by David Nelson
The Nature of Scoliosis
Scoliosis is a lateral curvature of the spine and corresponding rotation of the vertebrae. Because of the deformity of the spine, its normal lumbar, thoracic, and cervical curves may be reduced, the rib cage can rotate and deform, shoulder and/or pelvis heights may vary, and the head may tilt or lean.
The causes of scoliosis are varied and, left untreated, can progress dramatically to the degree of causing related organic mortality and diminution of life quality. Short of radical surgery and/or unwieldy braces, there does not seem to be effective medical therapy to correct scoliosis or prevent its progress. Yoga is an empowering, effective self-care therapy that can relieve pain caused by the condition and reduce and balance the forces contributing to the progression of the condition.
Functional scoliosis is an imbalance in the connective tissue supporting the spine. Back muscles, shoulder muscles, pelvic ligaments, etc. may develop unequal strength or flexibility and present the symptomatic shape of a scoliotic spine. It can be differentiated from structural scoliosis by observing that the spinal curvature will correct itself when it is put into a forward or lateral extension (sideways bend). Because it is limited to connective tissue, it can be treated with greater effect through yoga. Left untreated, it may result in structural scoliosis.
Structural scoliosis is the unequal growth of the calcified structures of the torso: the vertebrae and ribs. In this condition the left and right sides of the vertebrae are of different depths, the spinal process is off-center, the spinal canal is asymmetrical and one side of the rib cage may be larger than the other, with opposing posterior and anterior rotation of the ribs. Treatment of structural scoliosis will not reverse the calcified structural deformity, but can improve the secondary effects of the structure and reduce or stop progression of the condition.
Yoga Therapy for Scoliosis
Hatha yoga is the practice of extending consciousness to the gross, or physical body, incorporating movement, breath, sensory focus, and mental concentration. As a treatment for scoliosis, yoga is first a means for one to explore the nature of their scoliosis and to gain a greater awareness of the interrelationships throughout their body. For the yoga practitioner, yoga therapy for scoliosis is an opportunity to bring a higher degree of subtly and understanding to asana and pranayama practice.
To understand yoga therapy for scoliosis, I’ve found it useful to consider scoliosis as a process, rather than a condition. Whether functional or structural, the scoliotic process is a dynamic relationship of unequal pulls between the elastic tissue of the body, the leverage of the skeleton, and gravity.
Through conscious breathing, yoga can direct awareness to regions of the body that are often unfelt by the person with scoliosis. Thiscan result in letting go of tension and muscle contraction that may be contributing to or compensating for the primary scoliotic curve (or in the related joints and limbs).
As a means of decreasing the lateral curvature of the spine, yoga asana can actively lengthen connective tissue on the concavity of the spine while strengthening the supportive tissue in the abdomen, buttocks and on the convexity of the curve.  In the same way, it can contribute to the normal curves of the spine. Rotating asana can create greater flexibility and, when applied unevenly, can de-rotate the scoliosis and create better alignment. Standing poses not only impart a new understanding and control of vertical alignment, they also can start to unravel imbalance in pelvic structures and shoulder structures that contribute to the forces on the spine. Inverted postures reduce the effects of gravity and create space between vertebrae. Self-supported inversions strengthen the body with new foundations and relationships to gravity, creating opportunities to reverse the normal role gravity has in the scoliotic process.
One can reasonably expect yoga therapy to immediately reduce scoliosis-related back pain, to gain a new understanding of and participatory role in the scoliotic process, and to acquire comprehensive tools for self-care and growth in the maintenance of their health.
Readers are cautioned that as beneficial as yoga is in the scoliotic process, it can also be detrimental if practiced incorrectly. While movement usually makes the back feel better, over time an improper practice may actually contribute to scoliosis rather than reverse it. Therefore, practice under the guidance of a qualified professional.