Dr. Clint Woo, DPT, PT
Scoliosis and How Therapy Can Help
Scoliosis is where the spine curves sideways when normally the spine only curves in the front and back directions. As with all conditions, there are varying degrees and thus varying levels of symptoms. I myself have scoliosis which I have been managing with the very same tips that I give to my clients. If you have scoliosis and are reading this, you may have not needed anything for your back while others have needed a brace, fusions, or even implanting rods along your spine! A sideways curvature has ramifications on everything else in the body! Ribs are opened up to one side, shoulder height is affected, muscles have a different length and thus ability to activate properly, hips are uneven thus affecting the way you walk or even sit! Breathing can be affected due to the pressure on lungs, back pain is common, and general fatigue is rarely spoken of, but very likely. So when someone has pain seemingly independent of your spine, think again and realize that the alignment issue may actually be the source! Consider working with someone who has experience working with those with scoliosis of all severities.
As someone with a physical therapy background, my first move would be of course to see the level of curvature of the spine in terms of degrees and see if it is just one curve or two. I would also take into account what your daily routine looks like as this can heavily affect your back pain. We then assess movement and see where the spine has normal mobility, hypomobility, and hypermobility. I think of the spine as a bridge. If one section of the bridge is very loose, then every time a car drives over it, that part will move the most often again and again and again thus getting worn out. The more stiffer parts of the bridge will continue to stay stiff not helping with shock absorption so neither of these scenarios are ideal. From there we will assess if this hypomobility and hypermobility can be at least improved at all to help distribute that stress more evenly across the spine. Yes, even those with Harrington rods can benefit from this sort of assessment! After that we could assess for likely sources of muscle imbalance and attempt to even this out. For example if the scoliosis has caused the right shoulder to elevate, then that shoulder and side of the neck are more likely to have shortened muscles thus a constant tension leading to pain. Those same muscles are also most likely weak from being in a shortened positions. I think of a slingshot that had its band replaced with a shorter one. This would mean less ability to pull back and thus less power. Weak muscles also mean less stability at the joint causing more pain! Instability means joints are not supported and things get to "jingle" around like a rocks in a washing machine. As well as addressing muscle imbalance, it is important to calm muscles down that have been overworked throughout the years. Manual therapy (massage, myofacial release, etc) is an excellent way to let these muscles that have been doing too much to relax. Remember that a tight muscle will cause pain in it of itself as muscles attach to bone by definition! While scoliosis largely does not miraculously straighten out, that's OK! For when we know the back shape will not change, then we simply accommodate. This means working with a PT about how to use pillows to support parts of the spine that need it while sitting at work, driving, and sleeping (the three biggest culprits to exacerbating pain). When living with scoliosis, it's important to fix the things that can be fixed, and intelligently live with the things that can not.
Overall throughout my career, I have had great success with treating back pain for those suffering from spinal deformities without actually changing the orientation of the spine. I see a lot of claims online for "silver bullets" to instantly fix spinal deformities and I am not sure if I buy it. A simple crack here or a new modified type of brace over there is not in my opinion something that can likely change how one's anatomy is! Some follow up my skepticisms by saying it takes years for these miraculous cure-alls to be accepted by the medical field as it needs to be tested and yet that just seems to be a cop-out to explain why something supposedly so perfect hasn't taken the world by storm.
In the end, we know that the right combination of postural assessment, exercise, manual therapy, and accommodation can help decrease pain, improve your function, all while working around the unique anatomy that you have! THAT is what works!
Take these factors into account for a healthier you. If you have any pain or fear of developing pain, email us at firstname.lastname@example.org to discuss with Dr. Clint Woo how to work on your goals!
This is not intended to be professional advice. Please speak with a physician or physical therapist. Invest in yourself by bring the physical rehab to in your home or online! We at Woo Physical Therapy and Wellness LLC are proud to serve the Anne Arundel, Howard, and Prince George's counties in-home and online anywhere in the U.S. for general wellness!