Written and reviewed for scientific and factual accuracy by Dr. Austin Jelcick, PhD and Dr. Matthew Janzen, DC
Choosing a scoliosis treatment provider is a difficult task. There are multiple types of treatment options all claiming to be better than the other. Many treatments are expensive, some treatments look extremely painful, other treatments look like they’re a huge time commitment, and others just don’t seem like they’d actually work. In an ideal world, you could simply do some stretches and your spine would miraculously straighten out. Unfortunately, that’s not usually the case for most scoliosis curves. So, how do you choose which scoliosis treatment is right for you? Before you either spend a lot of money, waste a lot of time, or do a treatment that’s irreversible – these are 5 things you should know before choosing your scoliosis treatment provider.
1. There are Multiple Types of Scoliosis
It’s extremely important to know which type of scoliosis you have prior to choosing a provider, as some types are much more difficult to treat as well as time sensitive. Some of the different scoliosis types include Congenital Scoliosis, Degenerative Scoliosis, Neuromuscular Scoliosis, and Adolescent Idiopathic Scoliosis. Among the different types, the most common type of scoliosis by far is Adolescent Idiopathic Scoliosis, also sometimes just referred to as Idiopathic. It is commonly believed that Idiopathic Scoliosis has no known cause; however, there have been multiple hypotheses on what the cause might be. For more information on what Scoliosis Care Centers has found to be the most common root cause, read The Root Cause of Adolescent Idiopathic Scoliosis.
2. There are Two Main Categories of Scoliosis Treatment
In a broad classification, there are two core types of scoliosis treatments; nonsurgical treatment and scoliosis surgery. With scoliosis surgery, there are two main options as well, Spinal Fusion Surgery and Vertebral Body Tethering. Both options are invasive (as surgery tends to be) Spinal Fusion Surgery is entirely irreversible and while VBT can be reversed on occasion, that is contingent upon the type and point of entry. There are a variety of different nonsurgical treatment options which include, but are not limited to, Scoliosis Soft Bracing, Scoliosis Hard Bracing, Traction Devices, Scoliosis Exercises, Schroth Therapy, and multiple combinations of those used in tandem (AKA a comprehensive treatment).
3. Time is of The Essence
Idiopathic scoliosis curve progression is directly correlated with increased rate of growth. In other words, the spinal curvature can quickly spiral out of control during growth spurts. Nonsurgical treatment works best while the body is still growing as the spine is not skeletally mature. The “wait and see” method of monitoring annually and taking no action is not a good strategy when you’re still growing. Yet despite multiple scientific studies confirming the effectiveness of bracing for scoliosis while cautioning against “wait and wait” due to the high incidence of progression and surgery, some scoliosis treatment providers appear to have missed the memo.
This begs the question –“How do I know if I’m done growing?” Doctors factor in a couple of things when assessing whether you’re still growing. First and foremost, age. If you’re 11 years old, it is highly likely you’re still going to grow. Secondly, if you’re female, if you haven’t had your first menses, you’re probably still going to grow. Lastly, doctors look at your Risser stage. Your Risser stage is determined by analyzing the ossification in the iliac crest or the growth plate in a hand through either an X-ray image or MRI. The stages go from 0-5, with 5 being skeletally mature.
4. Understanding Your Scoliosis Curve Measurements
The curvature of the spine is measured by calculating the angle of the topmost tilted vertebrae above the apex of the curve with the bottom-most tilted vertebrae. Where the lines intersect is the Cobb angle. The severity of scoliosis is determined by the Cobb angle. The ranges are as follows: 10-24 degrees is mild scoliosis, 25 to 39 is moderate scoliosis, and 40 degrees and above is severe scoliosis. 40 degrees is also the surgical threshold – most surgeons will not operate until the curve exceeds this measurement. There are two types of spinal curves, S-curves and C-curves. S-curves have two main curves. When referring to the severity of an S-curve, doctors will usually refer to the higher Cobb angle (see example). Given that S-curves have two main curves rather than one, they are generally more difficult to treat. That said, contrary to popular belief, S-curves can still be treated non-surgically, even severe cases.
5. Not All Scoliosis Braces are Created Equal
Scoliosis bracing is the most well-known method of non-surgical treatment. It is also one of the most heavily ridiculed, and for good reason. Although some braces are effective at straightening the spine, there are plenty of other braces that actually make the curve worse. That said, it’s important to point out that, through extensive studies, scoliosis bracing is the only nonsurgical treatment method proven to provide scoliosis curve reduction beyond a reasonable doubt. To ensure that you choose the best brace possible for your specific curve, here are some traits to look for in brace design:
- Custom bracing — every spine and scoliosis curve is different, so every brace should be too. Avoid generic one-size-fits-all braces.
- The spine will never be straighter than the brace makes it — if your spine is not straighter in-brace than it is out-of-brace, then it is not doing its job. The purpose of the brace is to hold the spine in a straighter and centered position.
- Part-time bracing — for very small curves you might be able to get away with just a nighttime brace. However, as a general rule of thumb, the brace only works when you wear it, thus the longer you wear it, the better the results. This is only valid if point ”B” is true. So, if a brace is advertised as only needed to be worn for a few hours a day it is likely to be ineffective.
- Monitoring the performance — arguably the most important thing in any brace design, it is critical to CHECK IF THE BRACE IS REDUCING THE CURVE. An in-brace X-ray or standing MRI (preferably standing MRI to avoid radiation) should be taken immediately after fitting to test the effectiveness of the brace and identify areas for improvement. The brace should be monitored every three months after initial fitting to ensure it’s still providing adequate correction.
If you’re interested in learning more about Scoliosis Care Centers’ nonsurgical scoliosis treatment, visit our treatment page , learn more about the Silicon Valley Method for treating scoliosis, or contact one of our case managers to discuss today!