The treatment of scoliosis (scoliosis therapy) depends on the age of the patient and the severity of the scoliosis. The best therapeutic success with scoliosis therapy is achieved during the growth phase in childhood. If the spine is only slightly affected by scoliosis (curvature below 20°), physiotherapy may be sufficient to strengthen the back muscles.
If the curvature of the spinal column is more severe (over 20°), the vertebrae must be additionally loaded with the help of various corsets in order to avoid consequential damage. Wearing a corset for scoliosis therapy must be consistently maintained, which is especially difficult for children. In principle, the corset must always be worn, one says 23 hours a day.
It should therefore only be taken off for washing. This type of scoliosis therapy must be continued until the end of growth. A corset fixes the trunk and prevents the shoulder and pelvis from twisting against each other.
It works on the principle of pressure and relief. Physiotherapy in addition to scoliosis therapy should never be avoided. In cases of severe scoliosis, surgical therapy must be considered.
In order to optimally prepare the operation, a traction method should be applied in advance. The spine is then stiffened by a procedure called spondylodesis. Patients generally find this stiffening to be not very restrictive.
In stiffening, screws are screwed into individual vertebrae and connected with rods. Corset treatment is not necessary in this case. Several steps are necessary to straighten a scoliosis surgically: The spine must not only be straightened in its lateral curvature, but also rotation and torsion must be compensated.
Various surgical procedures are available: Ventral and dorsal procedures. In the ventral procedure, access is chosen from the front, in the dorsal procedure from the back. In the latter, the vertebral arches (the posterior part of the vertebral bodies) and their posterior extensions are exposed.
If the ventral approach is chosen, the spinal column must be prepared through the abdominal cavity. Like any surgical procedure, this operation also involves risks. The more severe the degree of scoliosis, the more risky the operation.
Possible complications, in addition to the general risks such as bleeding and infection, can include: damage to the spinal cord due to pressure, tension or displacement, circulatory problems, up to (temporary) paraplegia. Unfortunately, the straightening of the spine brought about by the operation can also recede again and the metal implants can tear out. Here are just a few of the possible complications
Exercises for scoliosis
Exercises to promote the back and support muscles are useful. The exercises should be based on the type of spinal curvature. This is mainly ensured with physiotherapy.
Breathing exercises and relaxation techniques can also be helpful. Three general exercises that can be used at home are explained below. However, it would be better to consult a physiotherapist to learn more specific exercises.
The left arm and right leg are stretched out and then bent at the elbows and knees until the two joints below the body touch. When stretching at the beginning, care should be taken to ensure that the back and neck form a straight line with the head. The exercise can be repeated as often as you like.
Afterwards the exercise should be repeated with the right arm and the left leg as often as necessary. Starting position: Prone position, arms stretched out forward, palms of the hands facing the floor, legs stretched out In this exercise the muscles of the whole body should be activated. The muscles are tensed.
The tensed arms and the head should be lifted towards the ceiling. The position should be held for five to ten seconds. Afterwards, the body and arms should be laid down again in a relaxed position.
Starting position: standing straight, back leaning against a wall, both arms relaxed at the sides of the body In this exercise the left arm is stretched over the head to the right and the upper body is bent to the right. This causes a stretching on the left side of the torso. The position is held for about ten seconds and then repeated on the other side.
It is important that the back is straight towards the wall and that the shoulders remain open. In general, exercise in your free time can help you to cope with the illness (muscle training, but also psychological components). Suitable activities are for example: swimming, cycling, jogging or yoga.
Three general exercises that can be used at home are explained below. However, it would be better to consult a physiotherapist to learn more specific exercises. The left arm and right leg are stretched out and then bent at the elbows and knees until the two joints below the body touch.
When stretching at the beginning, care should be taken to ensure that the back and neck form a straight line with the head. The exercise can be repeated as often as you like. Afterwards the exercise should be repeated with the right arm and the left leg as often as necessary.
Starting position: Prone position, arms stretched out forward, palms of the hands facing the floor, legs stretched out In this exercise the muscles of the whole body should be activated. The muscles are tensed. The tensed arms and the head should be lifted towards the ceiling.
The position should be held for five to ten seconds. Afterwards, the body and arms should be laid down again in a relaxed position. Starting position: standing straight, back leaning against a wall, both arms relaxed at the sides of the body In this exercise the left arm is stretched over the head to the right and the upper body is bent to the right.
This causes a stretching on the left side of the torso. The position is held for about ten seconds and then repeated on the other side. It is important that the back is straight towards the wall and that the shoulders remain open.
In general, exercise in your free time can help you to cope with the illness (muscle training, but also psychological components). Suitable activities are for example: swimming, cycling, jogging or yoga. – Starting position: four-footed position (supported on knees, shins and palms)
- Starting position: Prone position, arms stretched forward, palms facing the floor, legs stretched
- Starting position: standing straight, back resting against a wall, both arms relaxed at the sides of the body
All in all, it is difficult to perform exercises according to Schroth (also on the gymnastics ball/ezzi ball) only with the help of a written explanation.
Schroth’s therapy is about recognising incorrect postures together with a therapist. Mirrors are used for this. In order to correct the incorrect posture, certain exercises are performed.
The conscious perception of the body and its individual components (muscles, ligaments, tension, stretching) is very important in this process. During the therapy, certain exercises are worked out at home and it is pointed out which rules have to be followed. Unfortunately, carrying out the exercises without practical instruction is therefore not very promising. If you are interested in such a therapy, the doctor or orthopaedic surgeon can be consulted.
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