Chiropractors, as regulated health professionals specialising in musculoskeletal conditions, are educated and qualified to advise on posture. This may relate to posture in children, adults and the elderly or may be more specialised in relation to occupational, driving or sport/leisure activities. Many people presenting to chiropractors also have scoliosis.
Chiropractors assess posture by inspection and observation, physical examination techniques and, in some cases of severe deformity, by use of x-ray analysis. Treatment of postural dysfunction may be by patient education, functional neurological approaches, cranial work, ergonomic advice, foot orthotics, heel lifts and therapeutic exercise. This may be supported by manual therapy (chiropractic, massage or mobilisation) where indicated or referral to a medical doctor, dentist or podiatrist.
Scoliosis is a condition of the spine which results in abnormalities of posture and alignment, characterised by an exaggerated lateral deviation of the spine, which may or may not be painful. It presents typically in adolescents and may progress throughout growth years. It may also give rise to musculoskeletal disorders, including back pain, in later life.
Scoliosis may be structural (it is fixed: for example due to a shortening of the skeleton on one side compared to the other) or functional (it can change, for example on moving into a different posture).
Scoliosis may be progressive, and if the curvature exceeds 60 degrees, it may lead to heart and lung complications. It can also cause narrowing of the spaces through which the nerves exit through the spine. For this reason it is usual for the health service to monitor changes in juveniles with scoliosis and in some severe cases surgical intervention is appropriate.
Some people find chiropractic can be a useful adjunctive treatment to help them manage areas of pain caused by tight joints and muscles associated with changes in the spinal curves.
Chiropractors may utilise a number of treatment approaches to help with the management of mild to moderate stable scoliosis. Treatment can involve manual therapy (chiropractic, mobilisation or massage), functional neurological approaches, cranial work, stretching exercises, supervised rehabilitation, postural education and therapeutic advice. Management often includes foot orthotics and leg length correction using heel lifts. The success rates tend to depend upon the severity of scoliosis, but in mild to moderate scoliosis there is evidence that conservative care is a useful adjunct to other interventions [31,32].
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