Phsyiotherapist with patient

When performed correctly, physical therapy is an effective form of treatment for scoliosis, and is often used as an alternative to having to wear a back brace or undergo spinal fusion surgery. However, physiotherapy is a very broad and varied field, and it can be hard to decide which type of physical therapy is best-suited to combating your spinal curve. The NHS provides physiotherapy treatment for scoliosis sufferers, and many people resort to this to treat their condition. However, here at Scoliosis SOS, we offer a different form of physiotherapy that we call the ScolioGold method, and we feel it’s a more effective form of physiotherapy that will provide far better results than those available from the NHS. In order to demonstrate this, we’ve compared the two treatment methods and shown you where we differ from NHS physiotherapy below.

Physiotherapists

  • ScolioGold
Our physiotherapists have been specifically trained to treat scoliosis, and have also undergone months of extensive additional training and examinations to ensure they have the skills to treat a whole range of complex spinal conditions (including hyperkyphosis).
  • NHS Physiotherapy
There are no specialist physiotherapists for scoliosis at the NHS, and although they may have physiotherapy degrees, a recent study highlighted physio students’ lack of knowledge when it came to scoliosis and how to treat it. Our medical team are regularly invited to guest lecture on scoliosis at a number of UK universities and hospitals.

Treatment

  • ScolioGold
Our ScolioGold method is a hybrid of several scoliosis-specific treatments, exercises and methods from all around the world. By combining techniques such as FITS, SEAS, and osteopathy, we aim to provide the best non-invasive scoliosis treatment possible. In order to target each patient’s goals and give them the best possible care, we offer a combination of hands-on group therapies and individualised scoliosis-specific exercises. Our treatment method is continually monitored, and it constantly develops to reflect new advances in the non-surgical field, thus ensuring that our therapy continues to deliver gold-standard results. There’s no limit on the number of therapy sessions we can provide; you may attend as many as you feel you need. As well as providing physiotherapy, we also deliver radiation-free spinal and gain scanning, ergonomic assessments, and insole fitting to optimise posture and back health. We also provide patient education and long-term treatment and care plans for this lifelong condition.
  • NHS Physiotherapy
NHS physiotherapy programmes consist of generic stretches and strengthening exercises that are non-specific to your condition. There’s minimal hands-on therapy due to time constraints, and in some hospitals, physiotherapists are no longer allowed to even touch their patients, instead directing them to websites for advice and care. There are an increasingly limited number of physiotherapy sessions available due to NHS budget cuts, and most trusts offer a maximum of 6 x 30 minute appointments. Furthermore, you will often not see the same therapist from one session to the next, which results in a lack of continuity in care. There’s also no aftercare, no follow-up appointments, and no ongoing advice or support. 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.
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.
 
Lumbar scoliosis refers to the sideways curving of the lower back, known as the lumbar area of the spine. While this form of curvature can be linked with congenital scoliosis at birth, and may also occur as a result of a neuromuscular condition in adulthood, it is most commonly identified in patients with idiopathic scoliosis.  
 
Lumbar scoliosis can be visually identified using an X-ray or Adam’s forward-bend test, and is characterised by the distinctive ‘C’ shaped curve in the lower section of the spine and the apex of the curve has to be one of the lumbar vertebra. It differs from thoracolumbar scoliosis, which is when a single curve spans between the bottom few vertebrae of the thoracic spine and the top few vertebrae of the lumbar spine and the apex of a thoracolumbar curve has to be at either T12 (twelfth thoracic vertebra) or L1 (first lumbar vertebra). A lumbar scoliosis can occur in combination with a thoracic scoliosis to form an ‘S’ shaped curve, with the thoracic curve going in one direction (left or right) and the lumbar curve going in the other (right or left).
 
In most cases, symptoms of lumbar scoliosis will be distinguished during early to mid childhood, although in cases of adult degenerative scoliosis, it can also be linked with a number of corresponding conditions, including lumbar spinal stenosis and osteoporosis. 
 
Some visual symptoms of lumbar scoliosis include:
  • Uneven shoulders
  • Unusually raised hips
  • Uneven rib cage alignment 
  • Uneven waist 
  • Body leaning to one side

How is Lumbar Scoliosis Treated?

The recommended treatment for lumbar scoliosis may vary depending on a variety of factors, from the age and health of the patient, to the severity of the spinal curve, and its long-term implications. For those who experience pain and inflammation as a result of lumbar scoliosis, anti-inflammatory drugs such as ibuprofen may be prescribed, in an attempt to reduce discomfort for the patient. In other cases, doctors may recommend a course of corticosteroid injections into the spine, which are performed under X-ray, and can be received no more than four times in a 6-12 month period.
 
In the most severe cases, where the curvature is seen as being likely to progress, and may impact the patient’s overall health and wellbeing, a doctor will often recommend that the patient undergoes a corrective surgical procedure. This is known as spinal fusion surgery, and involves the insertion of rods and screws into the backbones, which prevents the spine from curving. 

Are There Viable Alternatives to Drugs and Surgery for Lumbar Scoliosis? 

An increasingly popular method for treating scoliosis, is the use of physical therapy and exercises, which is the treatment approach that we employ here at Scoliosis SOS. Performing a variety of movements, a physical therapist will work to correct the existing spinal curve and strengthen the patient’s back muscles, for continued maintenance and progress. Those who enrol on our ScolioGold programme, will receive a treatment plan that is tailored specifically to their condition, with an at-home exercise routine to complete once they have concluded their treatment.
 
For more information about how we can treat patients with lumbar scoliosis, please feel free to get in touch today!  You can contact the Scoliosis SOS team by calling 0207 488 4428, or by filling in our contact form.

Scoliosis surgery risks

In many mild cases of scoliosis (i.e. where the patient’s spinal curve is unlikely to progress to an extent that will cause major changes in their appearance or respiratory health), spinal fusion surgery will not be recommended. For those with a severe curve (45-50 degrees or more), surgery is usually recommended – particularly if the patient is a child, as their scoliosis will likely increase as they grow. Scoliosis surgery is also recommended to those whose curves have progressed rapidly over a period of monitoring their condition, as it can prevent further progression and health complications. While spinal fusion surgery is an effective treatment for some patients – and may be the only viable option for those with severe scoliosis – it is important to consider your full range of options before undergoing this procedure. You should also take time to consider any possible risks or complications of undergoing scoliosis surgery, as is advised before any major operation.  

Risks to consider before undergoing spinal fusion surgery

  • Back Pain – In some cases, patients will continue to experience back pain even after undergoing spinal fusion surgery, due to what is sometimes referred to as ‘failed back surgery syndrome’. While the surgery itself may have been a success, this does not necessarily mean that the patient will experience a full resolution of their pre-op symptoms.
  • Failure of Fusion – This occurs when the bone grafts used to complete the operation fail to fuse into solid bone, which can be caused by excessive movement, poor placement of screws and rods, or even the use of anti-inflammatory medication. This can sometimes lead to failure of implants, which can cause breaks, pullouts and chronic pain. If there is no pain and the curve seems to be stable, a broken rod may not be removed.
  • Neurological Complications – Some complaints which may occur soon after surgery include a loss of skin sensation, loss of strength in feet and legs, loss of bowel and bladder control, and in very severe cases, paralysis. These changes can be temporary or permanent and only occur in a very small number of cases, particularly in their most serious form.
The paper Neurological complications in adult spinal deformity surgery states: “Surgery of the lumbar spine for ASD has a neurologic complication rate between 0.5 and 17% and is dependent upon approach (anterior, lateral, or posterior), number of fusion levels [and] case complexity.” This means that the more severe or complex your scoliosis curvature is, the higher the chance that you will experience some neurological complications following spinal fusion surgery.

Other possible surgery risks include:

  • Infection
  • Self-image (due to scarring)
  • Osteoarthritis
  • Limited range of motion/flexibility
 

Is it possible to avoid these risks and complications?

If you are particularly concerned about the potential risks and limitations posed by surgery, it may be possible to eliminate the need for this procedure by reducing your spinal curvature through non-surgical techniques. Here at the Scoliosis SOS Clinic, we have treated a huge number of spinal surgery candidates who came to us in an effort to avoid spinal fusion. Using our ScolioGold treatment programme (which combines a selection of established non-surgical techniques), we have managed to not only reduce the Cobb angle of our patients, but also provide them with a lasting method to manage the symptoms of their scoliosis.  

Post-spinal fusion surgery

We also treat many patients who have already undergone spinal fusion surgery and are seeking help to recover from the procedure more quickly. For many of our post-op patients, the primary complaint is the level of pain experienced after surgery, which can be successfully reduced using our therapeutic techniques. Another key issue for post-surgery patients is mobility, which can also be improved with the guidance and supervision of our experienced physiotherapists.

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