Physical Therapy for Scoliosis

Scoliosis is a spinal deformity that affects approximately 2 to 3 million people in Turkiye. The human spine should look like a straight line when viewed from behind and resemble the letter “S” when viewed from the side. However, in a person with scoliosis, the spine, which should be straight when viewed from behind, is misaligned. From the back, the spine of a person with scoliosis looks like the letter “C” or the letter “S”. This condition causes some cosmetic problems and back pain and requires treatment.

If the curve is less than 40 degrees, scoliosis-specific physical therapy can be used. This includes the use of a scoliosis brace and various exercises. If the curve is more than 40 degrees, surgery will probably be used.

Scoliosis is not a fully curable condition. Instead, doctors try to reduce the patient’s pain, address cosmetic issues such as visible curves, and generally recommend treatment to improve the patient’s quality of life and, most importantly, to stop the progression of scoliosis. The vast majority of patients can be stabilized with physical therapy and bracing without surgery.

How is Physical Therapy for Scoliosis Performed?

In the treatment of scoliosis, there are 3 main treatment modalities recognized by the Scoliosis Research Society. These are

1. Observation
2. Brace treatment
3. Surgical treatments

During the observation phase, the patient’s x-rays taken at regular intervals are compared to determine whether the scoliosis is progressing or stable. For curvatures of less than 20 degrees, the use of corsets and surgical methods are usually not used. For these curvatures, patient follow-up and scoliosis-specific physical therapy options are more appropriate.

To halt progression or improve the patient’s quality of life, exercises and training to relieve pain and strengthen weak muscles may be recommended. Physical therapy options are also available after scoliosis bracing and surgery. General goals of scoliosis treatment may include

• Correcting the curve of the spine
• Pain reduction and control
• Since spinal curvature can cause breathing problems in some cases, these pulmonary problems should be addressed.
• Improving spinal strength and range of motion
• Eliminate cosmetic problems
• Improve posture

Physical therapy is used at every stage of scoliosis, from the simplest curves to adjunctive treatment for severe curves. While it is sufficient in simple cases with curves below 20 degrees, it can be used as an adjunct treatment with the use of a brace above 20 degrees and in the postoperative period for curves above 40 degrees.

In cases of scoliosis with curves below 20 degrees, physical therapy methods and some exercises can be used to prevent the curve from progressing and to improve the person’s quality of life. Simple exercises that can be done at home according to the doctor’s plan are helpful.

Scoliosis-specific physical therapy is important to the success of the scoliosis brace for curvatures greater than 20 degrees, which usually require the use of a brace. Exercises support the use of the brace. For scoliosis over 40 degrees that requires surgery, post-operative exercises under the supervision of a physician will speed up the healing process. However, all of these exercises should be done in appropriate branches in consultation with a physician.

Scoliosis-specific physical therapy movements and exercises are planned on an individual basis. The doctor presents the exercise and physical therapy program to the person, taking into account several factors, such as the person’s age, the degree of scoliosis, and whether or not the curve is progressing.

Scoliosis and Swimming

Swimming, one of the most popular sports for people with scoliosis, is NOT a treatment. In most cases, some sports are not suitable for people with scoliosis because of the curvature of the spine. In fact, some sports can make these spinal curvatures worse. Although swimming minimizes the pressure on the spine thanks to the buoyancy of the water, it can worsen scoliosis in scoliosis patients because it increases hypokyphosis. a person with scoliosis can engage in swimming, except for competitive types, after consultation with their doctor.

Will scoliosis go away with physical therapy?

Scoliosis is a condition that cannot be completely corrected with current medical knowledge. Does physical therapy make scoliosis go away? Unfortunately, the answer is NO. However, treatment methods focus on stabilizing and stopping the progression of the curve. In mild cases, there may even be improvement. Physical therapy is recommended by doctors depending on the condition of the person with scoliosis. It may be used to improve the patient’s quality of life.

Physical therapy methods are mostly related to the ability of the person with scoliosis to easily perform the tasks of daily life. In cases of scoliosis, the patient’s range of motion in the spine may have changed, affecting daily life. For example, the doctor may recommend range-of-motion exercises.

How many days does physical therapy for scoliosis take?

Physical therapy for scoliosis is an effective treatment for any degree of scoliosis. In simple cases of less than 20 degrees, early diagnosis, observation, and physical therapy can lead to improvement. Again, for curves between 20 and 40 degrees, where corset use is generally recommended, physical therapy may be recommended for immobility caused by corset use or problems caused by normal immobility in daily life. For the post-operative period, it is recommended for quick recovery. Unfortunately, there is no clear answer to the question “How many days of physiotherapy? The doctor or physiotherapist will choose the most appropriate treatment plan for you, and the physical therapy process may be longer or shorter depending on criteria such as age, curvature, etc.

Physical Therapy after Scoliosis Surgery

It is a fact that physical therapy is helpful at every stage of treatment. Physical therapy after scoliosis surgery will help speed recovery and increase mobility. The question of when to start exercising after scoliosis surgery is more important than the question of which exercises to do. In general, you can return to your old sports after 6 to 9 months, but it is very important to consult your doctor at this point. Again, the doctor will determine which sports are appropriate for a person with scoliosis.

In people with scoliosis, if the curve is advanced and over 40 degrees, spinal fusion surgery is usually used. For this reason, all kinds of exercises and movements that involve activities such as bending, twisting, and heavy lifting should be avoided in the beginning. However, light and short walks will be good for you. The 6 to 9 months mentioned above is the average recovery time for your bones and muscles. This can vary from person to person. Therefore, it is best for your future life and health to talk to your doctor.  People with scoliosis should avoid any exercise or sports that put pressure on the spine. This can worsen the curvature of the spine and accelerate the curve.

Swimming is generally preferred after scoliosis surgery (you should talk to your doctor about how long after surgery you can swim). The buoyancy of the water reduces pressure on the spine, and strengthening the core muscles in the back helps with recovery after scoliosis surgery.