In the proper naming of a scoliotic presentation, the direction of the spinal convexity compared to a referenced lower extremity is considered. Usually, spinal convexity is directed towards the shorter extremity. For example, in right-sided scoliosis, the convexity is to the right. The right side of the spine is elongated and Left side is shortened. The left hip lifts to bring the heels to the same level because the Left lower extremity is longer than the right (see Fig. 1).
Fig.1. A patient with R scoliosis. The L hip is angled higher which indicates that the L lower extremity is longer than the right
Furthermore, in a right sided scoliosis, the following signs may be present as well; The hump would be more prominent on the right side (when viewed from the back). The thoracic ribs would protrude on the right side especially in a ‘forward bend test’ and the right shoulder would be higher than the left shoulder.
Clinical interventions to manage scoliosis in the early stages will include a combination of stretching (tight muscles) and strengthening (weak or lengthened muscles) techniques. In this case, the muscles on the convex side are stretched and require strengthening while the muscles of the concave side are tight and require stretching.
If scoliosis is neglected, the curves may progress dramatically, creating significant physical deformity and even cardiopulmonary problems with especially severe curves. Currently, scoliosis is treated successfully by special braces, electrical stimulation, surgery or by combinations of these three techniques.