve this complex of problems.