Ask the PT – Scoliosis
I have scoliosis. Can physical therapy help my back pain?
Physical Therapist Ron Jagadeesh says when the pain is caused by scoliosis, the goal of physical therapy is to find a position as close to neutral spine as possible, then work to strengthen the muscles in that position. “Scoliosis is the deviation of the normal curves of the spine. It can include lateral curves, as well as rotation or collapse of the vertebrae. In severe cases, scoliosis may cause back pain, organ dysfunction, breathing problems, or neurosis caused by compression of the spinal nerves,” he says.
While scoliosis is a condition often seen in children, especially during growth spurts, adults can be undiagnosed and may not present with the traditional symptoms such as curvature of the spine. However, left untreated, even minor scoliosis may have long-term effects on organ function and spinal health. Trained in the Schroth Method, Jagadeesh says recent international literature reviews reveal that this physiotherapeutic treatment system is one of the most effective and highly reproducible methods for scoliosis rehab.
“While not new, the Schroth Method uses isometric and other exercises to strengthen or lengthen asymmetrical muscles in a person with scoliosis. Its goals are to halt progression of abnormal spinal curvature, and in the best case, to reverse the curves,” he says.
This system of exercise for scoliosis was developed by Katharina Schroth in the 1920s and further developed by her daughter, Christa Lehnert-Schroth in the 1960s. While widely used in other countries, and the standard non-surgical treatment for scoliosis in Germany since the 1960s, the Schroth Method has only recently gained importance in the U.S.
Jagadeesh emphasizes that dedication to the prescribed exercise is key, but over the course of one year, patients can expect a decrease in Cobb angles (the lateral curves of the spine), improved respiratory capacity, improved posture, and improved strength. Patients need to know that Pilates is not a quick fix. Improvements happen in small increments over time.
Insurance companies will often cover scoliosis treatment as many doctors find it medically necessary to reduce pain and other symptoms that interfere with wellbeing.
A typical therapy session may begin with some manual release techniques for the patient to quickly feel relief and stretch tight fascia and muscles. Then the focus is on breathing and strengthening the core and pelvic floor musculature.
“I start with small movements to give the patient and internal awareness and increase stability. We may then move on to larger movements once they have gained an awareness of how to stabilize the spine,” says Jagadeesh.