Physical therapist explained the possible consequences of scoliosis and the causes of its occurrence

Today, June 28, on International Scoliosis Awareness Day, Olga Filkina, a physical therapist at Odrex Medical House, told UNN about its causes and types of scoliosis.

Types and degrees of scoliosis

Filkina said that scoliosis can be classified by various characteristics:

1. By origin:

• congenital — associated with developmental disorders of the vertebrae during embryogenesis (segmentation or formation anomalies);

• idiopathic — the most common type (up to 80% of cases), its cause is unknown. Divided into: infantile (up to 3 years), juvenile (3–10 years), adolescent (after 10 years);

• neuromuscular — a consequence of neurological or muscular disorders (e.g., cerebral palsy, myopathy);

• degenerative — in adults, most often due to osteoarthritis, osteoporosis, degenerative changes in intervertebral discs;

• functional — temporary curvature due to other factors, such as different leg lengths or pain.

2. By curvature shape:

• C-shaped (one curve);

• S-shaped (two curves);

• Z-shaped (three curves).

Degrees of scoliosis

Filkina noted that degrees are determined by the angle of spinal deviation using the Cobb method (radiographically):

• Grade I — up to 10°: minimal curvature, often asymptomatic;

• Grade II — 11–25°: visible asymmetry of the shoulders, possible pain after exertion;

• Grade III — 26–40°: trunk deformation, noticeable rib hump, posture disorder;

• Grade IV — over 40°: significant deformation, possible cardiovascular and respiratory system dysfunctions.

What are the causes of scoliosis?

According to the physical therapist, a number of possible factors are distinguished:

• genetic predisposition — family cases of scoliosis;

• growth disorders — rapid growth during puberty;

• uneven load on the spine — for example, carrying a bag on one shoulder;

• muscle imbalance — weakness of deep stabilizing muscles of the spine;

• neurological pathologies — spasticity, paresis;

• poor posture in childhood — when sitting, carrying a backpack, etc.

What are the symptoms of scoliosis?

Filkina said that the following symptoms exist:

• asymmetry of shoulders, shoulder blades, or pelvis;

• visible curvature of the spine;

• rib hump when bending forward (Adams test);

• back fatigue after sitting or standing;

• back pain (more often at grades 2–4);

• breathing difficulties (in severe cases);

• in adults — reduced mobility, limitations in daily activities.

Possible consequences of scoliosis

Filkina noted that if left untreated, scoliosis can progress and lead to the following complications:

• chest deformations that affect lung and heart function;

• chronic back, shoulder, and neck pain syndrome;

• posture disorders, leading to secondary changes in the pelvis, knees, and feet;

• reduced quality of life, socialization difficulties, especially in adolescence;

• limited motor activity and increased risk of osteoarthritis in adulthood.

Methods of scoliosis treatment

According to Filkina, treatment depends on the degree, patient's age, form, and rate of progression:

1. Conservative treatment (Grade I–II):

• physical therapy — the basis of treatment, includes individual exercises for stabilization and correction;

• massage — an auxiliary tool for reducing muscle tension;

• swimming, especially backstroke and crawl.

• Orthoses (braces) — for example, Cheneau brace for progressive scoliosis (usually 2–3 degrees).

2. Surgical treatment (Grade III–IV):

• indicated for progression > 40° or organ dysfunction;

• spinal stabilization is performed with special metal structures (spinal fusion).

3. Supportive methods:

• occupational therapy (especially for children with concomitant functional impairments);

• psycho-emotional support.

Basic exercises for scoliosis (perform after consulting a physical therapist!)

1. Stretching exercises:

• on all fours, slowly arching and rounding the back.

• Side bends with arm extension.

2. Strengthening exercises:

• Plank position (with modifications).

• Lying on stomach: lifting arms and legs (like a "swimmer").

• "Boat" — strengthening back muscles.

3. Breathing exercises (according to Katharina Schroth's method):

• Asymmetrical breathing into the convex side.

• Control over chest expansion.

4. Corrective gait and balance:

• Walking on a line (with hands behind head).

• Balance on an unstable surface (fitball, BOSU platform).

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