Despite the Hype, There Are Still Only Three Approaches to Scoliosis Treatment
I happened upon a page on the American Chiropractic Association (ACA) Web site that explained scoliosis and its treatment options. Interestingly, the ACA lists three options for scoliosis treatment: careful observation, bracing, and surgery. Missing from this list are several commonly advertised methods of treatment for scoliosis. Most notably omitted is chiropractic. Despite a plethora of aggressively promoted options that are available to patients and their families, we think the ACA actually got this right.
To simplify this article, let us assume that the ACA included surgery as an approach for severe scoliosis cases only. Orthopedic surgeons cannot prescribe surgery for curves less than 45°. These cases would transcend an observation-only approach and push the limits of brace effectiveness. Therefore, let’s continue without surgery as one of the three approach options. Agreed? Good.
Next, let’s ponder the observation approach, which is commonly known as the “wait and see” approach. Although an important practice, technically there is no scoliosis treatment inherent in taking scoliosis curvature measurements every few months. Patients should consider the observing specialist’s scoliosis specialty. Orthopedic surgeons do surgery and might prescribe a rigid brace if the curve is below the surgical threshold, yet is progressing. Surgeons have their eye on patients reaching the threshold for surgery. There is also a specially trained group of chiropractors who offer a flexible brace that can be worn to correct and stop progression of curves ranging from 15°-45° degrees. This is called the SpineCor Brace. So, as the orthopedic surgeons’ specialty is surgery, the SpineCor chiropractors’ specialty is maintaining healthy spines. So, while surgeons focus on the progressed condition, chiropractors know their chances of treating scoliosis successfully are greater if detected and treated early.
There are a group of chiropractors, physical therapists and others who offer alternative treatment to manipulate scoliotic spines. On its Web site the ACA states that “Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis… ” Despite the ACA’s omission spinal manipulation (chiropractic) and therapies from its list of viable approaches plus the lack of clinical studies showing effective treatment, several providers are still leveraging popular exercises and therapies with catchy titles to lure patients. One such method uses the allure of a speedy fix, which entails a two-week “boot camp” – a trendy phrase that denotes focused exercises – which is coupled with an exercise regimen to be completed at home. Sounds simple, right? Unfortunately, this method has no randomized clinical study results to support the claims of the providers. Secondly, common sense tells you that scoliosis, which took months and perhaps years to progress, cannot be corrected in a matter of a couple or few weeks, no matter how many high-force gadgets and equipment the providers use to pull or push your spine in one direction or another.
We are all aware of the benefits of exercise such as yoga and pilates. However, for scoliosis sufferers these activities are likely to have little to no effect and can actually destabilize the spine if they are not in a flexible brace like SpineCor while exercising.
Schroth exercises have some enthusiastic support. However, the problem with these exercise regimen is that they are not administered to match the specific scoliosis curve of the sufferer. SpineCor, a company that offers a dynamic (flexible) scoliosis brace, developed a physiotherapy a regimen that specifies an exercise regimen that addresses many specific scoliosis curve types and is complemented the SpineCor Brace configuration.
When it comes to the bracing approach, there are two general types: rigid braces, i.e. the Boston, Rigo Cheneau, and Milwaukee braces; and the aforementioned SpineCor brace, which is the only clinically proven dynamic brace. The differences are huge. First of all, although Orthopedic Surgeons tend to recommend rigid bracing, clinical studies for these braces is dismal, causing many to wonder why they are so commonly prescribed. A big cause of failure with rigid braces, which are used only for pediatric cases, is lack of compliance due to discomfort and embarrassment. Rigid braces also make exercise almost impossible and are known to cause muscle atrophy when worn for prescribed periods.
Conversely, the SpineCor Flexible Scoliosis Brace allows patients a full range of motion and has a much lower profile, allowing it to be worn underneath clothing and while playing sports and completing exercise such as yoga and pilates. Both of these features increase the chances of full compliance. Furthermore, clinical studies comparing rigid braces to SpineCor show SpineCor achieved a much higher degree of success.
In conclusion, if your child has been diagnosed with scoliosis above 15°, I recommend that you act quickly if you want to ensure that they will not face surgery. Keep in mind what type of specialists will be handling your child’s case because that will determine which type of scoliosis treatment is likely recommended. Finally, if you believe bracing is the best approach, you will want to research clinical studies on rigid braces and the SpineCor brace published in credible journals.