What’s the Best Treatment For Scoliosis? I Rehab Malaysia

Sign and Symptoms 

Several signs may indicate the possibility of scoliosis, including a sideways curvature of the spine, sideways body posture, one shoulder being higher than the other, clothes not hanging properly, local muscular aches, and local ligament pain. A major concern in progressive severe scoliosis is decreasing pulmonary function. In one study, about 23 percent of patients with idiopathic scoliosis presented with back pain at the time of initial diagnosis. Idiopathic scoliosis may also affect pulmonary function due to changes in the shape and size of the thorax. Recent reports on pulmonary function testing in patients with mild to moderate idiopathic scoliosis showed diminished pulmonary function, with greater impairment observed in severe cases of spinal deformity, proximally-located curvature, and older patients.

Diagnosis 

Scoliosis diagnosis in children and teenagers often occurs during routine medical examinations due to the absence of noticeable symptoms. Scoliosis chiropractors undertake a comprehensive diagnostic approach, starting with a thorough review of the child’s medical history and family background, which may uncover potential underlying medical conditions contributing to spinal curvature. Some cases are even identified through school screenings. Following this, a physical examination assesses the child’s posture, checking for any asymmetry in the trunk or shoulders. When the child bends forward, the doctor looks for signs such as one side of the rib cage appearing higher than the other, which can indicate possible scoliosis. The most definitive diagnostic tool, however, is x-ray imaging, providing detailed insights into the extent and severity of the spinal curvature. By evaluating these x-ray images, practitioners can accurately determine the severity of the condition and devise appropriate treatment strategies tailored to each individual case.

Management 

Management of scoliosis depends on the severity of the curvature, measured by the Cobb angle, and the age of the patient.

Observation 

For mild scoliosis, which is defined as a Cobb angle of less than 20 degrees, observation is typically recommended, especially in growing children and adolescents. Regular follow-up visits every 4-6 months are essential to monitor the progression of the curve. If the curve does not worsen, no further treatment may be necessary.

Physiotherapy 

Physiotherapy can be particularly beneficial for managing mild to moderate scoliosis, defined as a Cobb angle of less than 20 degrees, or in some cases, up to 30 degrees. Physiotherapy aims to manage symptoms, improve posture, and strengthen the muscles that support the spine. Specific exercises tailored to the individual’s condition can help reduce the progression of the curve and enhance overall spinal function. By focusing on muscle balance, flexibility, and core strength, physiotherapy not only addresses the curvature but also promotes better posture and alignment, contributing to the patient’s overall well-being and quality of life.

Brace 

For moderate scoliosis, especially in growing children and adolescents, orthotic specialists provide braces designed to prevent further curvature. These braces are tailored to fit each patient and are regularly adjusted to ensure effectiveness. By applying gentle pressure to the spine, braces help to maintain proper alignment and minimize the progression of the curve during periods of rapid growth. Regular monitoring and adjustments by healthcare professionals ensure that the brace continues to fit correctly and functions as intended, promoting optimal outcomes in scoliosis management.

The most common type of brace used for scoliosis is made of plastic and is contoured to conform to the body, such as the Milwaukee brace. This type of brace is designed to be nearly invisible under clothing, fitting snugly under the arms and around the rib cage, lower back, and hips. Most braces are worn day and night, and their effectiveness increases with the number of hours worn each day. Children who wear braces can usually participate in most activities with few restrictions. If necessary, the brace can be removed for sports or other physical activities.

Braces are typically removed once bone growth has ceased, which usually happens around two years after girls start menstruating, when boys begin shaving daily, or when there are no further changes in height. In general, congenital scoliotic curves are not flexible and are resistant to correction with bracing. Therefore, braces are mainly used to prevent the progression of secondary curves that develop above and below the congenital curve, which can cause imbalance. In these cases, braces may be worn until skeletal maturity is reached.

Surgery 

Severe scoliosis typically progresses over time, and a specialist may suggest scoliosis surgery to reduce the severity of the spinal curve and prevent further worsening. The most common type of scoliosis surgery is spinal fusion. In this procedure, two or more vertebrae are fused together so they cannot move independently. Pieces of bone or a bone-like material are placed between the vertebrae, and metal rods, hooks, screws, or wires are used to hold that part of the spine straight and still while the old and new bone material fuses together. This stabilizes the spine and corrects the curvature to a more manageable degree.