One of the most common musculoskeletal disorders is scoliosis. It is a disorder which causes an abnormal curvature of the backbone or spine. Since the spine normally has curvatures when seen from the sides, the curvature associated to scoliosis can be seen from the front. Scoliosis is two-times more predominant in females than in males. It can occur at any age but is more common in people over 10 years of age. It is hereditary, which means a parent who has scoliosis would have children with scoliosis (http://www.medicinenet.com/scoliosis/article. htm#scoliosis).
The treatment for scoliosis is based on how severe the curvature is. The most common main categories of treatment are observation, braces and surgery. Bracing and surgery are the usual and customary management for scoliosis. However beneficial, they do not lack in complications like poor compliance for bracing and negative side effects for surgery. One major problem for the treatment of scoliosis is the lack of reliable prognostic tool (Romano & Negrini, 2008).That is why patients are looking for alternative therapy, including chiropractic treatment, massage therapy, manual therapy or manipulation. Chiropractors use these techniques based on anecdotal and historical information but there are no scientific evidentiary basis (Rowe, Feise. et al, 2006). The common conflict that arises here is the use of hands-on treatments, which are chiropractic treatment, massage therapy, manual therapy or manipulation, versus hands-off treatment. According to Thacker (1997), “There is still a tendency in most physiotherapy departments to follow a regimen of physiotherapy consisting of hands-on treatment, even though there is little evidence to suggest that this is of any long term use”. In addition, Straus (2004) stated that “the clinical evaluation of healthcare services commonly places the evidence base at the heart of best practice. However, recent commentaries have criticized the drive for evidence based practice, as it ignores patients’ values and preferences and promotes a cookbook approach”. With these, this paper will discuss the effects of hands-on treatment (chiropractic manipulation, massage or manipulation therapy) in comparison to hands-off treatment specifically in patients with scoliosis. In general, massage is the manipulation of the soft tissue muscles using the hands. According to the American Massage Therapy Association (AMTA), there are many advantages of massage, such as it improves blood circulation and movement of lymph fluid, strengthens the immune system, relieves muscle tension or stiffness, promotes deeper breathing, improves posture, fosters relaxation, satisfies the need for a caring touch, etc. But as stated by Kellie Heggie, there is one thing massage therapy cannot do, it is to increase the strength of the muscle being massaged. It just stimulates weak muscles or loosens the tight muscles. As stated above, massage is not a cure for scoliosis but it is still being used as an intervention despite the fact that there are still not much scientific evidences. In addition, according to the study done by Morningstar, Woggon and Lawrence (2004), preceding chiropractic authors looked into the efficiency of a variety of physiotherapeutic modalities for the treatment of scoliosis, like Pilates (Blum, 2001), stretching and massage (Tarola, 1994), therapeutic exercises (Golembiewski and Catanzaro, 2001), orthotics (Lantz and Chen, 2001), and ultrasound or electric stimulation (Feise, 2001). Investigating the possible advantages of combining manipulative and rehabilitative techniques from different chiropractic facilities is the reason for this study. The results showed that there is no significant alteration to the spinal structure when only spinal manipulation is done. Therefore, treatment should include manipulation and rehabilitative as well to promote structural change....
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