Classification:

• Structural scoliosis: irreversible lateral curvature with fixed rotation of the vertebrae. Rotation of the vertebrae is towards the convexity of the curve. A rib hump is detected on forward bending.
• Nonstructural scoliosis is reversible and can be changed with forwarding or side bending or with the realignment of the pelvis by correction of a leg-length discrepancy. It is also called functional or postural scoliosis.

Causes:

• Structural scoliosis: due to neuromuscular disorders, osteopathic disorders (osteomalacia, rickets, fracture) and idiopathic disorders where the cause is unknown.
• Nonstructural scoliosis: due to leg-length discrepancy, muscle guarding or spasm from a painful stimulus in the back or neck or habitual postures.

Muscle impairments and Symptoms:

• Mobility impairment on the concave side of the curve.
• Impaired muscle function due to stretch and weakening on the convex side.
• With advanced structural scoliosis, cardiopulmonary functions restrict.
• Nerve root irritation on the side of concavity.
• Pain from mechanical stresses to sensitive structures and from muscle tension.

Treatment:

• Develop awareness and control of spinal alignment in a variety of positions.
• Educate the relationship of symptoms with sustained or repetitive postures.
• Increased mobility in restricting muscles, joints, fascia by manual or self-stretching and joint mobilization.
• Learn safe body mechanics with functional exercises.
• Learn to correct stress-provoking postures/activities by developing a recreational environment.
• Learn stress management/ relaxation by breathing exercises.
• Improve aerobic capacity.
• Development of neuromuscular control, strength, and endurance in postural and extremity muscles.

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