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Scoliosis: an osteopathic approach

Blog by Dr. Michael Horowitz | April 24th, 2015

Scoliosis is a side-to-side curvature of the spine when viewed from the back. According to the Scoliosis Research Society, scoliosis is defined as a curvature of the spine measuring 10 degrees or greater. The curve can be “C” or “S” shaped and be present in one or two parts of the spine (e.g. lumbar, thoracic). Scoliosis develops most often during growth spurts of puberty. The most common type of scoliosis diagnosed is idiopathic (unknown cause), affecting around 80% of cases and is mainly seen in adolescent females. Other types are congenital scoliosis, as a sign of prenatal malformation of vertebrae and neuromuscular scoliosis, which develops secondary to an underlying condition such as cerebral palsy, inevitably leading to muscle paralysis. Scoliosis can also be caused by traumatic induced muscle paralysis, such as spinal cord injuries or fractures as well as by degenerative changes of the spine, i.e. osteoarthritis.


Scoliosis can be divided into structural and non-structural (functional) scoliosis. Non-structural scoliosis are fixable and can be caused by muscle spasm in the back muscles, leg length differences and are often due to muscular imbalances, hence “poor posture”. The scoliosis is typically mild and changes or disappears when the person bends forward. Structural scoliosis is typically more severe and is fixed, therefore can’t be corrected.


Symptoms can range from discomfort, to fatigue after standing or sitting, to back pain, and difficulty breathing in more severe cases. A common concern are the asymmetric changes in one’s appearance, e.g. uneven hips and shoulders which can weigh on the child’s self-esteem.

Treatment options

The treatment depends on the severity of the scoliosis. An x-ray will be taken to show the degree of the angle to help take appropriate measures, such as braces, surgery or conservative therapy. Contributing factors, which should be taken into account, are pain, the age of the child, and on whether they are growing. The treatment is aimed to prevent the curve from progressing or worsening.


As the scoliosis progresses, the vertebrae twist round and the spine rotates. In the case of a thoracic curve, this will cause compression or constriction of the ribs and vertebrae, impairing vertebral growth on one side (aka concave) and the ribs to “spread”, stick out more on the opposite side (aka convex), a “rib hump” accompanied by a more prominent shoulder blade. Changes seen in a lumbar curve are forward rotated and higher hips on the concave side and lumbar muscle protuberance on the convex side.

Osteopathic treatment

Osteopathy focusses on treating the whole person, in order to relieve pain, improve mobility and gain strength to recover. In mild to moderate cases of scoliosis, that don’t require surgery, osteopathy may do all of the above things. Therefore, the main focus is to improve posture and muscular imbalances. This is achieved by a thorough assessment of the curve of the spine. Treatment will be aimed to release restrictions in the spine and surrounding tissues, combined with strengthening and stabilization exercises. Moreover, I will work with the patient to improve awareness, posture and proprioception.

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