Scoliosis & Body Image
‘Body image’ is the name given to your perception of your own appearance. It is not necessarily linked to how others see you – someone may have a negative body image even if everyone else thinks they are very attractive.
A person’s body image can be affected by many different factors, although it is often argued that the media plays a particularly large role. Magazines and TV shows have frequently been accused of promoting a single, idealised standard of beauty, and this can adversely impact a person’s body image if they do not conform to that standard.
 
However, that’s a discussion for another day. Today we’d like to specifically look at the impact that scoliosis (a sideways curvature of the spine) can have on an individual’s body image.
 

The visible effects of scoliosis

The symptoms of scoliosis are many and varied. Many of them are invisible; for instance, you probably wouldn’t be able to tell whether a scoliosis patient was suffering from back pains, compromised breathing, or reduced flexibility just by looking at them.
 
However, if we’re talking about the impact scoliosis has on a person’s body image, it’s not the invisible symptoms we’re interested in – it’s the visible effects of the condition. Scoliosis sufferers are often identifiable by the following traits:
  • Visibly curved spine
  • Leaning to one side
  • Uneven shoulders, hips, legs, waist, and/or rib cage
These are the symptoms that can (and often do) negatively impact a scoliosis sufferer’s self-image. Because these physical characteristics depart from society’s definition of what a ‘normal’ body looks like, people with curved spines sometimes end up feeling ugly, unattractive, and/or awkward-looking.
 

Body image concerns amongst teenage scoliosis sufferers

Since idiopathic scoliosis (the most common form of scoliosis by some distance) usually develops during adolescence, there are many, many teenagers who suffer from scoliosis. If you’ve been through puberty, you’ll know that pre-teens and teenagers can be very sensitive about how they look – low body image is common even amongst teens without curved spines, and so the psychological impact of scoliosis on adolescents should be a key concern for those who seek to treat this condition.
 
The problem is that most forms of scoliosis treatment focus on halting the progression of the curve itself. This is an indisputably crucial goal, but helping scoliosis sufferers to achieve a positive body image is very important as well, especially given the impact that a negative body image can have on an individual’s mental health.
 

Boosting your body image

A little while ago, we conducted some research into our own ScolioGold treatment programme and its effect on patient body image. A detailed summary of this research project can be found here, but in case you’re not able to read the full document right now, here are our key findings in brief:
  • Patients reported a significant improvement in body image post-treatment.
  • All age groups (juvenile, adolescent and adult) reported substantial improvements.
  • These results suggest that intensive exercise-based programmes such as ScolioGold could be a very effective approach to treating certain psychological impacts of scoliosis.
Click here to find out more about our exercise-based treatment courses, or contact us today if you’d like to book a consultation.
20 degree scoliosis resultsperson-19person-19person-19
Scoliosis isn’t always easy to identify, but if a patient suspects that they may be experiencing symptoms associated with the condition, they will usually be given a physical examination before being sent for an X-ray to confirm the presence of an abnormal spinal curvature. This curve is measured using a metric that is commonly referred to as the Cobb angle, which is used to identify the degree of scoliosis present in each sufferer’s spine.
cobb angle x-ray
If the Cobb angle is less than 10°, this is usually an indication of a perfectly normal spine (since the human spine always has a certain degree of deviation – nobody’s back is totally straight). 10° is usually used as the threshold for diagnosing scoliosis; if the Cobb angle is identified as exceeding 20°, treatment is routinely recommended so as to prevent further curve progression, which can cause an increasing number of health problems if the Cobb angle is left to worsen. In some cases, treatment is also advised for those who have a curve between 10 and 20°, depending on a variety of different factors in each individual case.

What is 20 degree scoliosis?

In simple terms, the severity of an individual’s scoliosis is assessed on a scale ranging from mild (Cobb angle of 10-25°) to moderate (26-40°) to severe (40°+). This means a curve that measures around 20 degrees would be classed as mild scoliosis, which is obviously the least debilitating form of the condition.
However, while the word ‘mild’ may suggest that this form of scoliosis is fairly harmless, it does carry a significant risk of progression. This risk can increase up to 100% for a diagnosis in very young children once the curve exceeds the 20° mark. In cases of mild scoliosis, it is beneficial to undertake preventative measures in order to reduce the curve at an early stage and give yourself the best chance at limiting progression.

What are the symptoms?

Patients with 20 degree scoliosis usually suffer from one or more of the following symptoms:
  • Uneven shoulders and hips
  • Forward or tilted head posture
  • Legs appearing to be uneven
  • Mild pain
  • Clothes hanging unevenly
This form of scoliosis is most commonly found in adolescent females, although it can affect individuals of both genders, ranging from young people to fully-grown adults.

Treating 20 degree scoliosis

Young patients with mild scoliosis will usually be recommended to wear a specially-fitted back brace –  read about bracing here.
scoliosis treatment
At the Scoliosis SOS clinic in London, we practice an alternative form of scoliosis treatment called ScolioGold therapy. It is suitable for brace-wearers as well as those who opt to pursue a less restrictive form of curve prevention.
Our treatment programmes combine a variety of proven, non-surgical techniques, which are used to address multiple aspects of the condition and provide long-term results. Over the years, we have successfully treated patients with curves ranging from mild to severe, leading to Cobb angle reduction along with the improvement of pain, mobility, and visible symptoms.

Case Study: Lottie, aged 12

Lottie is a young dancer who was diagnosed with a 19° scoliosis curvature. She came to us for treatment to help prevent her scoliosis curvature getting worse as she grew. She really enjoyed her treatment with us and knows that she will be able to prevent her condition worsening by continuing to practice her exercises at home. See our full interview with Lottie here:

Schroth Method vs. ScolioGold
 
Originally, the Schroth method was the primary form of physical therapy used to treat scoliosis here at the Scoliosis SOS Clinic. However, we soon realised that there were several disadvantages to relying on this method alone. While Schroth remains a core element of the treatment we provide, we have since combined it with a variety of other well-established, scientifically proven spinal techniques to create the ScolioGold method, a far more comprehensive treatment programme that addresses all aspects of the patient’s condition. 
 
In order to explain the differences between these two approaches more clearly (particularly for those who are researching the benefits and limitations of non-surgical therapy), we have put together a useful guide which compares the Schroth method to our own ScolioGold therapy:

What is the Schroth method?

Schroth Exercises
 
Developed by Katharina Schroth in 1921, the Schroth method is a conservative exercise therapy that takes a three-dimensional approach towards elongating the trunk and correcting imbalances of the spine. This therapy aims to develop the inner muscles of the rib cage in order to change the shape of the upper trunk and correct any spinal abnormalities in all three planes of the body: sagittal, frontal, and transverse. This means that correction needs to occur not only from side to side and front to back, but also longitudinally. The Schroth method also places emphasis on the conscious correction of posture during daily living, as well as during strenuous exercise periods.
 
Schroth’s technique involves an intensive course of inpatient physiotherapy, lasting 6-8 hours per day for 4-6 weeks. Following the inpatient treatment, it is recommended that the patient maintains an at-home follow-up routine consisting of 3-4 exercises for 30 minutes each day; this helps to maintain the improved postural balance gained during therapy.
 
A Schroth treatment programme includes the correction of the scoliotic posture and breathing pattern with the assistance of proprioceptive and exteroceptive stimulation and mirror control. Using sensorimotor feedback mechanisms, the patients learn an individual correction routine and corrected breathing pattern, providing them with the tools to maintain the results of their therapy. There is no formal follow-up or aftercare, which means that the treatment relies solely upon the patient once their course is completed. 

The ScolioGold Method

ScolioGold
 
The ScolioGold Method was developed by the Scoliosis SOS team in 2006, replacing the Schroth method as the primary form of treatment delivered here at our clinic. The principal components of ScolioGold therapy include:
  • Katharina Schroth & Rigo-Schroth methods
  • Functional Independent Treatment for Scoliosis (FITS method)
  • Proprioceptive Neuromuscular Facilitation (PNF method)
  • Scientific Exercise Approach to Scoliosis (SEAS method)
  • Orthopaedic Medicine
Our treatment courses also incorporate several common manual physiotherapy techniques, such as:
  • Myofascial release
  • Osteopathy
  • Trigger point  therapy
Treatment is further facilitated and accompanied by other techniques such as acupuncture and dry needling.
 
ScolioGold therapy is tailored to suit the specific concerns and demands of our patients, and involves ergonomic assessments, pedoscans, and insole fitting to optimise posture and back health. The ScolioGold programme is also continually monitored and developed according to the latest scoliosis research, ensuring that we always provide the best possible care for patients. Treatment can be carried out in an intensive group setting of 1, 2 or 4-week courses; alternatively, many patients elect to receive treatment through individual 1:1 outpatient-style appointments of between 1 and 3 hours per visit. There is no limit to the number of therapy sessions you can attend, and a long-term treatment plan is provided in order to continually care for our patients.
 
The aim of the ScolioGold Method is to enable patients to maintain a more central posture during everyday activities, and is based upon 5 core principles:
 
  1. Body and Postural Awareness – Improving the patient’s understanding of their condition, anatomy and physiology, as well as representing their specific classification using the system of blocks.
  2. Axial Elongation – Stretching of the spine to open up areas of collapse and to better align the trunk whilst activating the muscles to address muscular imbalance.
  3. De-Rotation – Corrections of asymmetries in the transverse plane, using passive corrections (beanbags and wedges) to de-rotate the thorax assisted by rotational breathing.
  4. De-Flexion – Corrections in the frontal plane addressing coronal imbalance, pelvic torsion, rotation and shoulder positioning.
  5. Isometric Contraction – Prolonged muscle contraction to re-enforce corrections.
 
To find out more about ScolioGold therapy, please click here. You can also get in touch with Scoliosis SOS by calling 0207 488 4428 or by filling out our contact form.
Shoulder Pain
 
Given that scoliosis is a disorder of the spine, you might assume that the pain experienced by some scoliosis sufferers is exclusively concentrated in the back. But a person with a curved spine may also notice a degree of shoulder pain in addition to (or instead of) the more common back pains.
 

Why does scoliosis cause shoulder pain?

When a curved spine causes shoulder pain, it usually happens because the curve is located near the top of the spine and the muscles in this region are working harder than normal to control – and compensate for – the unusual angle. This puts a strain on those muscles, which may be felt as an ache or pain in the shoulder.
 

How severe is the pain?

The important thing to remember is that no two scoliosis patients have exactly the same experience. Even two people with exactly the same Cobb angle may report drastically different symptoms: one may feel no discomfort at all, while the other may be in such extreme pain that they require medication just to make it through the day.
 
The above applies to shoulder pain just as much as it applies to back pain. Shoulder pain (when it arises as the result of a spinal curvature) is usually limited to an achy or uncomfortable feeling – some scoliotics report feeling like they have a ‘knot’ in their shoulder – but it can be more severe in some cases.
 

How can shoulder pain be treated?

Extreme pain arising from a curvature of the spine may be treated using pain relief medication (various strengths may be prescribed depending on the severity of the pain). 
 
However, we at the Scoliosis SOS Clinic have found that an exercise-based physiotherapy regime – namely our own ScolioGold programme – can be very effective for relieving back and shoulder pain. We use a combination of methods, including Kinesio Taping and myofascial release, to reduce pain and inflammation while improving mobility and generally helping the patient to live a more comfortable life.
 
Phoebe from Crystal Palace is one of the many scoliosis sufferers whose shoulder pain we have helped to alleviate. Watch the video below to find out what she thought of her time at the Scoliosis SOS Clinic:
 
 

Other Useful Links:

Scoliosis (and its symptoms, such as chronic pain and reduced mobility) can have a huge impact on the lives of those affected by it. However, as many scoliosis sufferers will no doubt agree, it can make a huge difference simply to speak to other people who are suffering from the same condition.
Scoliosis Support
With that in mind, here is a list of scoliosis support groups (both online and offline) around the world. We will be updating this list periodically, so if you run or know of a scoliosis support group in your territory, please let us know via Twitter (@ScoliosisSOS) and we will consider expanding our list accordingly.

Scoliosis Association (UK)

SAUK is a nationwide support organisation for scoliosis sufferers in the United Kingdom (and their families). They provide advice and information on the condition, and aim to raise awareness both within the healthcare industry and amongst the general public. Their helpline (see number above) is manned from 9am to 5.30pm every weekday, and it allows people to phone up and receive friendly guidance and support instantly.

National Scoliosis Foundation

Headquarterered in Massachusetts, the NSF is a nonprofit organisation that aims to help “children, parents, adults, and healthcare providers to understand the complexities of spinal deformities such as scoliosis.” They offer numerous different types of support, including early screening programmes, advocacy / awareness initiatives, and numerous informative resources for scoliosis sufferers and their loved ones.

Curvy Girls

Curvy Girls was founded in 2006 by a young scoliosis sufferer named Leah. It began as a small support group specifically aimed at children and young people with scoliosis, and it has now grown into an international success, with groups currently meeting in a dozen different countries on six continents across the globe (see list above).

Vereniging van scoliosepatiënten

This Dutch-language website (roughly translated, the name means ‘Association of Scoliosis Patients’) hosts a wide array of informative resources for scoliosis sufferers, as well as a forum where Dutch-speaking scoliosis patients can interact with and support each other.

Beyond A Curved Spine

Beyond A Curved Spine is a “scoliosis awareness hub” based in Lagos, Nigeria. They aim to raise awareness of the condition while also providing financial and emotional support to scoliosis patients who need it.

SupportGroups.com

SupportGroups.com is a website that houses online support groups (forums) for a wide range of different conditions and life events, from depression and eating disorders to divorce, alcoholism, PTSD and more. Their dedicated scoliosis group is 17,800 members strong at time of writing, and the forum’s open style encourages users to share their feelings and offer support and a friendly ear to fellow scoliotics.
This list is curated by the Scoliosis SOS Clinic – click here to find out more about us and what we do.