June 8, 2021

Scoliosis Part 2: What's In A Number?

Scoliosis is a sideways curve in your backbone (or spine). Often, it first shows up when you're a child or teenager. The angle of the curve may be small, large, or somewhere in between. But anything that measures more than 10 degrees on an X-ray is considered scoliosis.

If you have a positive scoliosis screening, you need to then follow up with your pediatrician who may also refer you to see an orthopedist.

An x-ray is the likely next step. The x-ray is so important to see what is happening at the spine. It is necessary for true diagnosis. It helps dictate the plan moving forward.

Less than 10 degrees= PT is recommended at this phase. You may not yet have an official diagnosis, but need to be aware of what is going on from a muscle and joint standpoint. It may be you are catching your scoliosis at a very early phase and you will be most successful to start addressing the imbalance to prevent curve progression. Maybe you don't have scoliosis, but a PT assessment can identify the key muscle and skeletal issues whether it is a true scoliosis or if it is another type of imbalance. Imbalances can make you lose speed and power, that is most evident if you are an athlete. Inefficiencies can also translate into pain. Imbalances need to be addressed to prevent pain or worsening of the imbalance.

10-25 degrees = PT is recommended at this phase and depending on age and other factors, treatment may also need to integrate bracing. PT recommended specifically with PSSE(Physiotherapeutic Scoliosis Specific Exercise). This is a fancy way to describe that all PT is NOT equal. When we look at studies to see what is most beneficial for scoliosis..."core strengthening" is only one piece of the picture. We have to be more specific. The PSSE category describes the treatment that does more. Bracing is most commonly introduced between 20 and 25 degrees.

25-40 degrees = PSSE and bracing recommended at this phase. There are more changes to the structure of your spine at this point. This is where bracing comes in to help.

Greater than 40 degrees =surgery may start to enter the discussion. This is never an easy conversation, but a family needs to weigh the pros and cons of surgery and decide what is best for their specific situation. 40d + does not REQUIRE surgery in all cases. Some people choose to continue with conservative methods such as PSSE and bracing. The current research reflects Schroth has the greatest impact with cobb angles up to 55 degrees.

If you receive a positive diagnosis for scoliosis, there is hope. Being proactive and seeking treatment is key.

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