Your spine is not perfectly straight by design -- the natural curves of the spine help to support your back and reduce strain when sleeping, twisting and lifting. However, in some people, the spine can become abnormally curved -- a condition known as scoliosis. Scoliosis can encompass a variety of spinal curvatures, but the term typically refers to a spine that makes an "S" shape. For those whose curvature causes symptoms, conservative treatment methods may include physical therapy. Controversy exists among those in the medical field, however, as to whether these treatments are effective.
Physical Therapy Goals
When a person is first diagnosed with a spinal curvature -- typically at a young age -- physicians may recommend a "waist and see" approach to determine whether the curvature will progress to a problematic degree. In this instance, physical therapy can serve as an intervention, working to prevent a spinal curve from becoming more pronounced. In addition to this goal, both adult and young patients may engage in physical therapy with the hopes of reducing pain, increasing flexibility in the spine or strengthening the core muscles. Also, spinal curvature patients may suffer from breathing problems. Physical therapy may work to address these problems as well.
Treatment Controversy
The idea that physical therapy can correct spinal curvatures is debated in the medical community. According to James Hubbard, a physician writing on My Family Doctor, "No intervention has been known to reverse scoliosis...Exercise, physical therapy and chiropractic manipulation have not been shown to slow it at all." However, organizations like Spinal Dynamics of Wisconsin, located in Wauwatosa, Wisconsin, use physical therapy exercises to "change the asymmetric loading and minimize this progression of the scoliosis curvature." Experts like those at the University of Maryland Spine Center agree that scoliosis cannot be reversed in one group of patients: adults, whose spines have achieved skeletal maturity.
Exercises
While physical therapy may not be proven to have corrective effects for those with spinal curvatures, it can offer soothing results. Physical therapists can instruct in exercises that reduce strain on the back, such as swimming. They also may recommend daily stretches to ease tense muscles and breathing exercises to improve lung function. Special focus also is placed on spinal stabilization exercises that strengthen the muscles around the spine, offering better support for the spine. Examples include lower back lifts where you lie on your stomach and lift your shoulders off the ground, working the lower back.
Modalities
In addition to exercises, physical therapists may recommend special braces as a treatment modality. These braces help to keep your spine better positioned, which can reduce spinal curvature symptoms. If scoliosis renders one leg to be lifted slightly higher than the other, a physical therapist can recommend special shoe inserts to even the legs.
References
- My Family Doctor; Does Physical Therapy for Scoliosis Help? A Doctor Explains; James Hubbard, M.D., M.P.H.; May 2010
- Spinal Dynamics of Wisconsin: An Exercise-Based Option for Scoliosis Management
- University of Maryland Spine Program; A Patient's Guide to Adult Scoliosis; September 2007
- Move Forward Physical Therapy; Physical Therapy for Scoliosis; Elizabeth Reicherter, PT, DPT, PhD, OCS, CHES
