Scoliosis is a medical condition that results in an abnormal curvature of the spine. It can affect people of all ages, but it is most commonly diagnosed in children and adolescents. There are different types of scoliosis, including:

• idiopathic scoliosis (of unknown cause)
• congenital scoliosis (caused by vertebral abnormalities at birth)
• neuromuscular scoliosis (resulting from neurological or muscular conditions)

What are the early signs of scoliosis?

The signs and symptoms of scoliosis can vary depending on the severity of the condition. Some common signs and symptoms of scoliosis include:

1. Uneven shoulder height: One shoulder may appear higher than the other
2. Uneven hip height: One hip may appear higher than the other
3. Asymmetric waistline: The waistline may appear uneven or have a curve
4. Rib prominence: One side of the ribcage may appear more prominent than the other
5. Back pain: Scoliosis can cause back pain, particularly in cases where the curvature is severe
6. Limited mobility: In severe cases, scoliosis can limit mobility and cause difficulty with activities of daily living
7. Fatigue: Children with scoliosis may experience fatigue as their body works harder to maintain balance and alignment

It is important to note that scoliosis can develop slowly, and in some cases, children may not experience any noticeable signs or symptoms. If scoliosis is suspected, further evaluation by a healthcare professional, such as a physiotherapist is highly recommended.

What does the current research say?

There is ongoing research in the field of paediatric scoliosis management aimed at improving treatment outcomes and reducing the need for surgical intervention. Some common themes throughout the research include early detection and screening and quality of life. Early detection and screening are important for identifying scoliosis in children at an early stage when it is easier to manage. Researchers are exploring new screening methods and techniques that can be used to detect scoliosis earlier, such as 3D imaging and artificial intelligence algorithms.

Non-surgical interventions such as physiotherapy, bracing and low tone compression garments have been used for many years for managing scoliosis in children. Physiotherapeutic scoliosis-specific exercises (PSSE) have been found effective in avoiding bracing and halting the progression of curvature in adolescents with idiopathic scoliosis (AIS).

Postural care has progressed significantly in the last decade. It is a way of preserving and re-establishing body shape for people with movement difficulties. The principles of posture care are about ensuring that everybody with movement difficulties has their body shape protected over a 24-hour period, in all settings including when sleeping, sitting in a chair or standing.

Physiotherapeutic scoliosis-specific exercises (PSSE) and interventions are effective treatment options for children with scoliosis, especially for those with mild to moderate curvature. Physiotherapy aims to improve spinal alignment, mobility, and strength through a range of exercises and techniques.

What type of physio can help children with scoliosis?

Some of the physiotherapy interventions used for children with scoliosis include:

1. Active exercises: These are exercises that are performed by the child, such as stretching and strengthening exercises and games, to improve spinal alignment, function and range of movement.
2. Passive exercises: These are exercises that are performed on the child, such as manual stretching or massage techniques, to improve spinal alignment and mobility. This can include hydrotherapy interventions.
3. 24-hour postural care/education: This involves teaching the child correct posture and body mechanics to improve spinal alignment and reduce stress on the spine. Providing equipment for the child over a 24-hour timeframe including appropriate sleep systems, wheelchair/ stander/ walkers to support posture.
4. Breathing exercises: These exercises aim to improve respiratory function, which can be affected by spinal curvature.
5. Bracing/low tone trunk garments: In some cases, a brace may be recommended to help control the progression of scoliosis. Physiotherapists can work with the child and their family to ensure proper fit and use of the brace/ or a compression garment depending on severity.

It is important to note that the effectiveness of physiotherapy interventions may vary depending on the severity and type of scoliosis. Therefore, it is recommended to consult with a healthcare professional, such as a physiotherapist, to undergo an extensive assessment and determine the most appropriate treatment plan for each individual case.

References:

Negrini, S., Donzelli, S., Negrini, A., Parzini, S., Romano, M., & Zaina, F. (2019). Specific exercises reduce the need for bracing in adolescents with idiopathic scoliosis: A practical clinical trial. Annals of Physical and Rehabilitation Medicine, 62(2), 69–76. https://doi.org/10.1016/j.rehab.2018.07.010

Improving the Health and Wellbeing - Commissioning guide for CCGs. (n.d.). NDTi. https://www.ndti.org.uk/resources/improving-the-health-and-wellbeing