Physiotherapist HAN YEN has a special interest in helping people who suffer from scoliosis and musculoskeletal pain. Here she tells us more about the symptoms and causes of scoliosis, and why more people are turning to physiotherapy for scoliosis treatment.
Give us an overview of your job and why you enjoy doing it.
I work with multi-disciplinary healthcare teams to optimise the mobility and function of my patients. In my line of work, I come across many people who have to limit their daily activities and sometimes even give up on their personal dreams due to the drawbacks of musculoskeletal pain. It brings me delight to see how appropriate interventions carried out through physiotherapy can help patients conquer their pain and, in turn, achieve their personal goals without having to go through invasive procedures.
Why did you decide to specialise in musculoskeletal pain and scoliosis treatment?
It was a deeply personal decision. Having experienced scoliosis myself, I understand the impact it can have when not properly managed. This condition is often misunderstood and overlooked by both patients and healthcare providers, despite its relevance to many spinal cases. By specialising in scoliosis treatment and management, I aim to fill this gap and ensure that individuals receive the focused care they need to improve their quality of life.
What causes the different types of scoliosis?
Idiopathic scoliosis is the most common type and often develops during adolescence. It’s classified based on age of onset either as infantile idiopathic scoliosis (affecting those under the age of three years), juvenile idiopathic scoliosis (three to 10 years) and adolescent idiopathic scoliosis (10 to 18 years).
Less common, congenital scoliosis results from abnormal foetal spinal development and is present at birth. It may involve vertebral malformations or fusion of vertebrae. Then there is neuromuscular scoliosis, which is associated with conditions such as cerebral palsy, spinal muscular atrophy or muscular dystrophy. It can progress rapidly and may require specialised management.
The final type is degenerative scoliosis. This typically develops in adulthood due to age-related changes in the spine, such as disc degeneration, osteoarthritis, or vertebral compression fractures.
You mentioned the condition is often misunderstood. Tell us more.
Here are some of the common misconceptions about scoliosis.
#1 It’s just a cosmetic issue
Most cases of mild scoliosis primarily affect appearance, but more severe cases can lead to pain, discomfort and even affect lung function if the curvature of the spine becomes very pronounced.
#2 Scoliosis treatment always requires surgery
Surgery is typically reserved for severe cases where the curvature is progressive and significantly impacts quality of life. Many cases of scoliosis, especially mild to moderate ones, can be managed effectively through non-surgical means. Physiotherapy for scoliosis treatment is ideal with specific exercise, bracing and lifestyle modification.
#3 It can be completely cured with one scoliosis treatment
Scoliosis is a complex condition involving three dimensional deformity of the spinal column that often requires ongoing management rather than a one-time cure. Treatment aims to manage symptoms, prevent progression, and optimise posture and function.
#4 It’s always symptomatic
Having scoliosis doesn’t guarantee that you’ll have musculoskeletal pain. We still recommend regular monitoring, as the curvature can progress over time.
#5 It can be prevented
While certain risk factors may predispose individuals to scoliosis (such as genetics), there are no guaranteed prevention methods. Early detection and appropriate management are key to minimising the impact of scoliosis.
What does scoliosis feel like and how does it impact daily life?
Signs and symptoms may include uneven shoulders, waistline asymmetry, body prominence on the upper/lower back, feelings of shifting of body weight bearing to one side, and uneven leg length. People also report pain and discomfort, especially in the back, shoulders, and hips, along with reduced mobility and flexibility. Breathing difficulties may develop in severe cases where the curvature affects lung function. And some patients suffer a psychological impact caused by changes in appearance and self-image.
What are the scoliosis treatment options available, especially physiotherapy for scoliosis?
For comprehensive care, a multi-disciplinary approach is best. This involves collaboration between a spinal orthopaedic surgeon, orthotist (if spinal bracing required) and physiotherapist. Postural screening and education is an important piece of the puzzle.
I use the Schroth Method physiotherapy scoliosis-specific exercise. It’s an evidence-based approach whereby manual therapy, heat/cold therapy and electrical modalities are used to manage the pain associated with scoliosis effectively. Customised therapeutic exercises are simultaneously prescribed to target specific muscle groups, improving muscle balance, flexibility and core strength. These exercises help support the spine and reduce the progression of scoliosis.
Last but not least, lifestyle modification is important. Swimming, yoga, Pilates, and core strengthening can really help improve outcomes.
About the physio
Han Yen is a senior physiotherapist at City Osteopathy & Physiotherapy. Find clinics at Novena, the CBD, Bukit Timah, River Valley, Woodleigh and the East Coast.
This article first appeared in the September 2024 edition of Expat Living. You can purchase the latest issue or subscribe so you never miss a copy!
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