This case study is of a 57 yr. old adult, 35° Lumbar dextro-scoliosis (convexity to Rt at L1-2). She has been able to achieve significant improvements in visual appearance, reduction in Cobb angles and empowerment. An example of scoliosis management without bracing or surgery.

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Background:

An adult lady presented with a single C-shaped lumbar curve with a Cobb angle of 34°. Her curve was originally diagnosed at 5° in adolescence though increased through adulthood. Unable to stop this progression, this athletic lady presented with episodes of acute spasm that took months to recover from.

Scoliosis had both a significant physical and psychological impact on her life. Importantly, outdoor physical acitivites were curbed and indoor tutoring were disrupted.

Worried that her Scoliosis will further affect her lifestyle and career in the future, she pursued an effective management solution from many practitioners.

Her goal was to ensure that her muscle spasms could be managed, that her spine would not continue to progress, and that she would be able to exercise and work for many more years to come.

Method

As in all cases, effective management comes from appraising the lifestyle, medical history and x-rays. The setting of realistic meaningful goals and treatment plans are formulated to give both client and practitioner something to aim for. Actively collaboration is reinforced and in addition to the initial history further discussions about lifestyle ensued for 5 months.

Therapy

2 x 2hr sessions a week were used in the clinic to assess if initial change was possible

Exercise was then encouraged in both a dedicated time format and also incorporated in normal activities.

Specific exercises were continually tailored over the 5 months.

A workplace task analysis also revealed what to avoid. Harmful behaviours were identified in bush regeneration work and more importantly as a tutor.

Results (Over 5 months)

• On X-ray the Cobb angle reduced from 34° to 25° and moved closer to centre (middle photograph).
• Head remains more centred over the body
• Left sided waist curve has decreased and right-sided curve is appearing – symmetry is almost achieved.
• Frequency of pain and muscle spasms had significantly reduced. Certain exercises were found to increase pain and discontinued. The straightening of the spine was also thought to contribute to more even loading of the spine.

 

Discussion

This client was very dedicated and responded well to active treatment and behaviour modifications.

A visual improvement and overall reduction of 9 degrees achieved.

Whilst this is a satisfactory result over 5 months, with further clarity as to the cause of this scoliosis, stabilisation and possibly further reduction is likely.

These positive changes are supported by an X-ray which demonstrated a reduction in her Cobb angle from 34° to 25°.

Given the improvements and increased understanding, the chances of this lady’s spine progressing beyond 35° are now unlikely. Pain and muscle spasms were noticeably reduced over the first few months.

Certain exercises were trialled for both comfort and ease of application ultimately culminating in a close analysis of writing behaviours when tutoring. This had a profound effect on displacement of the spine away from midline and muscle activation.

With this knowledge, improvements to the third photograph ensued. This lady reported the development of muscles on the left side of her lower waist, which had previously become weak due to Scoliosis.

The understanding gained and improvements noted to this degree qualify for partial success. Ultimate success is determined by a follow-up film (Gold Standard)

Meaningful goals were realised.

Prognosis:

Unsure as to whether reduction to zero can be achieved, however a good gain was made in 5 months with more certainty for control, rather than progression.

 

All results on this site have been achieved without bracing, machines, surgery or medications.

Disclaimer: These results are not indicative that this can be achieved in every case.

See Also:

• Scoliosis Case Study 1
• Scoliosis Case Study 2
• Scoliosis Case Study 3
• Scoliosis Case Study 4
• Scoliosis Case Study 5

 

This case is an example of a large & aggressive ‘C’ shaped curve at 59 degrees in a young girl aged 13.
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Background:

A young lady, 13 at the time and in year 8, presented with a large single ‘C’ shaped curve measuring 59 degrees. She reported spinal pain occurring 50—75% of the time and growing deformity over the last 8 – 12 months. She was concerned about her breathing problems, possibility of degeneration and the likelihood of surgery. It was affecting her sitting and sleep positions and other daily routines. Interventions were required to stabilize the curve and to achieve reduction where possible. Surgery was advocated within 8 months.

Method

An initial consultation was arranged and the client’s medical history, lifestyle behaviours were analysed. The severity of the Scoliosis was assessed and measured. Preventative and proactive strategies to manage Scoliosis were then formulated, which empowered the client and her family with the knowledge to manage her own curve.

With surgery looming, this client commenced a 3-week daily intensive programme (3-hours per day). Sample exercises were trialled over the first first 3 days before settling on a specific programme of what to ‘do’ and ‘avoid’. Based on her spine’s responsiveness to the exercises, the most effective exercises were then tailored to her specific curve and maintained through the intensive period.

Results

• Her curvature humping flattened considerably
• The spine moved quite dramatically to centre with an increase of 12 mm in the 3 weeks

Visual improvement over three weeks

 

Discussion

The client responded well to preventive strategies and active treatment. As seen from the images and reported results, the client demonstrated movement of her spine towards the middle of the body, No follow up x-rays were taken nor necessary to demonstrate improvement.

One step better than stabilisation is reduction. This is not always achieved though was apparent in this case. The Gold Standard for measuring remains with x-ray, however if results can be visualised to this extent, x-rays may not be warranted. This case follows an intensive 3-week 3hourly session performed from late Nov to early Dec 2014.

Slouching is all too prevalent in our society and avoidance of this is one of the key components for a healthy spinal shape. Screens as in this case can lead to altered bio-mechanics and parents are well advised if they adopt a home strategy of advising their children to use screens at the table / desk.

Severe curves as seen in this case require urgent intervention.

Prognosis: Expectation is that this spine is likely to continue to centre given follow-up care over 1 year.

All results on this site have been achieved without bracing, machines, surgery or medications.

Disclaimer: These results are not indicative that this can be achieved in every case.

 

See Also:

• Scoliosis Case Study 1
• Scoliosis Case Study 2
• Scoliosis Case Study 3
• Scoliosis Case Study 4
• Scoliosis Case Study 5
• Scoliosis Case Study 6

 

This case is an example of a significant low ‘C’ curve responding to preventive and proactive treatment strategies. The first X-ray was taken prior to starting care and revealed an increase of 17 degrees (in 11 months) to a  71 degree Cobb angle.  The second X-ray was taken 2 weeks after the initial consultation and when the first recommendation was given. That is before any intensive treatment began. The third X-ray was taken at the conclusion of two weeks treatment.
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Background:

A year 10 student presented with a single C shaped lumbar (71° Cobb angle). The curve had progressed 6 degrees in the two weeks preceding treatment to a total of a 17 degree increase within the last 11 months. She reported little discomfort, although her appearance indicated constant leaning towards the left. Given her scoliosis’s potential to grow at her age, the severity of her Scoliosis, and the spinal curve being significantly off centre, progression with surgery  looking increasingly likely. Interventions were urgently required to stabilize the curve and to achieve reduction where possible.

Method

Scoliosis care commenced and the family’s concerns were articulated, and the client’s medical history, lifestyle, and Scoliosis were extensively assessed. Practical preventative and proactive strategies to manage Scoliosis were then formulated, which empowered the client and created relief for her family with the knowledge that something could now be done to manage her the curve, instead of ‘watching and waiting’.

Two weeks after the initial consultation, this year 10 student decided to commence a 2 week daily intensive programme (4 hours a day). Specific exercises were introduced in the first few days to discover the appropriate approach to address the curve. Based on her spine’s responsiveness to the exercises, the most effective exercises were then tailored to her specific curve and maintained through the intensive period.

Results

• The cobb angle reduced from 71° to 65°  – Update: Great News! The client has further improved her Scoliosis in the time with us. Her curve has now been reduced to 58 degrees.
• The spine’s maximum point away from centre consecutively de-translated (moved to centre) from 80 mm to 68 mm to  60 mm from midline.
• T7 is now aligned with the centre of the spine.
• The angle of the bottom vertebra changed from 43 degrees to 34 degrees.

 

 

Discussion

The client responded well to preventive strategies and active treatment. As seen from the images and reported results, the client demonstrated movement of her spine towards the middle of the body, and consecutive reductions in Cobb angle were observed.

The potential of preventative strategies to improve or stabilize Scoliosis can be observed in this particular case.

The first x-ray is the client’s spine prior to the implementation of preventative strategies discussed in the initial consultation. The second x-ray was taken before intensive treatment, and demonstrates an improvement in the spines positioning towards the midline.

With active treatment, the client was able to further translate her spine closer to midline, resulting in a drop from 80 mm to 60 mm by the end of her 2 weeks. Her Cobb angle was also able to reduce to 65 degrees. The bottom vertebra that was tilted the most changed in its angle of inclination as well. Initially at 43 degrees from horizontal, the angle changed to 41 then 34 degrees. The movement to midline is largely affected by what happened at this level.

The client is expected to continue to improve with the implementation of preventive strategies (e.g. behaviour modification) and exercise on a regular basis for the following months (twice weekly sessions in the clinic for 1-2 hours after school, along with regular exercise at home). With continued de-translation and de-rotation of the spine, she is expected to significantly reduce her Cobb angles, further translate her spine to the centre, and thus stabilize her spine in the coming months.

Please note that severe curves as seen in this case require urgent intervention. As previously described on our Scoliosis page, high Cobb angled curves have a significant chance to proceed over time, and this will subsequently further increase concern and urgency. The chances of the spine to twist even further and for instrumentation (surgery) become more urgent.

The more ‘off-line’ the spine, the more danger there is in the spine sinking and twisting (rotating). This case demonstrate that a spine can be brought back to mid-iline and also shows a decreasing Cobb angle. Further work is required to de-rotate the spine once it has hit midline. Midline was achieved in this case in a rapid time frame. De-rotation (unwinding) exercises and strategies are advocated.

All results on this site have been achieved without bracing, machines, surgery or medications.

Disclaimer: These results are not indicative that this can be achieved in every case.
See Also:

• Scoliosis Case Study 1
• Scoliosis Case Study 2
• Scoliosis Case Study 3
• Scoliosis Case Study 4
• Scoliosis Case Study 5

 

Case 5 is an extreme case. A 47 year old lady with significant pain and quality of life issues was able to reduce her Scoliosis curve from 90° to 73°. As a result, her  pain was reduced and her quality of life improved. This is a remarkable testament of the spine’s potential to improve even at a mature age.
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Background

A 47- year old mother presented with a very severe Scoliosis curve measured at 90 degrees. Diagnosed with scoliosis at 53 degrees 23 years prior, she experienced significant pain and disability, and needed three very strong and addictive painkillers on a daily basis in order to cope. She experienced difficulty walking and sleeping and on several occasions was wheelchair bound and hospitalised.

She was urgently advised by specialists to undertake scoliosis surgery within two years otherwise face the likely scenario of being in a wheelchair permanently. Struggling with a low quality of life and a bleak future and with little confidence in surgical procedures, she was keen to start non-surgical approach.

 

Treatment

Scoliosis care commenced after a detailed analysis of her history and behavioral patterns.  A 2-fold strategy was implemented where key behaviors were addressed and specific exercises were tailored to her unique curve, and performed for 3-4 hours a day over a 2-week daily intensive programme. Key behavioral hazards were identified and eliminated with the view to halt progression and control the pain.

Specific spinal exercises were also used to attempt to reduce the curve..

Visual improvement over 2 Weeks

 

Results

• Her visual appearance improved (as seen from above pictures)
• A 17 degree consecutive drop in the curve, from 90° to 78° to  73°, was seen by the end of week 2.
• Reduced pain and a subsequent reduction in medications with one prescription painkiller  stopped altogether.
• Lung capacity improvements – cessation of smoking during care.
• Increased Sleep (could only sleep for 2-3 hours at beginning of care). She is now able to sleep through the night.

Discussion

Traditional assumptions about Scoliosis would suggest that this lady would have no option but to undertake surgical treatment. This is due to her severe “surgical” curve (90° Cobb angle), and her mature age (47 years of age).

However, this case demonstrates the spine’s potential to improve despite challenging odds. Her spine was able to respond well to non-surgical treatment, and the results were encouraging.

With her sustained efforts, a final X-ray on day 14 indicated a 17° reduction in her spinal curve. She reported this reduction as “life-changing”, as it subsequently improved other aspects of her life.

She reported having improved sleep as she did not wake up as often from pain. She stated that she now only takes half the amount of painkillers, and has even dropped one painkiller medication altogether. Furthermore, she stated that she can look after her three children without having to worry as much about her future with them. Such changes are a positive start. With continued exercises and guidance at home, it will be expected that her curve can be further reduced, and her quality of life will continue to improve.

NB: Results vary from case to case. Our commitment is to make a break-through for large curves and to prevent smaller curves from getting bigger.

Where reduction is possible it is often seen within months.

All results on this site have been achieved without bracing, machines, surgery or medications.

 

See Also:

• Scoliosis Case Study 1
• Scoliosis Case Study 2
• Scoliosis Case Study 3
• Scoliosis Case Study 4
• Scoliosis Case Study 6 (NEW)