There are multiple types of scoliosis, or spine curvature disorders. The curving of the spine to the side is defined as being scoliosis. The condition commonly affects the areas around the chest and lower section of the back. The cause of the condition is often unknown, though a few preexisting conditions, such as cerebral palsy, muscular dystrophy, and spina bifida can be some factors in the patient’s development of scoliosis. When the spinal disorder is found in children, it is often left untreated because the curve of the spine often corrects itself as the child develops. It is still recommended, depending on the severity of the curvature and the age of the child, that the patient undergoes physical therapy in combination with a scoliosis brace.1 There are also different types of scoliosis: lordosis and kyphosis. The spine is curved inward at the lower back when the condition is lordosis while kyphosis is diagnosed by the presence of an abnormally rounded upper back. The patient may develop lordosis if they have conditions such as achondroplasia, the disorder associated with dwarfism, osteoporosis, and obesity. Kyphosis can come from poor posture, arthritis, osteoporosis, and other spinal conditions. It is the different types of scoliosis curves that distinguish the different spinal disorders. These disorders can be painful and affect the patient’s long term health and living.2
When Is a Brace Needed For Scoliosis?
The uses of different types of scoliosis braces are determined by the severity of the spinal curvature. The pressure from the braces is used to prevent the curve from progressing, and some braces must be worn full-time while others might only be worn at night while sleeping. The type of brace provided can also be determined by what the patient’s clinic has experience with. The Boston brace is the most commonly prescribed full-time brace. A mold that best fits the patient is selected and then corrected with the additions of pads removal of some areas to finish shaping the brace for the patient’s body. The brace puts pressure on the misaligned spine and promotes its realignment on the other side. The Wilmington brace is molded based on a cast taken while the patient is lying face up, with all of the specifications of the patient’s body done before the brace is officially finished. The Milwaukee brace is rarely used because the previous two braces are newer and less bulky, though it is still used sometimes for the correction of curves located higher on the spine. For nighttime use, the Charleston bending brace and Providence brace are two options. Both employ a stronger corrective force and as such are meant to be worn lying down. The Charleston bending brace is the more common of the two. A cast is made of the patient and then additional corrective forces are designed based on the patient’s spinal x-ray. The bend in the spine is held in an overcorrected position while the patient sleeps. The Providence brace, rather than overcorrecting the curve in the opposite direction, elevates one shoulder to apply lateral rotational forces on the curve. Nighttime bracing may be preferable for some patients who may find the simpler routine easier to adhere to, though full-time bracing is favored by doctors.3 There is some controversy over whether or not bracing works. It is difficult to prove the effectiveness of bracing due to there being very few random control trials done to study the use of braces. Patients also often exaggerate their adherence to bracing or do not properly keep track of the hours wearing the brace. Some types of scoliosis braces are also designed or used improperly, such as when measurements of the patient are inaccurate or the patient does not notice the brace becoming loose. It is also debated whether soft or rigid braces are more effective, with the rigid braces being the most likely to produce a positive result despite the discomfort the patient may experience while wearing one.4
Alternative Treatment for Scoliosis
Chiropractic treatment may be helpful in the treatment of scoliosis, though the techniques used are often not the same as a traditional chiropractic spinal adjustment. The realignment of a spine with scoliosis must be gradual; it is more delicate than a regular adjustment. Finding the right chiropractor who knows what techniques to perform and what exercises to prescribe is important. “Scoliosis exercises include balance training [and] strength training”.5 Maintenance of a strong back and overall balance can include the performance of several types of yoga poses. Mountain pose is a good pose to begin with. The patient should stand with their big toes touching and their heels slightly separated, lifting onto the balls of their feet for a few seconds before returning to the neutral position. This is a good preparatory pose before moving onto the tree pose. The body’s weight is put on one foot while the other leg is lifted and bent so that the sole of the foot is against the opposite thigh or calf. The position is held for a few moments before repeating on the other side. Other yoga poses for the different types of scoliosis include cat/cow pose and child’s pose.6
Learn more about chiropractic care and scoliosis.