Further therapeutic measures

If the hunchback is more pronounced, so-called orthoses, i.e. corsets, provide relief and straightening of the spine. This is often used for children in the growth phase. If the hunchback is so pronounced that conservative measures are no longer sufficient, surgery is also performed.

In physiotherapy, in addition to strengthening and stretching, much work is done with manual therapy and mobilization of the thoracic spine. These three therapeutic measures are presented in more detail below. In manual therapy, work is performed directly on the spine.

The vertebrae are mobilized according to their biomechanics. This can be done in a sitting or lateral position. It is important to mobilize the spine in an upright position, as this is where the greatest problems occur.

If there is little movement during mobilization, blockages may occur. The therapist gently releases these blockages and also mobilizes the ribs, which can inhibit movement. Due to the compensatory hyperlordosis of the lumbar and cervical spine, this area should also be mobilized into increased flexion.

If blockages are present here, these are also gently released. If the spinal column is difficult to mobilize, this could be due to excessive tension of the muscles. Soft tissue techniques can be used to lower the tone.

It is important that the patient is instructed in self-mobilization. Self-mobilization is enormously important for the patient to find his way out of the incorrect posture. Just like the erection, the rotation of the spine is very important.

The position can be chosen freely. A ball or weight can be used to support the spine, otherwise the hands can be used in a prayer position and rotate to the right and left.To lean sideways while standing, let your arms hang down next to your body and slide your arms along the side. All the mobilization exercises should be done as often as possible to improve the posture.

In the seat, the patient is instructed to straighten the back with the head, chest and pelvis directly above each other so that the body is straight. In order to increase the uprightness, the patient straightens up and curls back forward. It is important to pull the shoulders back with the patient to achieve complete tension in the straightening process.
When standing he should always make sure to keep his back straight and not be pulled into the usual position.
An equally good mobilization exercise is in the quadruped position.
Here he pushes the spine towards the ceiling “cat’s hump” and in the opposite direction, lets himself sag (pot-bellied pig).
In addition, the prone position is ideal for overstretching the thoracic spine. The hands are held loosely at the temples and the entire trunk is lifted. Pulling the shoulder blades together strengthens the straight position of the thoracic spine.
In addition, with the help of all aids (rod, yoga ball, medicine ball) in a sitting or standing position, the spine can be trained in an upright position by lifting the device upwards.

A corset for the spine should be worn when massive shifts and above all pain occur.

In the case of a hunched back, there is an erection orthosis which ensures that the back tends to be kept straighter. This orthosis is used for adults who already show a clear protrusion or who will have a rounded spine in the long term due to Bekhterev’s disease. In this case, this orthosis can already be worn as a preventive measure.

For children, a corset is used during the growth phase. This is a little lighter than the one used for adults and should not interfere with play. Especially children with a diagnosed Scheuermann’s disease should consider a corset fitting to avoid a hunchback.

If a corset is prescribed by a doctor, it should be worn daily and for the period of time indicated by the doctor. In children it will be at least for the entire growth period. Besides the straightening orthosis there is a corset for scoliosis, which is even more important. Scoliosis causes a complete twisting of the spine, which can also have a negative effect on the organs. Children are diagnosed with scoliosis at an early age and should be treated immediately with appropriate therapy and corset if they have a certain degree of scoliosis.