3 Sep 2019   |   By : Dr Albert Winandar B.S, D.C

Scoliosis Treatment

Scoliosis Treatment


There are misconception that the only scoliosis treatment available is through surgical means. In this article we will help you understand what is scoliosis, its causes and what are the available scoliosis treatments. So you can make a well informed decision before going through any treatment. 

 

What is Scoliosis?

Scoliosis is not a familiar word that we heard in a day to day basis. We have heard of back pain, neck pain, headache, dizziness, numbness, Frozen shoulders, knee pain, and many more symptoms that affecting and alter our functional self. Scoliosis is another symptom that causing our body to alter spine structure and function.

What is scoliosis? Scoliosis is a condition when a spine laterally curve and rotate that causing imbalance of body function against gravity. In general, scoliosis may develop into a C shape curve or an S shape curve. Although generally scoliosis develop into a C or an S shape curve, there are no individual scoliosis condition that are the same. This is due to the amount of vertebrae that embedded and becoming our spine.

We have 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 2 pelvis and 1 sacrum (makes up into hip joints), and a skull. Combination of these vertebrae makes up scoliosis curves. In addition, there are muscles that are attached on each individual bones that is located deep inside our body. These muscles (Multifidi muscles) are the one that controlling the movement of our spine.

 

Causes Of Scoliosis

What is the cause of scoliosis? Scoliosis cause is unknown, hence the diagnosis is Adolescent Idiopathic Scoliosis (ADI), however someone that suffer from scoliosis has to be analysed (not just their spine structure through X-rays), it is important to analyse their X-rays and posture from different angle, biomechanics of the body, balance, muscle activities, Joint hyper-mobility (ligament laxity), bone density and activity of daily living.

Most scoliosis sufferers have sensory-motor reintegration disorder that lead to improper communication between brain and muscles that are responsible in controlling balance, coordination, and posture (www.CLEAR-Institute.org). Thus, scoliosis is not just a spine that is laterally bent and rotate, but also imbalance of deep involuntary muscles such as multifidus muscle that control the movement of the spine. These muscles become tighter on the convex side of the curve and weaker on the concave side of the curve. Overtime, these would change the posture and would create twisting motion towards the trunk of scoliosis patients and build a compensated posture, muscle memory movements, and scoliotic habits of each individuals.

 

Scoliosis Treatment Options

As we get better understanding about scoliosis, what do we need to do if you or your child has scoliosis? Most of the time scoliosis will not get detected unless we’ll take X-rays of the spine, a preliminary diagnosis of scoliosis can be done by determining whether or not posture are balance. A few indication that needs to be checked are shoulder position if it is even or not, hips are level or not, if there’s protruding shoulder blades, if posture is shifting to the left or right.

Despite all of these, the main goal is an early intervention of scoliosis. Whether it's a mild scoliosis or severe scoliosis, intervention is the key to fix its condition and improve its condition. Severe scoliosis always start with mild scoliosis, so rather than waiting until a mild scoliosis become severe, start scoliosis treatment as early as possible, as little Cobb angle or scoliosis curve as possible, to get the maximum result.

There are many ways of scoliosis treatment, the most common that many orthopaedic specialists are doing is watching and waiting for mild scoliosis curves, then every 6 months there will be an X-ray to evaluate and to see if the curve worsen, if it does then approach will be taken according to the size of the scoliosis curve.

At All Well Scoliosis Centre, we are strongly recommend to treat smaller scoliosis curve and prevent this curve to worsen. Severe scoliosis curves started from mild scoliosis curve, treating mild scoliosis curve will have better outcome and will prevent these mild scoliosis curve to get worse.

 

Scoliosis Braces

Scoliosis brace usually recommended if the scoliosis curve are moderate. The most common prescribe brace are Boston brace or commonly known as Thoraco-Lumbo-Sacral-Orthoses (TLSO). This type of brace intention is to stop scoliosis curve progression. Many of the TLSO braces are “off the shelf” designs, and NOT custom made for each individual patients. The design itself are merely a cylindrical tube that design to hold individuals torso. Many modern research reveal that combination of exercise based scoliosis treatment and proper custom bracing are effective in improving scoliosis.

There are many types of scoliosis braces:

  • Charleston or Providence brace, which are night time brace and effective with smaller scoliosis curves.
  • Milwaukee brace or Cervico-Thoraco-Lumbo-Sacral-Orthoses (CTLSO), which are rarely use because it may cause damage to neck and jaw.
  • Rigo Cheneau brace is a de-rotation brace based of Cheneau brace that are being developed by Dr. Rigo.
  • SpineCor brace is a soft brace. This brace type may not be effective on stiffed spine and curve larger than 20-25 degree.
  • Scolibrace is a custom 3 Dimensional over-corrective brace that helps progressive scoliosis that are not getting good respond on exercise based approach alone.
     


Scoliosis Surgery Methods

Most commonly used is spinal fusion surgery methods that are using rods and hooks. Fusion two or more vertebrae permanently to a single, rigid section of spine that is no longer moving. Other common scoliosis surgery methods MAGECTM (MAGnetic Expansion Control) System is a system which rods can be expanded remotely. Vertebral Body Tethering (VBT), Vertebral Body Stapling (VBS) are other types of Scoliosis Surgery methods that are still being tested.

 

Exercise-Based Scoliosis Treatments (CLEAR Scoliosis Treatment)

These treatments are designed to help create coordination of brain and body understanding towards 3 dimensional plane line. Scoliosis patients usually have lack of coordination with their 3 dimensional plane line or we called it proprioception. CLEAR Scoliosis treatment is an outstanding scoliosis treatment based of 3 steps of MIX which is increase spine flexibility and reduce deep muscles stiffness, FIX which is improving alignment and restore normal curvature using custom corrective exercises, SET creates brain and body coordination, posture control through specific CLEAR Scoliosis Institute exercises.

SEAS (Scientific Exercises Approach to Scoliosis) is exercise based approach to stabilising scoliosis based on Self Correction during which patients is personally trained in front of a mirror on how to unbend. Schroth Method is a physiotherapeutic treatment system to reshape the rib cage and de-rotate spine through isometric and breathing exercises. This treatment is very complex and for home exercise is difficult movements to follow. Some other exercise based treatments are Methode Lyonaise, Functional Individual Therapy of Scoliosis (FITS), Side Shift, Vojta, Dobomed, The Barcelona Scoliosis Physical Therapy School (BSPTS).

 

All Well Scoliosis Treatment Approach

At All Well Scoliosis Centre, we are providing CLEAR Scoliosis treatment protocol to build patients understanding and improvement in their posture and scoliosis curvature. Each individual that goes through our treatment would experience both isotonic and isometric exercises, specific scoliosis stretching procedure, active Self Correction, Sensory Motor Reintegration(SMR), modified Activity of Daily Living, proper diet and Nutritional improvement specifically for Scoliosis patients. Thus understanding the importance of their changes and build deep muscles balance as well as strength to create proprioceptive coordination.

Our scoliosis treatment purpose are not just to improve scoliosis curve in particular, but we would furthermore educate patients, create awareness of their habits, and possibly improve their condition long term. Scoliosis is a symptom of brain and body lack of coordination due to lack of activation of proprioception in each individuals that suffers from this condition. Lateral curve in the spine is the effect of proprioception problems and eventually lead to rotation and lateral curve of the spine or scoliosis. Scoliosis treatment that are non-invasive should include giving awareness to each individual with scoliosis and changing their habits and activity of daily living. Without giving awareness and understanding about the condition, it is just the same like giving medication without knowing the cause of the condition. Scoliosis treatment has to be customised on every individuals to achieve improvements.

Scoliosis Treatment

 

References:
www.clear-institute.org
www.hudsonvalleyscoliosis.com