Treatment of Scoliosis
You're not alone. Many experience the discomfort and challenges that come with Scoliosis, feeling uncertain about how to improve their condition.
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Scoliosis affects more kids and teens than most people realise, and as such many are living as an adult with scoliosis. In fact, it's such a common spine condition that it has prompted a wide range of treatment options and support communities to help manage it.
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Postural conditions can be congenital (caused by a spinal malformation at birth), idiopathic (caused by asymmetrical/abnormal bone growth), neuromuscular (caused by a condition) syndromic (connective tissue/ hyper-mobility) and can also onset or progress as an adult (degenerative).
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It is important to see a qualified health professional to ascertain the type of postural conditions you may have and the best treatment.
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At QLD Scoliosis & Spine Clinics, we treat all types of postural conditions of the spine and ribcage, in all ages.
Pectus
Changes in ribcage shape Pectus excavatum is where the sternum and ribs grow inwards toward the spine Pectus excavatum is where the sternum and ribs grow outward and bracing is very useful at treating this in growing kinds/teens
Scoliosis
Scoliosis, a condition characterised by a curvature of the spine in 3 planes of movement - torsion/ twisting of the spine is the main clinical feature, along with a sideways curvature and often a flat or rounded back. There are different types of scoliosis. Often scoliosis present in one of the growth spurts; infantile, juvenile, or adolescent. 80% of cases are idiopathic are are most likely due to a combination of factors including genetic history, and can progress during any rapid period of growth, or later in life. Some are associated with disorders of the brain, spinal cord or muscular systems that can cause alterations in muscle tone and inability to support usual spinal alignment. Physiotherapy and bracing is effective in most cases at preventing/lessening curvature progression to surgical range, improving rib cage mobility, posture and respiratory function and to prevent/minimise the onset of associated complications.
Congenital defects
Congenital defects Abnormal vertebrae growth during foetal development, can cause changes in spine shape and progress during growth spurts.Casting and bracing often aim to lessen progression but often surgery may be needed need to correct. Physiotherapy aims to minimise pain, improve spinal stabilisation, minimise postural collapse, improve aesthetics and maintain function and quality of life.
Hyperkyphosis
Scheuermann's disease describes a condition where the vertebrae grow more at the back than the front resulting in wedge shaped of the vertebrae, causing greater than normal kyphosis. Physiotherapy and bracing are effective at limiting progression, treating pain and improving posture and function.
Adult postural conditions
Degenerative Scoliosis and kyphosis More than 60% of adults over 65 years old will have  some type of curvature in their lower spine usually due to asymmetrical degenerative / age related changes in the spine which in turn, leads to an uneven distribution of load and increased wear of other spinal structures - pain is very common due to the resultant stress on soft tissues and bony, neural structures. Physiotherapy can help with addressing pain , improving posture and function and lessening progression.
Stop your curve from progressing and support your scoliosis for a pain free life
​QLD Scoliosis and Spine Clinics offers specialized, evidence-based scoliosis treatment through a broad spectrum of treatments tailored to age, including but not limited to, scoliosis bracing and scoliosis physiotherapy, ensuring a holistic approach to managing this condition. Understanding how scoliosis is treated involves recognizing the importance of a multidimensional treatment plan that may incorporate additional therapeutic options to complement physiotherapy, such as specific bracing techniques or, in certain cases, considering surgical interventions for more severe curvatures.​
Treatment of Scoliosis in Kids and Teens
Treatment is determined based on curve magnitude, probability of curve progression or known curve progression and skeletal and sexual maturity.
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10 -15 degrees - Exercises & monitoring
16 - 20 degrees - Exercises, part time bracing & monitoring
> 20 degrees - Exercises, full time bracing
> 50 degrees - Surgical referral, sometimes bracing
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Physiotherapeutic Scoliosis Specific Exercise
Scoliosis exercises are helpful at any stage of your journey - whether you are watching and waiting or wearing a brace, there are multiple research studies supporting their use, especially during the period of monitoring where they were shown to be superior than monitoring alone in lessening risk of progression, improving posture, respiration, muscle endurance and quality of life (Schrieber et al 2015).
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Bracing
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Scoliosis bracing is the most common non-surgical treatment often needed for progressive scoliosis especially in younger patients and is often prescribed by your specialist to try and stop the curve progressing and avoid surgery, according to one high quality study bracing was 70% effective at preventing curve progression and can be up to 92% effective if wearing a 3D style scoliosis brace (Weiss et al 2017). Combing bracing with specialised exercise programs are shown to be more effective than bracing alone (Hong et al 2017).
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Surgery
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Surgery for scoliosis is often considered when the curvature is at risk of progression as an adult and/or significantly impacts the patient's quality of life or poses health risks. The choice between a back brace for scoliosis and surgery depends on multiple factors, including the severity of the curvature, patient age, and potential for growth.
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Treatment of Scheuermann's Hyper-Kyphosis
Treatment is determined based on curve magnitude, probability of curve progression or known curve progression and skeletal and sexual maturity.
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50 - 59 degrees - Exercises & monitoring
60 - 79 degrees - Exercises, full time bracing & monitoring
> 80 degrees - Exercises, sometimes bracing & surgical referral
* If pain is present soft bracing may be utilised for postural support​
Physiotherapeutic Scoliosis Specific Exercise
In a randomised control trial, back exercises in general, and Schroth therapy in particular, is an effective treatment for preventing and significantly improving the thoracic Cobb angle and symptoms in Scheuermann’s patients (Bezalel et al 2019).One study looking at Schroth exercises in young female and male adults with thoracic and thoracolumbar Scheuermann's kyphosis showed improvement in pain with intensive rehabilitation (Weis et al).
Bracing
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3 point bracing systems are used in curves exceeding 60 degrees to stabilise progressive curves or improve posture in some curves.
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Surgery
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Surgery is considered in curves exceeding 70 degrees to stabilise progressive curves or improve posture in some curves.
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Treatment of Scoliosis and Postural Conditions in Adults
Treatment is determined based on a broad number of factors, particularly curve magnitude, risk of progression, presence/ absence of symptoms and patient goals.
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Without pain, not at risk of progression - Observation​
With pain and/or risk progression - Exercises, sometime bracing
Progressive curves or pain not responding to treatment- specialist referral
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Physiotherapeutic Scoliosis Specific hands on and Exercise based treatment interventions
Specialised physiotherapy and specific, individualised exercise programs help scoliosis patients to overcome their symptoms and adopt a more balanced posture while also reducing pain/stiffness and stabilising/ lessening the curve’s progression without the need for surgery. Bracing is sometimes used for support and pain relief. One study looking at scoliosis exercises in adults with scoliosis showed improvement in posture and Cobb in 68% of patients (Negrini et al 2015).
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