What is scoliosis?
It’s a sideways curve of the spine. All our spines are S-shaped when viewed from the side. A scoliotic spine is C- or S-shaped when viewed from the back. It’s perfectly common for people to have some asymmetries. But if a sideways curve has a Cobb angle (the standard measure for scoliosis) of more than 10 degrees, it’s classed as a scoliosis.
A scoliosis of less than 25 degrees is ‘mild’, and these are often amenable to treatment. It’s ‘severe’ at 40 to 50 degrees, when surgery to correct and fuse the spine may be the best option.
There are several ways to categorise scoliosis. There’s also a variety of causes, some more serious than others. Scoliosis can be divided into two main categories: structural and functional.
In a structural scoliosis, there are bony changes in the spine. Treatment aims to prevent the curve developing further and can sometimes reduce it. The chance of reduction is best if it’s caught early, while the patient is still young.
So what triggers a structural scoliosis to develop? In eighty percent of cases, it’s ‘idiopathic’. This means the cause isn’t fully understood, and there’s likely to be a combination of factors. This is common, affecting four to five percent of adolescents, and more girls than boys.
There are certain activities which can worsen an idiopathic scoliosis. Carry weight evenly rather than on one side. Avoid activities or sports that cause a lot of spinal compression, such as trampolining. Focus instead on activities that involve different kinds of movement to maximise mobility.
The other twenty percent have identified causes. They might be congenital, meaning present at birth. As a foetus grows in the womb, sometimes a fault means one of the vertebrae doesn’t fully develop. Its wedged shape means the spinal column tilts sideways.
In other cases, the scoliosis can be secondary to a neuromuscular disorder, such as spina bifida, cerebral palsy or muscular dystrophy. Or it might be a disorder of the connective tissue, called Marfan syndrome.
Some have surgery and some don’t. This can involve having a ‘metal Rod’ fixed to the spine to straighten it, generally the upper – middle (Thoracic) part of the spine or in the lower (Lumbar) part of the spine. When this is in position there is lack of spinal mobility and movement of the spine will happen above and below this strong fixing. Another new approach is developing for a young growing spine using a flexible wire fixed to individual vertebrae (VBT) allowing spinal mobility and movement. This is another longer discussion of this topic.
In addition, many older people develop mild scoliosis. This is due to normal aging processes in the spine, such as changes to the intervertebral discs. Often asymptomatic, they can sometimes be accompanied by aches or pain. This may even be elsewhere in the body, such as shoulders, hips or knees, as posture and weightbearing alter.
‘Functional’ here means the curve isn’t set in the spine. It’s there to compensate for something happening elsewhere in the body. If that factor can be eliminated, the curve will disappear.
Most of these factors are in the pelvis and legs. It might be a leg-length difference, or a hip or pelvic problem. Sometimes a scoliosis develops because of back pain – the body seeks a way to position itself more comfortably.
Functional scoliosis can also result from the way the body adapts to regular strain. Muscles, ligaments and joints respond over time to positions we habitually put them in. Research demonstrates that carrying a weight on one side of your body induces a sideways curve. It’s important, then, not to let that curve become set in. Carry your backpack on two shoulders rather than one. If you’re a parent of a young child, alternate which side you carry them on.
Whether a scoliosis is structural or functional, idiopathic or neuromuscular, it’s always three-dimensional. The spine twists as it bends, so there’s always a rotational component. Each scoliosis will have its own, unique pattern. That means each treatment plan must also be unique.
How we can help
Our team can help to ease the symptoms that can accompany scoliosis. If the scoliosis is mild, exercise and mobilisation can help to prevent it worsening. In the case of a functional scoliosis, we can help to identify the underlying cause and correct it where possible. We’re on hand to support, guide and advise you – and we’ll always refer you to your GP if necessary.
Osteopathy for scoliosis
Your osteopath – Suzanne, Austin or Jack, will perform a thorough evaluation to understand your scoliosis and how it affects you. As well as strength and mobility, that might include checking your tendon reflexes, heart and breathing.
We build your treatment plan according to your needs and wishes. First, we get a full understanding of your situation and what you want to achieve. Then we’ll discuss a plan aimed at easing pain, increasing mobility, and helping you manage your scoliosis.
If you have a structural scoliosis, we’d focus on maximising your function and slowing or stopping the curve progressing further. We’ll discuss with you what you’d like to gain. That might be easing pain and reducing stiffness. Or it might just be maintaining your function so you can keep dancing, rowing, playing tennis, or doing whatever keeps you happy.
Osteopathy can be particularly beneficial for scoliosis that’s occurred because of aging processes in the spine. Osteopathic treatment gently stretches muscles and mobilises the small spinal joints, so you stay as flexible as possible. We’ll also treat other areas that have to cope with changes in your posture. You may be bearing weight more on one side, or a shift in your ribcage could affect your shoulders. Our osteopaths can assess, treat and advise on these issues so you can continue living life to the full.
We find and, where possible, correct any underlying biomechanical issue that may be causing a functional scoliosis. For example, restrictions in the ‘sacroiliac’ joints (at the base of your back) can hold your pelvis at a tilt. Mobilisation frees the joints, enhances function, and settles the pelvis back into its normal position. That way your body can correct itself naturally.
We can also offer advice to help you stay active, healthy and pain-free.
I came to Suzanne almost a year ago, with terrible pains underneath my ribcage which interfered with my school work and with sitting at a desk. Suzanne told me that I had scoliosis within the first session. I had been to other practitioners before and received a diagnosis of ‘growing pains’.
I did receive the diagnosis of scoliosis from one other practitioner but I was told that nothing could be done. With Suzanne, I felt relief after the first session and the exercises she advised me to do helped me between sessions.
Stella P., September 2016
Pilates with Physiotherapy for scoliosis
With a focus on strength and flexibility, Pilates is ideal to alleviate the strain that scoliosis can place on your body. Our physiotherapists, Eduardo Verdi (Monday & Wednesday) or Patsy Beck (Sunday) will customise a programme to strengthen those areas that provide support and balance. This can reduce the effects of your scoliosis. These exercises often involve using one side of the body more than the other to counteract the curve’s shift. With regular use, Pilates can develop core strength, facilitate balance, improve posture and increase confidence.
Combining Pilates with osteopathy or physiotherapy sessions gives double the benefits. The beneficial effects of manual therapy treatment – such as improved joint mobility, reduced tension and enhanced blood flow – both aid the practice of Pilates and are prolonged by it. This is a great way to achieve long-lasting results.
The GYROTONIC® method is a specialised system of assisted exercise. It utilises equipment to encourage multi-directional movement – circular, spiralling and lengthening. This is taught by a licensed Gyrotonic® movement teacher, Nicki (Starting September/October – weekday & Weekend) Who will develop a sequence of flowing movements tailored to your scoliosis and your abilities. As you perform the sequence, they will guide and gently challenge you, so you get the most from your session. Contact us for sessions with Nicki Charalambous. Seeing both her daughters live and face the challenges, having had both types of surgery, one of them pioneering to correct a severe scoliosis, Nicki understands the discomfort, pain and disfigurement a scoliosis can cause and create, when the spine bends and twists the rib cage. She can aid, guide you and knows how to give the right support to you. Whilst training and teaching you and your body to be strong.
Using this method and through her experienced knowledge, you will become equipped with better coping mechanisms. Whether you have a slight/mild scoliosis or a severe scoliosis. Nicki can help you.
Our new ‘Gyrotoner’ equipment is specially designed to improve mobility in your joints, such as your hips and shoulders, without loading or stressing them. All movement starts from your centre of gravity, or ‘Seed Centre’. Through the Seed Centre, Gyrotonic mobility engages and integrates your entire body as you work your joints through their ranges of motion. The Gyrotoner, then, is the perfect solution to ease stiffness and naturally enhance mobility throughout your body.
Gyrotonic® exercise gently mobilises your spine, easing strain and restriction. The three-dimensional flow of movement enhances flexibility in all planes. It opens the chest, combatting the inward curve that can arise from postural, emotional or traumatic issues. An inwardly curved chest limits shoulder function and affects the extent of our reach. This unique approach connects movement to breath, activating the deep core muscles to improve strength, flexibility and posture. Its mindful nature heightens body awareness and improves co-ordination.
The GYROTONIC® method stimulates the integration of nerve, muscle, skeletal, respiratory and cardiovascular systems – all of which can be affected by scoliosis.