What is scoliosis?

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. The cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.

   

What are the signs and symptoms of scoliosis?

  • Uneven shoulders
  • One shoulder blade that appears more prominent than the other
  • Uneven waist
  • One hip higher than the other
  If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing.   Doctors don't know what causes the most common type of scoliosis — although it appears to involve hereditary factors, because the disorder tends to run in families.    

How can physiotherapy and massage therapy help scoliosis?

Manual Physiotherapy

Although physiotherapy exercises can't stop scoliosis, there are a number of other factors that come into play with this sideways curvature. Essentially, with scoliosis, all of the lifestyle changes that are required to prevent joint disease in general and back pain are even more important because now there are two sets of curves. The normal lordosis, kyphosis, lordosis and the sideways cure of a scoliosis, must interplay and fight the effects of gravity to keep optimal alignment and posture. Curves cause joint stiffness and joint stiffness leads to a lack of mobility and compensations. Typically right at the apex of the curve, joints become stiff. The resultant compensations are in effect imbalances that then lead to dysfunctions and pain syndromes. A healthy spine is a mobile spine and one that can move in all directions and plans of motions both on a segmental level and on a functional level. Your physiotherapist can assess the intervertebral joint motions, the small motions between each vertebra, and they can then perform techniques that can specifically get these joints moving again. Manual physiotherapists have the ability to use their hands to palpate suppleness and joint motion. Each spinal level has a unique plane of movement and each has a slightly different functional angle. Restoring this mobility and suppleness will allow the spine to move as a functional unit without having to compensate.

   

Massage Therapy

Due to the changing structure of the spine, the goal of the Massage Therapist is to help decrease the muscle tone and spasm on either side of the curve as well as relieving secondary issues that can occur such as headaches, sciatica and back pain. Deep tissue techniques, in combination with increasing circulation to the blood and lymphatic systems is essential to decreasing scoliosis related symptoms.  

How can exercise and physical development help after back pain?

Although exercise cannot correct the cure of scoliosis, general exercise or participating in sports may have the benefit of improving overall health and well-being. Your physiotherapist can assess your specific strengths and weakness with a focus to keep your spine moving well, and design a program that will prevent your spine from becoming unhealthy.   We start with a functional movement screen that looks at some of the essential movement skills for daily living and also for an activity based lifestyle. This information in addition to our previous orthopaedic assessment findings will allow us to develop a personal improvement plan just for you. This plan will have specific goals, be measurable, will call you to action, will be realistic, and will be time sensitive so that you will see progress and we will monitor and support your success from a medically based standpoint and from a sports science stand point.

   

Scolisis associated with back pain or injury

It is important to regain functional back range of motion, as well as to strengthen the muscles which help to support the back and spine. In addition to Manual hands on therapy techniques, exercises to increase range of motion can be performed at home and at physiotherapy. These include flexion (knee to chest), extension (back arching like a cat), side flexion (arm down side of body), and rotation (twisting). Your Physiotherapist will perform manual therapy techniques to release restrictions and follow up with range of motion exercises in order to maintain this new range of motion. Maintaining range of motion exercises can help to decrease pain and improve joint health by aiding blood and nutrients in getting to the joint. The next important goal following a back pain is to regain strength and correct posture. There are a series exercises to progressively develop optimal posture. Patients will start with simple posture correction exercises that both reinforce good posture but also stretch and strengthen this postural pattern. Trunk control, engaging the abdominal and scapular muscles by engaging your core muscles and brining your shoulder blades back and down initially in standing and in supine, later in sitting and while lifting and bending. Abdominal control during different activities and in different positions are essential for the development of safe functional movements such as when, lifting or bending, or working and then during posture control while driving a car or putting dishes away or working at the computer etc. We typically start with active postural correction and then with resistance using elastic bands and cables. Your Physiotherapist will advise which exercises are appropriate at which point of each patient's treatment and will progress the exercises throughout the course of treatment.

   

Physical Development with Scoliosis

The final step is to establish a personal improvement health plan to continue to develop physically throughout your life. This is especially necessary after injury or an accident when you have become deconditioned. All of our staff have a combination of health sciences and sports sciences training, having dual training in both kinesiology and physiotherapy and allowing us to provide a biomechanical focus. Once you have recovered from your injuries, our therapists will perform a functional movement screen and analysis to identify individual muscle imbalances that are unique to your inherited structure, to your movement patterns, and to your goals and interests in living a healthy physical life. We develop a individualized program that focus on:
  • Your specific imbalances and movement patterns at work, home, and those evident during the activities that you participate in.
  • You structural and genetic posture and alignment characterizes and how they affect your interests to do activity etc.
  • We look at the ergonomics specific to your workplace and home
   

How can low intensity laser therapy help a painful scoliosis?

Low Intensity Laser Therapy (LILT) is the use of monochromatic light. Meditech Bioflex has been producing this technology for 20 years and has an extensive in house clinical lab.   The light source is placed in contact with the skin allowing the photon energy to penetrate tissue, where it interacts with various intracellular biomolecules resulting in the restoration of normal cell morphology and function. This process also enhances the body's natural healing propensities.   Low Intensity Laser Therapy does not heat or cut tissue. Unlike many pharmacological treatments that mask pain or only address the symptoms of the disease, Laser Therapy treats the underlying condition or pathology to promote healing. The technology utilizes superluminous laser diodes to irradiate diseased or traumatized tissue with photons. These particles of energy are selectively absorbed by the cell membrane and intracellular molecules, resulting in the initiation of a cascade of complex physiological reactions, leading to the restoration of normal cell structure and function.   The process is curative and therefore results in the elimination of symptoms including pain. In addition, it enhances the body’s immune system response and facilitates natural healing. The therapy is completely safe and has no adverse side effects. The technology is highly effective in the treatment of musculoskeletal conditions, arthritis, sports injuries, wound healing and a wide range of dermatological conditions. Whiplash injury typically involves injury to muscles, ligaments, and joints and typically involve several levels and a more wide spread area of injury due to the force full nature of the injury. Muscles of the neck, although short, cross over several joints and so the discomfort is generally more global initially. Laser therapy directed by multiple diodes are able to reach these tissues.    

Physiological effects of Low Intensity Laser Therapy

With LILT there is an increased production and release of:  
  • Endorphins which - natural analgesics
  • Cortisol – a precursor of cortisone
  • Growth hormone – instrumental in tissue repair
  • ATP – improves and regulates cellular metabolism
  • An increase in protein synthesis – collagen, DNA, fibroblasts
  • A facilitated venous and lymphatic flow
  • Increased angiogenesis – the elevation of oxygen saturation
  • Enhanced immune response
  These responses are some of the many processes that accelerate cellular regeneration (cartilage, epithelium) and restore normal cell morphology and function. Treatments are typically 25 minutes to over 1 hour depending on the condition and area being treated   The most popular technical / clinical information requested is available on the Meditech website under Laser Reports. You may visit the Meditech website research section directly for detailed abstracts, case profiles and articles on a variety of topics relating to the use of low intensity laser therapy in the treatment of various medical conditions.  

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