Managing Scheuermann’s Disease | How Physiotherapy Can Improve Spine Health and Posture? | Blog by CB Physiotherapy, Active Healing for Pain Free Life.

 Scheuermann’s Disease, also known as Scheuermann’s Kyphosis, is a condition that primarily affects adolescents and results in a forward rounding of the upper back. Named after the Danish radiologist Holger Scheuermann who first described the condition in 1921, it is considered one of the most common causes of structural kyphosis during adolescence. This blog delves into the nature of Scheuermann’s Disease and explores how physiotherapy can play a vital role in managing the condition.

What is Scheuermann’s Disease?

Scheuermann’s Disease is a growth disorder of the vertebrae, where the bones of the spine grow unevenly, with the front growing slower than the back. This uneven growth leads to a wedge-shaped deformity of the vertebrae, which causes the spine to bend forward abnormally. The condition typically affects the thoracic (upper back) region but can also occur in the lumbar (lower back) region.

The exact cause of Scheuermann’s Disease is still unknown, though it is believed to be multifactorial, involving genetic, mechanical, and possibly endocrine factors. It tends to occur more frequently in boys than girls, with symptoms often appearing between the ages of 10 and 15.

The most noticeable symptom of Scheuermann’s Disease is an abnormal curvature of the spine, typically resulting in a rounded, hunchback appearance. This kyphosis is usually rigid, meaning the spine cannot be straightened fully by posture correction alone. Other symptoms can include particularly in the area of the curvature. Pain often worsens with activity or prolonged standing or sitting. Individuals may experience stiffness in the back and a reduced range of motion, particularly in the thoracic spine. Due to the abnormal posture, muscles in the back can become fatigued more quickly, leading to overall tiredness.

In severe cases, where the curvature is extreme, the disease can lead to respiratory and cardiovascular issues due to the compression of the chest cavity.

Treatment Options for Scheuermann’s Disease

The treatment approach for Scheuermann’s Disease depends on the severity of the condition and the symptoms experienced by the patient. Treatment options range from observation and conservative management to surgical intervention in extreme cases.

Role of Physiotherapy in Managing Scheuermann’s Disease

Physiotherapy is a cornerstone in the conservative management of Scheuermann’s Disease. The primary goals of physiotherapy are to reduce pain, improve posture, enhance spinal flexibility, and strengthen the muscles supporting the spine. Below are the key components of a physiotherapy program for Scheuermann’s Disease:

1: Postural Education and Correction
A key focus of physiotherapy for Scheuermann’s Disease is teaching patients about proper posture and maintaining it. Although the kyphosis in Scheuermann’s Disease is structural and cannot be fully corrected by posture alone, improving postural awareness can help reduce pain and prevent further progression of the curvature. Physiotherapists educate patients on how to align their spine correctly and practice good posture during daily activities.

2: Stretching Exercises
Stretching exercises are designed to increase flexibility in the muscles and ligaments surrounding the spine, particularly in the thoracic region. These exercises target tight muscles, such as the pectorals (chest muscles) and hamstrings, which can contribute to the abnormal posture seen in Scheuermann’s Disease. Regular stretching helps to alleviate stiffness and improve the range of motion in the spine.

Common stretches may include:
a: Chest stretches: To open up the chest and counteract the forward pull caused by tight pectoral muscles.
b: Hamstring stretches: To alleviate tightness in the back of the thighs, which can contribute to poor posture.
c: Thoracic extension exercises: To promote the extension of the thoracic spine, counteracting the forward curvature.

3: Strengthening Exercises
Strengthening exercises are crucial in stabilizing the spine and improving the overall posture. These exercises focus on strengthening the muscles that support the spine, including the core muscles, back extensors, and scapular stabilizers. A strong core provides better support for the spine, reducing the load on the vertebrae and potentially slowing the progression of the curvature.

Examples of strengthening exercises include:
a: Core stabilization exercises: Such as planks and bridges, which strengthen the abdominal and back muscles.
b: Back extension exercises: To strengthen the muscles along the spine, particularly the erector spinae.
c: Scapular retraction exercises: To strengthen the muscles between the shoulder blades, helping to correct rounded shoulders and improve posture.

4: Manual Therapy
Manual therapy techniques, including joint mobilizations and soft tissue massage, can be beneficial in managing Scheuermann’s Disease. Joint mobilizations help to improve the mobility of the spine, particularly in areas where movement is restricted due to the kyphosis. Soft tissue massage can alleviate muscle tension, reduce pain, and improve circulation in the affected areas.

5: Breathing Exercises
In cases where Scheuermann’s Disease affects the thoracic region severely, it can impact lung function by compressing the chest cavity. Breathing exercises can be incorporated into physiotherapy to enhance lung capacity and improve respiratory function. These exercises focus on diaphragmatic breathing and expanding the rib cage, promoting better oxygen intake and reducing the risk of respiratory complications.

6: Bracing and Orthotics
In certain cases, particularly in younger patients with a more significant curvature, bracing may be recommended in conjunction with physiotherapy. The brace helps to halt the progression of the curvature by maintaining the spine in a more neutral position. While wearing the brace, physiotherapy exercises continue to be essential to strengthen the muscles and improve posture.

Scheuermann’s Disease is a challenging condition, particularly for adolescents who are already navigating the complexities of growing up. However, with the right approach, including a comprehensive physiotherapy program, many of the symptoms can be managed effectively. Physiotherapy not only addresses the physical aspects of the condition but also empowers patients with the knowledge and skills to maintain a better quality of life.

 

Disc Herniation | Relieving your Back pain by Physiotherapy

If you suffer from back pain due to herniated disc and are afraid that you might have to live with it. Then it's time for you to relax and get ready to lead a quality life. You can return to your daily routine by availing of Physiotherapy services. Physiotherapy not only helps to enhance the healing process, but reduces pain, and also helps the patient to get back to normal function. This blog will throw some light on the herniated disc and its physiotherapy management.

 

What is a Herniated Disc?

The spine is made up of vertebrae, which are held next to each other by the disc. The disc is a combination of strong connective tissues, made of a strong outer layer, annulus fibrosus, and a gel-like center called nucleus pulposus. The disc may start to lose water content, which makes the disc less effective as a cushion. This may cause herniation through a crack in the outer layer. Disc herniation commonly occurs in the bottom two discs of the lumbar spine. A herniated disc can press on the nerves in the spine and might cause pain, numbness, tingling, or weakness of the leg.

 

Physiotherapy Management:

Physiotherapy management comprises of a number of therapies and techniques like:

 

Cold Therapy:

Herniated disc presses on the nerve in the spinal canal, which causes pain and inflammation along the spinal walls. Cold therapy is found to be effective for pain relief because it constricts the veins along the spine, slowing the circulation and reducing inflammation.

 

Heat therapy:

Heat therapy is a non-invasive pain relief therapy for muscle and joint pain. This therapy is used to promote blood flow, blood helps to heal the area by delivering extra oxygen and nutrients, it removes waste byproducts from muscle spasms reduces pain in the joints, relaxes tight muscles, tendons and ligaments.

 

Kinesio Tape:

Kinesio-tape is a latex-free tape that can be worn for days. Kinesio Tape is applied to the spinal area to facilitate the body's natural healing process while providing support and stability to muscles and joints without restricting the range of motion. It also helps to increase blood flow and reduce pressure on the nerves which helps to decrease pain (localized as well as radiating) and inflammation.

 

Ultrasonic Therapy:

Therapeutic Ultrasound helps to increase blood flow and reduce pain. It uses ultrasonic waves that pass into the skin causing a vibration of local tissues. This vibration causes deep heating in the area without any sensation of heat. As the vibrations created by the ultrasound pass through the soft tissue, this increases heat within the tissue, which in turn increases blood flow, reduces pain, relaxes muscles, increases the extensibility of connective tissues, promotes scar tissue breakdown, and improves flexibility.

 

Vasopneumatic Compression:

Vasopneumatic compression helps to accelerate recovery. It cycles ice-cold water and air through a sleeve which is placed around the affected part of the body. This integrated cold and compression therapy helps to reduce pain, swelling, muscle spasms and enhances lymphatic function and oxygenated blood flow.

 

Transcutaneous Electrical-stimulations:

Transcutaneous electrical stimulations use electrical currents that pass through the electrodes placed directly on the patient's skin. Transcutaneous electrical stimulations cause an increase in the blood flow to promote healing and reduce inflammation. Stimulation act on the pain gate to block the transmission of pain signals, it also causes muscle stimulation for neuromuscular re-education and strengthening.

 

Low-Level Laser Therapy:

Low power laser therapy is effective in the treatment of patients with acute cases of disc herniations. It speeds up the recovery process, decreases inflammation, and pain.

 

Spinal Traction:

Spinal traction is a form of decompression therapy, it helps to relieve pressure from the spine. This type of distraction can be performed with manual techniques as well as machines. Spinal traction is indicated for the treatment of herniated discs, it decompresses spinal discs and facet joints by utilizing traction, distraction, and body positioning.

 

Manual Therapy:

Manipulative treatment for disc herniation is found to be safe, effective, and seems to be as effective as other therapies. It leads to short-term pain relief when suffering from acute low back pain and has an effect similar to NSAIDs. It includes techniques like spinal mobilization, spinal manipulation, massage, myofascial release, etc.

 

Stretching Exercises:

Stretching exercises are included in the treatment plan to decrease soft tissue tightness and improve posture to balance the forces placed on the spine.

 

Strengthening Exercises:

The spine is supported by strong muscles and thus can better handle pain. Core muscle stability is important to regain strength and power. Strengthening exercises help the patient to regain functionality.

 

Treatment of disc herniation is important to control pain, development of disability, prevent a recurrence, and accelerate the return to work. Therefore immediate treatment should be taken before the condition progresses further.