Non-Surgical Scoliosis & Kyphosis Treatment

When treating our patients with spinal curvatures such as scoliosis and kyphosis (Scheuermann's disease or round back), we design a therapeutic program based on the Schroth Method from the Barcelona Scoliosis Physiotherapy School (BSPTS). The Schroth™ Method was originally developed in Germany in the 1920s by world pioneer in scoliosis treatment, Katharina Schroth.  The Schroth Method as taught by the BSPTS has been recognized by the Scoliosis Research Society as a viable conservative approach (one of seven PSSE schools) to the treatment of spinal deformities. 

The Rationale

The muscle and postural imbalances that are typically seen in patients with either scoliosis or kyphosis can create uneven forces in the spine, and potentially contribute to the aggravation of the curve. Temporarily correcting these imbalances using scoliosis specific exercises can improve posture and help prevent curve progression.

 
xray review  

The First Visit - Evaluation

The PSSE therapist needs to review your spine x-rays and perform an intensive evaluation before treatment is rendered.

A prescription for “physical therapy services for scoliosis/kyphosis” from a medical doctor is not required but preferred.  We strive to be a part of the traditional medical model working closely with other professionals.  We believe the best quality care comes when medical doctors, physical therapists, orthotists, and patients are all on the same team and have an understanding of the three-dimensional nature of scoliosis.

The initial evaluation on the first visit includes:

   

Movement, strength, balance and functional mobility examination

Posture exam with digital photographs

Breathing and lung capacity assessment

Analysis of most recent full spine x-ray

Curve pattern classification according to the Rigo classification system.

Determination of risk for curve progression
   

Specialized Treatment using the Schroth Method

 

David Feldman, MD, discusses the Schroth Method during Scoliosis Awareness month.

For the treatment of patients who are not in the surgical range, we utilize elongation exercises specific to the curve, opening of the concavities or collapsed areas by muscular transverse forces, targeted breathing into the concavities, active and passive corrections of the postural asymmetries, trunk stabilization in the corrected position, and home program education.  

The program is recommended for both adolescents and adults with idiopathic scoliosis. Adults with de novo degenerative scoliosis can experience reduced associated back pain and improved trunk stability.  

Patients who have undergone spinal fusion surgery for scoliosis can be treated after healing is complete post-surgery.  The specific exercises will address the trunk imbalances above and below the fusion, maximizing symmetrical forces in the spine after the fusion.  

For patients in need of bracing, we can make recommendations for orthotists who specialize in scoliosis bracing following Rigo-Chenêau bracing principles.  The Rigo System Chenêau brace is specifically designed to work well with the Schroth-based exercises in patients who are skeletally immature.  For more information about scoliosis bracing you may visit: www.align-clinic.com.

Physiotherapy Scoliosis Specific Exercises (PSSE)

Physiotherapy Scoliosis Specific Exercises: A Comprehensive Review of Seven Major Schools.  Scoliosis and Spinal Disorders.  June 2016.

Rigo-Cheneau Brace information:

WCR brace introduction for patients and families

WCR brace introduction for professionals.

WCR construction

Family Resources

Research article supporting rigid brace over soft brace. SpineCor associated with increased risk of curve progression (January 22, 2016)

The efficacy of three dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial.  February 8th, 2015.

The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: "SOSORT 2015 Award Winner".  September 2015.

Scoliosis Research Society (SRS) Statement on Physiotherapy.  By M. Timothy Hresko, MD.  May 2014.

Physical Therapy for Adolescents with Idiopathic Scoliosis.  Physical Therapy Perspectives in the 21st Century - Challenges and Possibilities. Refer to page 12 for Barcelona Scoliosis Physiotherapy School.

Straight Talk with the Curvy Girls.  By Terry Mulvaney and Robin Stoltz.

New York Times article featuring Schroth physical therapy.  Hope for an S-Shaped Back.  By Rachel Rabkin Peachman.  March 2014.

Philadelphia Inquirer article sharing a patient's experience with Schroth physical therapy.  Beyond Braces for Scoliosis Patients.  By Melissa Dribben.

International Society on Scoliosis Orthopaedic and Rehabilitative Treatment (SOSORT): founded in January 2004 by a group of physicians (from Europe and Asia) who are interested in studying the efficacy of various methods of conservative treatment. Dr. Manuel Rigo was the first president.


Paying for services


Insurance

We are an out-of-network provider for most insurance companies with “out-of-network benefits and physical therapy coverage.” We accept traditional Medicare as primary insurance as well.  When you call our clinic to schedule, our billing office will contact your insurance company to verify your coverage and then explain your benefits to you.

Private Pay

Many of our patients opt to pay for the Schroth-based treatment privately without billing the insurance. Some of the reasons these patients choose private pay include:

  • No physician referral required and immediate access to our services
  • Taking advantage of our reduced rates if under a high deductible policy
  • No out-of-network coverage

In this case, a discounted physical therapy rate is applied for paying at the time of service. We provide these patients with a receipt containing the required information for insurance reimbursement. The patient will then submit any paperwork to obtain reimbursement from the insurance company. The patient pays us directly, and we will not bill the insurance.

Scheduling

Following the evaluation, you may schedule your sessions at the frequency and duration that better matches your specific case:

If you live locally you may attend 1-2 hour sessions 2-3 days per week for 20-26 sessions.

If you are driving a distance or visiting from out of town you may schedule for extended 3-4 hour sessions, for 10-15 days.


Our goal is to give you a strategy to care for your own back.  You will learn how to perform a routine of exercises specific to your curve pattern with the purpose to facilitate the correction of the asymmetric posture and maintain the corrected posture during your daily activities. We will provide you with the tools to help you adopt a more centered and balanced posture.

Please note that enrolling in this program will require a high level of commitment from your part.  For questions about the program, insurance coverage, private pay reduced fee, or to schedule a session, you may fill out the Inquiry Form or call at 305-428-2790.  Make sure to leave a detailed message if we are unable to answer your call. 

 

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