September 19, 2018
render of pained spine

Straight Advice for Scoliosis

by Berkeley Wellness  

Scoliosis—an abnormal sideways curvature of the spine—typically develops in adolescence, far more commonly in girls than boys (8:1 ratio). But it’s not just a malady of childhood.

In fact, scoliosis often progresses over time and can become a cause of back pain in adulthood, as well as pain in the hip, legs, and neck. Moreover, many people develop scoliosis for the first time as adults due to age-related degenerative changes in the spine, as from arthritis or osteoporosis-related compression fractures. (In turn, scoliosis may contribute to degenerative changes.)

Though estimates vary widely, a 2010 Johns Hopkins study in the American Journal of Neuroradiology found that 13 percent of people ages 46 to 60 had some degree of scoliosis, as did 39 percent of those over 60. An earlier study in the journal Spine found an even higher rate—68 percent—in healthy people over 60. Other studies cite lower numbers. Most people with scoliosis are not bothered by it, physically or socially. But in more severe cases, it can be disfiguring and can compress organs and cause breathing difficulty, nerve impairment, and other problems.

Fortunately, if you have scoliosis there are ways to help keep it in check as you get older. As the Scoliosis Research Society states on its website, “Different physical therapy methods have been designed to offset the effects of scoliosis and improve the shape and look of your body,” with “some scientific evidence” that they can help you “look straighter and improve your breathing.” Some therapies may even help reduce the curvature.

If you’re concerned about scoliosis, you should be evaluated by a physician (such as your primary care doctor, a physiatrist, or a spine specialist). You might then be referred to a physical therapist with expertise in scoliosis, who can design an individualized treatment plan.

Some good moves

One type of physical therapy that has been receiving increased attention lately in the U.S. is the Schroth Method, which was developed in the 1920s by a German woman, Katharina Schroth, to deal with her own scoliosis. Now a standard non-surgical treatment for scoliosis in some parts of Europe, it utilizes special posture and breathing exercises, along with mental imagery, to elongate, derotate (untwist), and stabilize the spine. Preliminary research suggests that the Schroth Method may reduce curvature progression, pain, and the need for surgery, as well as increase lung capacity— but randomized controlled studies are needed to confirm these observed benefits.

According to some case reports, exercise programs such as SEAS (Scientific Exercise Approach to Scoliosis) as well as movement therapies (such as the Alexander Technique) may also help alleviate pain, increase chest capacity, and reduce curvature—though such reports rely on anecdotal data. It’s unknown how many people might actually benefit and how long the effects last.

What about yoga? A small study in Global Advances in Health and Medicine in 2014 found that a modified side plank pose (Vasisthasana)—when done most days of the week over an average of seven months—reduced the angle of the primary curve in adolescents and adults with varying degrees of scoliosis, as seen on spinal X-rays. The participants did the pose on their weaker side only (to strengthen the spinal muscles on the convex side of the curve) and held it for up to two minutes. The National Scoliosis Foundation lists 11 beginner yoga poses you can do on your own.

Being active overall is also important for maintaining muscle and bone strength in scoliosis. That includes doing core exercises and appropriate stretching exercises, since scoliosis causes one part of the back to be constricted while the other part is overstretched. Swimming, in particular, is a good activity.

Corrective surgery is often done in adolescents with severe scoliosis but is riskier in adults and should be considered only if the benefits—namely a reduction of severe pain or spinal curvature—would outweigh the risks.