Your child is in the middle of treatment for adolescent scoliosis. It is hard work for both the parents and the child or teen herself (sometimes himself). Between physical therapy, bracing of different types or even spinal surgery in extreme or sometimes unnecessary cases, it would be comforting to know that in the long-term, improvement and rectification of the spinal curvature will be permanent.
The right time for brace treatment is during the growth spurts of your child. We know that brace treatment effectively curtails curvature progression, but questions remain about long term stabilization into adulthood and beyond. There is still some controversy of scoliosis bracing among certain homeopathic practitioners. In this article we will touch on both, the short term and long-term effectiveness of scoliosis bracing for children and adolescent sufferers of adolescent idiopathic scoliosis.
Let us look at an actual real-life case of a girl with adolescent idiopathic scoliosis. The case we are studying is the treatment of an eleven-year-old girl. (For ease of explanation we will call this girl Lisa, since privacy prevented publication of her name). Lisa’s treatment was started when she turned eleven and weaning from the brace began when she was fifteen, since no more residual growth was anticipated by the scoliosis experts and her doctor.
When Lisa began treatment with the Rigo-Chêneau brace her Cobb angle measured thirty- eight degrees. After two years of bracing, the Cobb angle was reduced to nineteen degrees. The Cobb angle did increase slightly to fourteen degrees at weaning. When Lisa turned twenty-one, five and a half years after brace weaning, there was no change in the Cobb angle, which steadied at nineteen degrees. Lisa and her happy parents were extremely satisfied with the outcome of treatment and Lisa has full functionality in every way.
Why does the idea that bracing does not work remain when so much research and case histories show that the opposite is true? There is a practical side to this claim for practitioners who are not medical doctors, for example chiropractors and nutritional experts to boost and sell their treatment plans. Their claims may have validity for small Cobb curves of less than twenty-five percent. Especially for actively growing children and teens, anyone with a Cobb curve above twenty-five percent, treatment without a brace is quite risky and even dangerous having permanent ramifications as they turn into adults. In fact, there was a major well-known study called, The BrAIST study which ended prematurely because of ethical reasons. Why allow a child with scoliosis to be treated with a questionable non-brace treatment and put them into long term jeopardy when the data was clearly showing that there was a great likelihood of them suffering permanent irreversible damage?
Chiropractors such as Dr. Jordan Axe, use muscle strengthening techniques and soft braces. These ideas in themselves sound appealing but only if the Cobb curvature is negligible or under twenty-five degrees. However, with a substantial curve, muscle firming and strengthening is not going to do it because it is not the muscles that are the problem but the bone structure of the back. Let us compare it to a bone fracture. For example, if a person can use a soft cast for a minor fracture that is great but for other more serious breaks a hard cast must be worn. Similarly, a person who has a major curvature of the spine needs a hard brace to realign and fix the bone structure itself. Dr. Axe claims correctness is lost after the patient stops wearing the brace sometimes requiring surgery afterwards. When good bracing practices are utilized reliable scientific evidence shows that these claims are false.
Dr. Stuart Weinstein’s, 2013 BrAIST study, isone of the most important conclusive studies of the benefits of scoliosisbracing for adolescent idiopathic scoliosis. Nine additional studies met theScoliosis Research Society’s criteria confirming that bracing is the mostsuccessful treatment available. In fact, each of these studies confirmed thatthe average success rate of the treatment is 85.4%. As of last year, 2019, itwas confirmed by the above society that bracing is successful in treating mostpatients suffering from adolescent idiopathic scoliosis.
When Maddie Houser, a ten-year old youngsterfrom North Liberty, Iowa was given a scoliosis diagnosis, her mom Becky wantedto avoid surgery at all costs, so she volunteered for her daughter to be partof Dr. Weinstein’s study. Becky had her own experience with scoliosis surgeryherself. Becky spent three weeks in the hospital and nine months in an upperbody cast when she had her surgery thirty years earlier.
At thirteen years of age, Maddie, Becky’s daughter was given the good news that she no longer needed her scoliosis brace since her growth spurts had stopped and she was stable at a twenty-eight degree curvature.
Dr .Weinstein presented his findings at the forty-eighth Annual Meeting of the Scoliosis Research Society, in Lyon, France. At the same time, he published the results of his study online in The New England Journal of Medicine. Several medical facilities worked simultaneously to conduct a medical study of the highest level to answer the question of how effective bracing was in children and adolescents. Two-hundred-forty-two patients at twenty-five sites across America and Canada were included in Dr. Weinstein’s study. The children, who were still growing, ranged from ten years to fifteen years of age. Their Cobb degrees ranged from twenty to forty degrees.
A special monitor was placed inside the brace of the patients in the bracing group to keep track of how long the brace was worn each day. The prescription for this study was eighteen hours. (The length of time has been increased recently to up to twenty-three hours in many scoliosis centers.) There was a control group which did not receive bracing. Of the brace wearing group, seventy-two percent of the wearers avoided any type of surgery while over fifty percent in the control group required corrective surgery. Increased wearing time of thirteen hours and more increased the success rate by ninety percent. This study concluded that not only was brace wearing crucial to recovery but the amount of time the brace is worn is so important. Strong evidence of the value of brace treatment was especially valuable to those adolescents who were at high risk for surgery requirements.
An article in the New York Times concludedthat wearing of a scoliosis brace will slow the progression of the idiopathicadolescent scoliosis and help avoid surgery. As stated above, the trial wasstopped earlier than originally planned because the clarity of the bracing wasso pronounced.
A 2017 study by Angelo Aulisa followed patients for fifteen to twenty years after completion of scoliosis bracing. Over a twenty-one-year period, two-hundred and nine adolescents with scoliosis were in the Aulisa study. All curves (within three degrees increase) stayed around the same even after fifteen years of treatment completion. What the curve was before made little difference, if the curve was smaller than thirty degrees or larger than thirty degrees before beginning brace treatment.
Long term studies have been conducted for the last forty to fifty years stating that when left untreated scoliosis can worsen according to the size of the curve. Even after the patient stops growing the deterioration will continue especially when the curve is above fifty degrees. Studies following patients even twenty years following spine correction surgery with screws, rods and bone fusion have found that curves can continue to increase.
Conclusion
Finally removing a brace that was worn by your child or adolescent for several years is a crowning moment to be cherished. Looking at the results and improvement is a happy moment for sure for both parents and child. Celebration is certainly in order with a trip to the mall for a new fashion wardrobe and a peaceful and undisturbed night’s sleep. A parent would be even happier if they could be assured that their child’s progress and the greatly lessened Cobb degree angle that was measured at brace removal would be permanent. From major studies conducted, it seems that the answer is, yes. Even if the Cobb angle increases slightly over the years of adulthood, the patient’s quality of life does not decrease. Learning the skills of standing straight along with exercising regularly, the adult scoliosis patient has a great chance of never going back to the humpy uneven look of their childhood.
As bracing becomes accepted each year more and more as the optimum treatment of adolescent idiopathic scoliosis, we will see more studies of its treatment successes. There are so many different types of braces today each one specifically engineered for the patient’s optimal valuable therapy. Looking to the future is always beneficial in any type of temporary therapy, whether, psychological, physical, or even dieting. Seeing actual case histories of patients similar to your own child will help both you and your child look to a winning future and seeing the brace in the closet, basement or garage will be a reminder of your child’s victory and for your perseverance as parents to keep your child positive in reaching their goal.
FAQs
Long Term Effects of Scoliosis Bracing? ›
There are some concerns that wearing certain types of braces for long periods of time can immobilize the spine and the muscles, accelerating the process of disc degeneration and causing muscle atrophy and weakness.
What is the side effect of scoliosis brace? ›- Depressed mood.
- Physical limitations that can reduce one's overall quality of life.
- Increased stress.
- A decrease in self esteem.
- Decreased flexibility.
- Social isolation and anxiety.
- Negative body image.
- Pain and sores from the pressure the brace exerts on the body.
Does bracing work for scoliosis? A small percentage of curves can still get worse after bracing, even if the brace was worn correctly. That's why it's important to have close follow-ups with your orthopaedic doctor and regular X-rays, and keep up with your scoliosis exercises.
When is it too late for scoliosis brace? ›Don't despair because you're an adult with scoliosis — it's never too late for treatment.
What is the success rate of scoliosis bracing? ›About scoliosis bracing
Of these patients, about 75 percent are successfully treated with scoliosis bracing. The other 25 percent go on to need spinal fusion surgery. Orthopedic doctors typically recommend scoliosis bracing for kids and teens who are still growing and have a curvature of 25 degrees or more.
One of the disadvantages of using a back support is that it can cause weakness of your spine if you wear it excessively. This can be easily avoidable if you do not rely on your back brace as a crutch. Occasionally, patients may have increased pain while wearing a back brace.
Does scoliosis brace weaken muscles? ›The short answer is no. Used properly and for the correct duration, back braces usually do not weaken back muscles. On the contrary, back braces can significantly strengthen muscles when used in accordance with proper guidance from your chiropractor.
How many hours a day should a scoliosis brace be worn? ›In general, if the treatment goal of bracing is support and pain reduction, it will be worn for 4 to 6 hours a day; if the treatment goal is curvature reduction, it will need to be worn full time, meaning around 20 to 23 hours a day.
Can sitting too long worsen scoliosis? ›Conclusions: Maintaining a sitting position for a long time results in advanced asymmetries of the trunk and scoliosis, and causes a decrease in lumbar lordosis and kyphosis of a child's entire spine.
What happens if you wear a brace for too long? ›Wearing a brace too long can be counterproductive. If a brace is worn too long, that can cause muscle weakening (atrophy) and de-conditioning of the surrounding ligaments, joints, and muscles; especially if daily exercises to strengthen the area are not done.
Can you fix scoliosis without a brace? ›
Most people with scoliosis do not have to wear a brace. About 1 out of every 6 adolescent patients shows signs of their curve enlarging during their growth spurt. The larger a curve gets, the more likely surgery may be needed to correct it.
What is the best sleeping position for scoliosis brace? ›In terms of sleeping position, the best position for someone with scoliosis is to sleep flat on their back. The use of pillows to fill the gaps between the back and the mattress help to keep the spine in a straight and neutral position.
What degree of scoliosis is severe? ›Health care providers measure scoliosis curves in degrees: A mild curve is less than 20 degrees. A moderate curve is between 25 degrees and 40 degrees. A severe curve is more than 50 degrees.
What are the cons of scoliosis braces? ›This brace can cause a lot of muscle soreness. The brace can worsen a secondary curve if there is any because it only addresses the major or primary curvature. The brace leads to decreased muscle activity and eventual weakness, though not as severe as other braces.
Are scoliosis braces permanent? ›Bracing can be effective for slowing or halting progression of your spinal curve when you have scoliosis. It can't completely or permanently straighten your spine. It can only be used if the curve is moderate in size and while your bones are still growing.
How many people wear scoliosis braces? ›Growing Incidences of Musculoskeletal Disorders
This is often right before puberty when kids have a growth spurt. More than 600,000 people with scoliosis go to private doctors each year. According to estimates, about 30,000 children are given braces every year.
It is important to note, that back braces are not meant to be worn all the time. Listed below are some activities which maybe appropriate to wear a brace however it is not meant to be worn more than about 2 hours daily. Excessive use of a back brace can actually lead to muscle atrophy and weakening of your core.
Is it OK to sleep with the back support brace on? ›It is critical to note that the lumbar support is not safe to be worn 24×7. Until you are advised by your doctor, it is not recommended to sleep with the lumbar support belt on as it may eventually lead to rashes on skin and muscle weakness.
Should I sleep with or without back brace? ›It's possible for you to wear a back brace 24/7 if advised by your doctor. If you have pain and discomfort when lying down, try wearing your back brace. If you're uncomfortable lying down with your brace on, sleep without it.
What muscles are tightened in scoliosis? ›In typical forms of scoliosis, the abnormal curvature will bend to the right, away from the heart, and in cases of scoliosis that produce an over-pronounced 'S' shape, the lower curve will bend to the left, and this can lead to excessive tightness in the right side of the piriformis muscle.
Does strengthening your back fix scoliosis? ›
Strengthening exercises build muscle strength and endurance in your core to slow the progression of the spinal curve and reduce scoliosis-related pain and discomfort.
Which side of muscle is weaker scoliosis? ›The researchers refer to the right bulkier muscled side (convex) as being the “weaker side.” While the right side is the longer side of the spinal extensors, it is not necessarily the weaker side.
How tight should a scoliosis brace be? ›When you or your helper pushes on both sides at once, there should be no "give" or movement of the brace. Wear it as tightly as possible. The straps should be tightened beyond the original mark if possible.
Can you exercise in a scoliosis brace? ›All kinds of land exercises (such as cycling, badminton, and dance) are encouraged as exercising with the brace speeds up the curve correction. The soft brace also allows much better muscle retaining and joint mobilization, which has a great impact on curve correction retention after the brace treatment is over.
Can you sleep on your side with a scoliosis brace? ›Sleep with pillows, even if you wear a brace.
When sleeping on your side, Dr. Velikova suggests tucking your knees into your chest. Then place one pillow between your knees and another pillow under your waist for extra support. Dr.
In particularly severe cases of scoliosis the ribcage can be pushed against the heart and lungs, causing breathing problems and making it difficult for the heart to pump blood around the body. This can also increase the chances of lung infections, such as pneumonia, and lead to problems such as heart failure.
What not to do with scoliosis? ›- Looking down at your phone. ...
- Lifting heavy objects. ...
- Certain exercises. ...
- One-sided / impact sports. ...
- High heels, flip-flops, and other shoes that don't provide much support.
In addition, certain yoga poses can actually exacerbate scoliosis-related symptoms and cause more harm than good. These types of poses include those that involve twisting the torso, bending backwards, hyperextending the middle back, bending the rib cage, and/or unnaturally bending the head forward.
Is 5 years of braces too long? ›The average orthodontic treatment plan is anywhere from 18 months to three years. It's different for everyone, but anything beyond a four-year treatment plan warrants getting second, third and fourth opinions.
What happens if you wear braces for 10 years? ›If brackets remain in place for years, plaque could build-up in places that are hard to reach, eventually leading to tooth decay and gum disease. Some Brackets May Later Dislodge– Under normal circumstances, when a bracket dislodges, your orthodontist will reattach it.
Is 3 years with braces too long? ›
The average amount of time for braces is between 1 and 3 years. But you may need them for a shorter or longer amount of time depending on your circumstances.
How can I straighten my scoliosis naturally? ›Mild scoliosis is often managed simply with exercise, medical observation, scoliosis-specific physical therapy, and chiropractic treatment from a chiropractic scoliosis specialist. For some people with scoliosis, yoga or pilates is also recommended to decrease their pain level and increase flexibility.
Can chiropractor fix scoliosis? ›A chiropractor for scoliosis can develop a non-invasive, drug-free scoliosis treatment plan that addresses multiple symptoms. While chiropractors are unable to straighten your spine completely, studies have shown a marked improvement in spine curvature, pain, and disability rating among those with scoliosis.
What is the newest treatment for scoliosis? ›New Surgical Treatments for Scoliosis: Vertebral Body Stapling and Wedge Osteotomies. Two techniques showing promise for scoliosis in kids who are not done growing. Randal R. Betz, M.D.
How do I stop my scoliosis from progressing? ›Proper exercise is crucial to prevent the progression of scoliosis. As the spine curves, the muscles around it grow weaker and subsequently allow for the curvature to increase. You'll need a strong back and abdominal muscles to keep your spine upright, but it's essential to work with an expert.
Is twisting bad for scoliosis? ›Unless you're certain it will not aggravate the rib arching, scoliosis patients should avoid twisting the torso against the pelvis. The rib arch is increased as it rotates backwards into the existing curvature, regardless of whether the rotation is to the left or right side.
What vitamins are good for scoliosis? ›Amino acids and specific B vitamin supplements (very safe supplements for scoliosis) can fix most neurotransmitter imbalances. For example, serotonin is crucial for the body's proper dynamic postural control. Plus, the body converts serotonin into melatonin, which is another deficiency linked to scoliosis.
Is Walking good for scoliosis? ›Walking is a safe and healthy form of exercise for people with scoliosis because it doesn't play into the condition's asymmetrical effects by overusing one side of the body, nor does it involve repeated jarring motions that can increase compression.
What age is best for scoliosis surgery? ›Yet, scoliosis spinal fusion surgery is often recommended when a scoliosis curve measures over 50 degrees. It also gets recommended before children are done growing — as young as age 14.
Is S or C scoliosis worse? ›S-shaped scoliosis, the more dangerous form, is its affinity to rotate or twist spinal bones as it bends sideways. The C-shaped scoliotic curve may not present with the rotatory component, and as such, they are easier to treat.
Does scoliosis limit life expectancy? ›
Most people with scoliosis are able to live normal lives and can do most activities, including exercise and sports. The condition does not usually cause significant pain or any other health problems, and tends to stay the same after you stop growing – see a GP if it gets any worse.
Has scoliosis ever been reversed? ›Happily, the answer is yes – given the right type of treatment, scoliosis can be reversed.
Has anyone ever fixed their scoliosis? ›As a progressive structural spinal condition, scoliosis isn't curable, but it is highly treatable. While there are no guarantees, proactive treatment delivered through a conservative chiropractic-centered treatment approach can help patients achieve corrective results.
What percent disability is scoliosis? ›One of those conditions is scoliosis, which is rated under the VA's General Rating Formula for Diseases and Injuries of the Spine between 10% and 100%.
Is it normal for a scoliosis brace to hurt? ›It's normal for a brace to be uncomfortable for the first couple of weeks, but the brace shouldn't hurt. If it does, the family probably needs to go back to the orthotist to have it adjusted. Also, the patient's skin should not be red or blistering.
Can you sit down with a scoliosis brace? ›If you are uncomfortable we would recommend asking to sit on a chair, as sitting on the floor for a long period of time can be very painful and uncomfortable in your brace.
How should I sleep with a scoliosis brace? ›When sleeping, I recommend to sleep with a pillow between your knees and also with a wedge higher up to help reduce pressure on your brace, especially if you sleep on your side. Try to sleep on the side which pushes in the least from your brace so that gravity cannot work against you.
How tight should my scoliosis brace be? ›When you or your helper pushes on both sides at once, there should be no "give" or movement of the brace. Wear it as tightly as possible. The straps should be tightened beyond the original mark if possible.
How many hours a day should you wear a back brace? ›It is important to note, that back braces are not meant to be worn all the time. Listed below are some activities which maybe appropriate to wear a brace however it is not meant to be worn more than about 2 hours daily. Excessive use of a back brace can actually lead to muscle atrophy and weakening of your core.
Should I sleep without pillow if I have scoliosis? ›It's generally recommended to use a pillow if you sleep on your back or side. However, what's most important is that you feel comfortable and pain-free in bed. If you have neck or back pain, or if you have spine condition like scoliosis, sleeping without a pillow may be unsafe.