• Treatment of Scoliosis in Adults and children


    Front of the bank at school or in front of the table at home, we should be sitting well in the chair, and the table should be very close to our body, so that we do not have the opportunity to lean towards one. Excessive cell phone games, long hours in front of the Internet TV, and bags full of books are all causing the spinal deformities to appear at an early age. This concern is becoming more and more a problem for many parents. Children aged 8-18 are the ones who are suffering from this. In an interview with the reader of the newspaper "Shëndet +", physiotherapist Endrit Mone explains what scoliosis is, what causes it and the forms of its treatment.


    Doctor, what is scoliosis in adults?

    Scoliosis in adults represents the lateral distortions of the spinal cord. This disease is a consequence of irregular stay, for example, in students at the school bench, carrying school bags on one side, etc.


    Every day there are problems with the backs of our children, where does this concern come from?

    The spine is made up of a flexibility that allows and enables only a few types of movements. In the case of the 'immature' spine, such as that of children, it is very easy to have changes beyond the allowable ones, especially if we have large loads on them, for example 30% more than body weight. We have problems if we stay for a long time in a forced position or from some external factor, such as a stroke or from an accident. Also, many problems come from congenital, congenital pathologies, which are reflected in the asymmetry of the body.


    Who is more likely to have such problems?

    Children up to the age of 18-20 are most prone, when bone maturity is reached. Later changes in bone structure are slower and more difficult. The female sex is more affected than the male sex by the age of 10-13. Women are almost 10 times more at risk than their male peers. This is because they achieve even faster development than men. Children who have not had a normal birth or have had a premature birth. Children born with various pathologies, which appear on the spine. Those born with coxofemoral luxury, those born with muscle problems. Children who have asymmetry in the limb.


    How else are these deformations known and how can we catch them in time?

    The pathological changes of the spine are kyphosis and scoliosis. Scoliosis is a lateral deformity of the vertebra that is also associated with its rotation. Scoliosis can present a primary curve (thoracic, thoracic-lumbar, lumbar, cervico-thoracic) or two primary curves (thoracic and lumbar curve, double thoracic curve, thoracic and thoracolumbar curve). Scoliosis is measured in degrees and is treated based on the degrees it carries. Up to 15 degrees, scoliosis is treated with posture exercises by the physiotherapist. From 20-30 degrees scoliosis is treated with regulatory bust and physiotherapy. Over 35 degrees is treated with regulatory bust and is assessed as a case for surgery.

    While kyphosis is a dorsal curvature, which appears in profile even if it exceeds 35 degrees is considered abnormal, although treatment should be started earlier. The kyphosis is quite visible because the column takes on a curved appearance at the back. These spinal deformities, quite detrimental to the child's health, can be evidenced by the parents when the children undress or show a problem, by the physical education teacher or the school doctor.


    What are the risks of these deformities and their signs?

    Their danger lies in the fact that if these deformities are not caught and treated in time by the age of 18, it is later difficult to have noticeable changes as the bone has reached a maturity of its own. The risk reaches fatality in cases which are above 40 degrees. The risk for women lies in the fact that women will become mothers and in the coming years there will be birth pressures. Those deformities that are at the thoracic level, also endanger the organs by obstructing breathing. In addition to an aesthetic risk, deformities cause rapid fatigue, difficulty breathing, back pain, and so on. People with scoliosis should know that scoliosis never goes 0 degrees, but it should also be treated and maintained at a level that is not harmful.


    Signs that would help parents to have a quick check:

    Shoulder level, in deformations their level is asymmetric.

    The level of the iliac crests, the pelvic part, the end of the abdomen, their level should be the same.

    Lower limb level, knee level.

    In a normal posture, the space that the elbow creates with the arch of the body should be the same on both sides.

    The shoulder level should be the same. If we bend the child with the gathered legs, we also notice that one side is higher than the other side at the expense. In a standstill for a few minutes, the child tends to change body weight from side to side.


    Once we identify one of these signs, what is the path to follow?

    Once you have encountered one of these signs, it is advisable that the child have a check-up by an orthopedic doctor. The doctor, after identifying some of the above signs, advises to perform a spinal graph. Based on the graph, the real situation is also looked at and the angle is measured. The appropriate treatment is also determined based on the angle.


    What are some of the tips that affected people should keep in mind?

    We need to be careful with the shoes we use, if we have problems with the feet, we should use the right, non-flat sneakers even if it is necessary with the right plantar, for a more comfortable stay. Children should not be sidelined. A lot of time in a position (for example in front of a computer or TV) don’t even do these things lying down.

    When we stand in front of the bank at school or in front of the table at home, we should be sitting well in the chair, and the table should be very close to our body, so that we do not have the opportunity to lean towards one. We need to do sports (swimming is preferred), a sport that can keep our back muscles toned. We should not carry heavy weights only on one side, the weight should be well distributed on both sides.

    To avoid worsening, in the first case you feel a concern, you should see an orthopedic doctor and your physiotherapist.


    What are some of the exercises used in physiotherapy for the column?

    Posture exercises are also varied based on the curvature, the problem, becomes a special program.

    A physiotherapist is recommended 3-4 times a week and the exercises focus on balancing the muscles, because in such problems, some muscles are elongated and some are shortened and a balance is claimed to be established.


    It is recommended that most exercises be performed in front of a mirror, and aids are:

    A stick, a teraband, a Swedish ladder, a pillow.

    It starts with stretching exercises, trying to regulate breathing.

    Neck muscle extensions are very important.

    There are many exercises that focus on the movement of the hands, to gain an extension and relaxation of the muscles of the pectoral and dorsal muscles.

    Many exercises are performed on the ball, the ball serves as a stopping point to gain balance.

    We have extensions near the Swedish level where some pressure can be exerted by the physiotherapist on the curvature.

    Also the muscles of the lower limbs are very important in the affected muscle chain.

    Once some balance has been reached, we try to tone our back muscles a little, getting up on "four legs" and keeping the balance with one hand and raising the leg of the opposite arm.

    We end the therapy again with breathing recovery.