Scoliosis

Description

Managing Scoliosis

For anyone, exercise has many health benefits and is important for maintaining strength and muscle tone and stabilizing weight. Early studies did not find any reduction in or slowing of progression of curves with exercise. Few were performed, however, and researchers in Germany are suggesting that such studies were done before specific exercises were developed that might be helpful. Some centers claim that an in-patient program with exercise-based therapies can reduce progression. In one German study, patients with an average curvature of 27% showed less progression after physiotherapy than that expected in patients with no treatment.

Stretching exercises may be beneficial in children whose scoliosis is due to uneven leg lengths or a shortened tendon.

Alternative Nonsurgical Procedures

Strengthening the Muscles That Turn the Torso. A promising approach focuses on training and strengthening the muscles that turn the torso. Studies using specific equipment (e.g., MedX Torso Rotation machine) are showing promise. In a 2003 California study, 16 of the 20 patients study experienced curve reduction and no curves progressed. In an earlier study, patients increased strength from 12% to 40%. One girl with a severe lumbar curve required surgery, but there was no progression of curvature in the remaining 11 patients, and four of the patients experienced a reduction in their curvature. No braces were used. Clinical trials using this approach are underway in California, Maryland, Missouri, and Tennessee. Exercising the torso to build muscle strength is important, in any case, in conjunction with braces.

ASCO Scoliosis Treatment Method. ASCO Scoliosis Treatment Method is a Russian approach that consists of isometric and stretching exercises, vibration, spinal manipulation, and electrical muscle stimulation. Some US centers are reporting success in halting curve progression but more research is needed to determine possible benefits.

Biofeedback. Biofeedback has been investigated on the premise that being given a signal to improve ones posture when slumping may reduce spinal deformities in some cases. (Some experts believe that braces work only because the young patients self-correct their curves by retraining their posture to avoid the discomfort of the brace.)

Chiropractic Care. There are numerous case reports that chiropractic manipulation of the spine may help stop progression of mild curves. However, no rigorous studies have been done to prove this. One small 2001 study reported no benefits from chiropractic in girls with spinal curves less than 20 degrees. (About 80% of such curves will not progress significantly without any treatment.)

Improving Lung Function

Airway Ventilation at Night. Some studies have investigated the use of airways systems, such as nasal continuous positive airflow pressure, for patients with severe scoliosis and reduced lung capacity. Such systems are used during the night to force air into the upper airways and into the lungs. In one study, the use of these devices reduced hospitalization and improved lung function, shortness of breath, and fatigue. Such systems are used in the treatment of sleep apnea, a common sleep disorder.

Breathing Exercises. Breathing exercises may help improve lung function in children with scoliosis and signs of lung problems.

Heel Lifts for Secondary Scoliosis

When secondary scoliosis is caused by differences in leg lengths, adding lifts to the heels may decrease a mild curvature. In one study it decreased by an average of 5.3 to 7.5 degrees. (Curvatures were all less than 20 degrees.) Patients with the greatest curvature experienced some muscle pain, fatigue, and even nausea during the first few days they were using the lifts, but these symptoms eased within 10 days.