Physical Therapy Management of Hip Pain in Adults with Scoliosis: A Case Series

Abstract

Background and Purpose: Adult scoliosis (AS) is a structural deformity of the spine in a skeletally mature patient and can cause asymmetrical loading on both the spine and the extremities. The purpose of this case series is to highlight physical therapy management of 3 adults with AS and hip pain by incorporating scoliosis specific exercise (PSSE) into their course of treatment. Case Description: The three patients in this study all had structural scoliosis of the spine found on radiograph, complained of hip pain that limited their quality of life, and varied in ages: 31, 48 and 68 years. All three patients had prior treatment to address their hip conditions with only temporary relief. The patients were treated with a combination of PSSE to address their scoliosis and posture in addition to more traditional physical therapy modalities to manage their pain and tissue healing. Outcomes: At the completion of physical therapy, all three patients reported a decrease in pain on VAS, improved scores on LEFS and reported meeting functional mobility goals in ADLS with self-management of symptoms. Discussion: Scoliosis is an asymmetrical deformity in multiple planes of motion and therefore causes asymmetrical forces to the pelvis and hip leading to stress, soft tissue and intraarticular breakdown to the hips across an age span. Non-operative treatment of orthopedic sequelae in this population should include assessment and management of the spine and, if managed earlier in a lifespan, may help minimize permanent damage to the joint.