Category: Blog

Do Boys Get Scoliosis?

Posted on July 8, 2020 by - Blog

Do boys get scoliosis? It’s a good question – and it’s one which we don’t hear people ask enough. While it’s certainly true that the majority of scoliosis cases which you’ll hear about in the news are females – and if you know someone with scoliosis, they’re more likely to be female, Males, can, and do get scoliosis.

 

Scoliosis and Gender

It’s a generally stated fact that scoliosis affects girls more than boys, or, more broadly, it’s frequently noted that about 75% of adolescent idieopathic scoliosis cases are females. Both statements are true – but adolescent idiopathic scoliosis is not the only kind of scoliosis, and 25% is still a large number of people!

To be a little more specific, let’s break the question down – first, scoliosis in children.

Idiopathic scoliosis is a 3-dimensional distortion of the spine and trunk that occurs in otherwise healthy children. 80% of scoliosis cases in this age group are considered to be “Idiopathic” or “of unknown cause” – scientists are fairly sure that genetics can play a role, but the exact onset of scoliosis Is still not fully understood.

A well-recognised theory about how scoliosis develops in adolescence revolves around asymmetrical growth of the vertebrae which de-stabilises the spine and makes the vertebrae prone to becoming wedged. Wedging of the vertebrae then creates a lateral spinal curve which places uneven loading on the vertebrae and precipitates further asymmetrical growth and progression. It is then thought that spinal cord tension develops as the spine bends and twists and brain function and growth is altered as muscle asymmetry develops.

We break idiopathic scoliosis down further into age groups – and here’s where the numbers get interesting.

Infantile idiopathic scoliosis is the name given to idiopathic scoliosis cases which are diagnosed in children between the ages of 0 to 3 years. Statistically, it is the least common of all forms of idiopathic scoliosis and comprises about 1% of all idiopathic scoliosis in children – while the numbers of overall cases are smaller about 60% of patients are boys.

Juvenile idiopathic scoliosis is diagnosed when scoliosis of the spine is apparent between the ages of 4 and 10. It is less common than adolescent idiopathic scoliosis but more common than infantile. In total, it comprises 10-15% of idiopathic scoliosis cases.
Juvenile scoliosis is also found more often in boys between the ages of 4-6, whereas between 6 and 10 it becomes more common in girls.

Adolescent idiopathic scoliosis is the type which we most frequently hear about – and here is where between 75% and 80% of cases are girls. It is usually noticed around 11-12 years of age in girls and slightly later when diagnosed in boys.  AIS is estimated to affect between 3 and 4% of teenagers. In most cases, AIS begins to develop noticeably at the initial onset of puberty and becomes more apparent as is worsens during growth spurts.

While it’s clear that when taken as a whole, girls will tend to make up the majority of scoliosis cases, there are substantial age groups where boys are the most common patients. It’s also critical to understand that while all scoliosis cases should be considered as potentially debilitating, the time available for scoliosis to progress (it typically stops at skeletal maturity) is a huge factor in determining risk.  Scoliosis discovered in a 5-year-old boy has considerably more time to progress, than in a 16-year-old girl.

Finally, there’s another common form of scoliosis to consider – affecting a very different age group. Older adults are at considerable risk of another common form of scoliosis, known as “de-novo” (degenerative) scoliosis. De-novo scoliosis is caused by wear and tear to the spinal discs as we age, and is therefore quite common – research suggests that as many as 30% of the over 60’s suffer from scoliosis. Although de-novo scoliosis progresses much more slowly than childhood or adolescent scoliosis it can still have a major impact on quality of life, if not properly treated.[1] De-novo scoliosis affects both males and females – and since such a large percentage of older people can suffer from this condition, there’s a very real argument to be made suggesting that taken over a lifespan, the rates of male and females scoliosis are much closer together than it might seem at first glance.

 

If you think you may have scoliosis

If you think you may have scoliosis, the advice is simple – regardless of gender, see a scoliosis specialist sooner rather than later. At the UK Scoliosis clinic, we offer in-person consultations at our Essex clinic, as well as online consultations from the comfort of your own home.

 

 

 

[1] ‘Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender‘
Kebaish KM, Neubauer PR, Voros GD, Khoshnevisan MA, Skolasky R, Spine 2011 Apr 20;36(9):731-6.

‘The prevalence and radiological findings in 1347 elderly patients with scoliosis‘
Hong JY, Suh SW, Modi HN, Hur CY, Song HR, Park JH.,  Journal of bone and joint surgery 2010 Jul;92(7):980-3

 

I Have Back Pain… Is it Scoliosis?

Posted on June 30, 2020 by - Blog

Back pain is probably the single most troublesome and common condition for people to suffer from today – our changing lifestyles as well as more time spent at a desk (or a home desk.. perhaps even worse) mean that BUPA now estimates that a many as 2 in 3 of us will suffer from back pain in our lives.[1] I began my career in spine care as Chiropractor, and proudly practice to this day. Each and every week I treat hundreds of patients for all kinds of back pain – most often it’s a common symptom, stemming from a common problem with a clear treatment pathway. Sometimes, however, back pain can be a symptom of something more serious – like scoliosis. So, could your back pain be due to scoliosis, and should you see a professional?

 

Does scoliosis cause back pain?

The issue of scoliosis and back pain has been somewhat contentious – many organisations will still tell you that back pain is not a symptom of scoliosis, or that scoliosis is “painless”. Today, however, these views are out of date – there’s a growing body of research that shows that while pain may not be the main symptom of scoliosis, it can certainly be a factor.

One recent study concluded that “Spinal pain is, in fact, a frequent condition in AIS patients, further supporting the need for early detection and screening to minimise potential pain and suffering”[2] and at the UK Scoliosis clinic, we support this view.

Research has also shown that in patients under 21 treated for back pain, scoliosis was the most common underlying condition (1439/1953 patients)[3] while another, involving 2400 patients with adolescent idiopathic scoliosis showed that 23% reported back pain at their initial contact[4]. Estimates suggest that scoliosis patients have between a 3 and 5 fold increased risk of back pain in the upper and middle right part of the back[5] – and support the view that chronic nonspecific back pain (CNSBP) is frequently associated with AIS, with a greater reported prevalence (59%) than seen in adolescents without scoliosis (33%)[6] It’s also been shown that patients diagnosed with AIS at age 15 are 42% more likely to report back pain at age 18.[7] – and finally, more positively, that part-time bracing in adult scoliosis cases can improve chronic pain[8]

So, can scoliosis cause back pain? Yes it can.  Does that mean your back pain is caused by scoliosis? Possibly – let’s explore more.

 

Back pain in adults

Back pain is incredibly common in adults – as stated above, 66% of us at least will suffer from it. The vast majority of these cases will not be scoliosis. Scoliosis progression is lowest in adulthood, and the incidence of new cases is almost nil amongst the general young and middle aged adult population. It’s certainly possible that undiagnosed, untreated childhood scoliosis is the source of your pain – but there are any number of common conditions which are far more likely. If you’re aged 25 – 60, it’s highly unlikely that scoliosis will be your problem.

As we age, the picture starts to change, however – mainly due to the presence of a condition known as “de-novo” or degenerative scoliosis. De-novo scoliosis is caused by wear and tear to the spinal discs as we age, and is therefore quite common – research suggests that as many as 30% of the over 60’s suffer from de-novo scoliosis. Although de-novo scoliosis progresses much more slowly than childhood or adolescent scoliosis it can still have a major impact on quality of life, if not properly treated.[9]

To the core point of this article, while most forms of scoliosis are detected at a scoliosis specific screening,  De-novo scoliosis is most often discovered as the result of a back-pain investigation. Patients with degenerative De-Novo scoliosis typically present for treatment with complaints ranging from debilitating back or lower extremity pain to spinal imbalances, as well as as a response to incidental findings on lumbar radiographs.

Counter-intuitively, the pain caused as a result of adult scoliosis is not related to the size of the curve. Several good studies show there is little to no relationship between the size of the curve and the intensity of pain – therefore a 20 degree and a 55 degree curve have the same chance of causing pain in an adult. Pain in adults is more commonly linked to the degree to which vertebrae individually shift to the side in what is called ‘lateralisthesis’ and their ‘postural balance’ or degree to which their trunk or upper body is shifted to the side or forward over their pelvis This means that a visual observation is not always sufficient to rule out scoliosis in adults, and a professional consultation is the best approach. Put simply, if you’re over 60, and suffering with new back pain – a scoliosis consultation isn’t at all a bad idea.

 

Back pain in Children and Young people

Finally, let’s look at the youngest population – children and teens. While we often associate back pain with older populations, this is a bit of a misconception – One meta-study from 2013 (nearly 7 years ago now) suggested a rate of low back pain among adolescents aged 9–18 years of about 12% at any given moment, whereas the number who would experience an episode of pain during a 12 month period was 34%.[10] This number certainly will not have improved!

It’s important to note that this headline figure is an average too – and the studies used in this broad-spectrum analysis showed great variation in the estimates of prevalence. For example, estimates from the Nordic countries showed a weekly occurrence of spinal pain in young people at around 20%[11], and a small Danish study showed a lifetime prevalence of spinal pain of 86% in a population of adolescents aged 11–13 years, with neck pain being the most prevalent.[12]

Scoliosis, whilst statistically less common in the young than the older, is far more risky for the young – since the opportunity for the condition to progress to the surgical threshold is greatest. Scoliosis is also known to develop rapidly and unevenly during growth spurts, making this a time for real concern. As an average figure, 3-4% of teens will develop scoliosis. Left untreated in young people, Scoliosis can be a life-limiting condition –  but treated early, its impact can be almost entirely mitigated. Back pain won’t always be present in a scoliosis case – so if you have concerns about the shape of a young persons back (this is the most common way scoliosis is detected) do not be dissuaded from seeking a consultation due to the absence of back pain – but, if presented with a young person with new back pain, a scoliosis consultation may be a wise approach.

 

 

[1] https://www.bupa.co.uk/health-information/back-care/back-pain

[2] ‘Back Pain and Adolescent Idiopathic Scoliosis: A Descriptive, Correlation Study’,
Theroux Jean, Le May Sylvie, Labelle Hubert [University of Montreal, Quebec, Canada; Murdoch University, Perth, WA, Australia], Spine Society of Australia 27th Annual Scientific Meeting (8-10 April 2016)
Jean Theroux, DC, MSc, PhD, Sylvie Le May, RN, PhD, Jeffrey J. Hebert, DC, PhD,and Hubert Labelle, MD : SPINE 153607

[3] Dimar 2nd JR, Glassman SD, Carreon LY. Juvenile degenerative disc disease: a report of 76 cases identified by magnetic resonance imaging. Spine J. 2007;7:332–7.

[4] Ramirez N, Johnston CE, Browne RH. The prevalence of back pain in children who have idiopathic scoliosis. J Bone Joint Surg Am. 1997;79:364–8

[5] Sato T, Hirano T, Ito T, Morita O, Kikuchi R, Endo N, et al. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City. Japan Eur Spine J. 2011;20:274–9

[6] Jean Theroux et al. Back Pain Prevalence Is Associated With Curve-type and Severity in Adolescents With Idiopathic Scoliosis Spine: August 1, 2017 – Volume 42 – Issue 15

[7] Clark EM, Tobias JH, Fairbank J. The impact of small spinal curves in adolescents that have not presented to secondary care: a population- based cohort study. Spine (Phila Pa 1976) 2016; 41:E611–7.

[8] Scoliosis bracing and exercise for pain management in adults—a case report
Weiss et al, J Phys Ther Sci. 2016 Aug; 28(8): 2404–2407.

[9] ‘Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender‘
Kebaish KM, Neubauer PR, Voros GD, Khoshnevisan MA, Skolasky R, Spine 2011 Apr 20;36(9):731-6.

‘The prevalence and radiological findings in 1347 elderly patients with scoliosis‘
Hong JY, Suh SW, Modi HN, Hur CY, Song HR, Park JH.,  Journal of bone and joint surgery 2010 Jul;92(7):980-3

[10] Calvo-Munoz I, Gomez-Conesa A, Sanchez-Meca J (2013)  Prevalence of Low Back Pain in Children and Adolescents: A Meta-analysis  BMC Pediatr. 2013 (Jan 26); 13: 14

[11] Torsheim T, Eriksson L, Schnohr CW, Hansen F, Bjarnason T, Valimaa R (2010)
Screen-based activities and physical complaints among adolescents from the Nordic countries.
BMC Public Health 10:324

[12] Aartun E, Hartvigsen J, Wedderkopp N, Hestbaek L (2014)  Spinal Pain in Adolescents: Prevalence, Incidence, and Course:
A School-based Two-year Prospective Cohort Study in 1,300 Danes Aged 11-13
BMC Musculoskelet Disord. 2014 (May 29); 15: 187

COVID-19 and Scoliosis – What you need to know

Posted on June 17, 2020 by - Blog

As we all know, COVID-19 seems, for the most part, seems to have a more significant impact on those with pre-existing health conditions. Sadly, many fit, healthy younger people have died from the virus, but it’s clear that those with health complications or who are simply a little older are disproportionately represented in the death statistics.

We have had questions from many clients, and indeed non-clients, wondering about how COVID-19 impacts those with scoliosis. While it’s important to stress that you should consult with your GP on your individual case, here are our best answers to some of your common questions at this stage.

 

Does scoliosis increase my risk to COVID-19?

At present, the UK government has defined two groups of people who are expected to be extremely vulnerable, and moderately vulnerable to COVID-19. At the present time, there is no evidence to suggest that Scoliosis itself is a factor in COVID-19 risk, although there are some areas where we would advise our clients to be cautious.

These lists are subject to change as we learn more about the virus, however at this time, the conditions listed are:

 

People at high risk (clinically extremely vulnerable)

People at high risk from coronavirus include people who:

  • have had an organ transplant
  • are having chemotherapy or antibody treatment for cancer, including immunotherapy
  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer
  • are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)
  • have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine
  • have been told by a doctor they have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)
  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)
  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)
  • have a serious heart condition and are pregnant

 

People at moderate risk (clinically vulnerable)

People at moderate risk from coronavirus include people who:

  • are 70 or older
  • have a lung condition that’s not severe (such as asthma, COPD, emphysema or bronchitis)
  • have heart disease (such as heart failure)
  • have diabetes
  • have chronic kidney disease
  • have liver disease (such as hepatitis)
  • have a condition affecting the brain or nerves (such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy)
  • have a condition that means they have a high risk of getting infections
  • are taking medicine that can affect the immune system (such as low doses of steroids)
  • are very obese (a BMI of 40 or above)
  • are pregnant – see advice about pregnancy and coronavirus

 

While scoliosis is not specifically listed here, there are several conclusions and cases we can take into account.

Firstly, severe cases of scoliosis can restrict breathing and reduce respiratory function – it has been shown that even under normal circumstances, those with scoliosis tend to have the lower functional capacity in this regard (that is to say, the ability to respire effectively). Many individuals with scoliosis do not experience these difficulties, however, it may be prudent to practice very strict social distancing out of caution. If you are aware that you have breathing difficulties as a result of scoliosis, we would suggest that you contact your GP for further advice, but consider yourself at higher risk.

Secondly, many scoliosis patients are older individuals suffering from de-novo scoliosis. De-novo scoliosis is very common in the population over 70 and again, may serve to limit mobility and perhaps respiration. In line with government guidelines, we recommend that this group take extra care.

Thirdly, while scoliosis is not generally considered a major issue as far as pregnancy is concerned, we suggest you inform your care team immediately if they do not already know you have scoliosis. It is important, for example, when placing an epidural, for your clinical care team to be aware that you have scoliosis. Because of the additional factors which scoliosis can bring to birth specifically, we recommend that you plan to have your child in hospital rather than considering a home birth or an alternative due to coronavirus.

 

Lockdown and scoliosis – what should I do?

Lockdown, while unpleasant has thus far been the most effective method available to control coronavirus. It’s clear that by reducing social contact we can slow the spread of the virus – however, it’s also becoming clear that many are now not persuing medical issues and treatment which they otherwise would. Initially, it was not possible to continue with many treatments, however, most clinics are now running as normal, with safety measures in place. We recommend the following while in lockdown:

  • Try to stay active as you normally would – if you have prescribed exercises, ensure that you do them each day as normal.
  • If you are bracing, continue with your wear time as usual. Do not be tempted to alter this yourself without consultation.
  • If you are due a brace or exercise review, the clinic is now open for you, if you are able to attend.
  • If you cannot attend the clinic in person, we can arrange a telehealth appointment for you as an alternative. We would suggest that a telehealth appointment is preferable to travel on public transport at this time, although if you can attend the clinic using private transportation this is better still.

 

I think I may have scoliosis, what should I do?

It’s critical that new scoliosis cases continue to be treated as quickly as possible, notwithstanding COVID-19. In Adolescent cases, in particular, even a few weeks can make a significant difference to the path of treatment as well as the potential outcome.

The UK Scoliosis clinic has re-opened for current patients and new or suspected worsening scoliosis cases. Social distancing can be maintained at all times at our clinic and special measures have been put in place to protect you. The total exposure to others required for a scoliosis consultation and even the instigation of a treatment plan is very low.

What is scoliosis anyway?

Posted on June 9, 2020 by - Blog

As you may – or may well, or well not ­– be aware, June is Scoliosis awareness month. Since so many of us are working from home, or simply having to take a break from normal life at the moment, you may well have noticed some talk about this online, so, what is Scoliosis, and why should be you be aware of it?

 

What is Scoliosis?

Simply put, scoliosis is a spinal disorder which causes the spine itself to be curved from side to side. A normal spine does indeed have a forwards and backwards curvature, so that viewed from the side it looks like an “S” shape – but in scoliosis, the spine also has a side to side curvature, so that viewed from the front or the back, it has an “S” or “C” shape. In fact, scoliosis is more complicated than this – there’s typically also a rotation of the vertebra (the spinal bones), but the general shape is what you might be able to notice in someone’s posture.

 

Can I see Scoliosis?

Scoliosis is sometimes possible to see, usually in more severe cases. In some individuals with very low body fat, it may be possible to notice the curvature of the spine – however, most common signs (like uneven shoulders and hips, or a rib hump when bending forward or one shoulder blade seeming to stick out more than another) tend to be the only noticeable change. It’s true that the worse a scoliosis case is, the more visible it will tend to be – but scoliosis can remain almost invisible for a long time before reaching this point.

Like all conditions, scoliosis is much easier to treat if it’s spotted early –  this is where scoliosis screening comes in. Scoliosis screening is a fast, painless and simple procedure which you can even try at home. In fact, many countries include scoliosis screenings as part of their public health measures, however, this isn’t the case in the UK.

 

Who can get Scoliosis?

Anyone can get scoliosis – on average, about 3% of children will develop scoliosis, whereas some forms of scoliosis, common amongst the older population can affect up to 30%.[1]

There are many different sub-types of scoliosis, but for ease of explanation we typically divide them into two groups – these are adult, and childhood scoliosis.

Adult scoliosis is caused either by the degeneration of the spinal bones, ligaments & discs with age or as a result of childhood scoliosis which was not treated. Childhood scoliosis (affecting infants through to young adults) is more of a mystery – right now the exact cause for about 80% of cases is unknown. This is termed “Idiopathic” scoliosis. The remaining 20% of cases are typically caused by congenital or genetic conditions, spinal malformations, underlying neuromuscular conditions, metabolic conditions or trauma.

Idiopathic scoliosis in children is typically classified according to the age that it is diagnosed. It is most common in adolescents (over 10 years) but also occurs in infants (under 3 years) and juvenile’s (3-10 years).

Approximately 3-4% of children are affected by scoliosis, that’s about one in each class at school. In adults over the age of 50, this figure increases to 30-40%.

The earlier scoliosis is detected, the more effective a treatment and management plan will be. This helps reduce the risk of progression and the potential need for surgery. If scoliosis specific exercise and/or bracing are used early enough in the development of scoliosis, curve progression can be stopped, and surgery avoided. In some cases, near-complete correction of the curve is possible.

 

How do I screen for scoliosis?

Screening for scoliosis is easy to do and takes less than 5 minutes – remember that early detection is the most important factor, so screen regularly and if you have concerns, get in touch with a scoliosis professional.

 

 

[1] Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender‘

Kebaish KM, Neubauer PR, Voros GD, Khoshnevisan MA, Skolasky R, Spine 2011 Apr 20;36(9):731-6.

Online consultations now available!

Posted on May 20, 2020 by - Blog

Get answers on Scoliosis- Fast, and from home.

If you have concerns about Scoliosis, perhaps after a screening or worry that you or a loved one may be developing Scoliosis, help form the UK Scoliosis Clinic is on hand when you need it. If you are unable to visit the clinic in person or want to get an initial opinion in advance, an online “telehealth” consultation could be a great option for you.

A Telehealth consultation can take place in your own home, wherever in the world you live – it’s also a fantastic option for those who have other medical concerns, such as coronavirus, which may discourage them from traveling unless strictly necessary.

Scoliosis is a complex condition which develops differently in each patient, so an in-person appointment at the clinic is always required at the start of a treatment program – however, an online consultation is an excellent first step to discerning if Scoliosis is or isn’t the cause of your problems. It is usually not possible to formally diagnose a new case of Scoliosis via a web consultation – however, if you already have X-rays we often can. At the end of your consultation, we will be able to provide you with a very strong indication of your likely diagnosis and how you might proceed to the best treatment options.

Online consultations are also an excellent way to quickly get a second opinion on a scoliosis case, which we strongly advise before embarking on a course of treatment.  In some instances, we may also recommend online consultation as a method of checking and updating exercise programs for those who are currently undergoing an exercise-based treatment plan.

As you would expect, the content of your online consultation will be held in the strictest confidence.

 

How does an online consultation work?

A telehealth consultation is much like a discussion on skype, or any other video conference system. For telehealth, we have to conform to strict guidelines around security and data handling but as a patient, your experience will be much the same as a normal chat.

To participate, you will need:

  • a laptop/ PC with built-in webcam and speakers
  • OR a laptop or computer with external webcam and speakers
  • OR an iPad/tablet device with webcam and speakers
  • a stable internet connection
  • a well-lit area with a clear wall/plain background
  • to wear clothes suitable for exercise or assessment
  • the webcam set up so your full posture can be seen on screen (from feet to top of head)
  • any prescribed exercise equipment ready for the session
  • if the consultation is related to a brace, have it ready
  • For those under 18, a parent or guardian must be present during the entirety of the consultation.

 

After your consultation

After your consultation you will receive a written report from Dr Irvine, detailing his observations on your case, recommendations for treatment (if required) and next steps.  If it is agreed that you would benefit from an in-person scoliosis consultation, we can arrange this for you at the earliest possible convenience.

Please note that our online consultation service is a “stand-alone” option, and there is absolutely no obligation to commit to a course of treatment at the UK Scoliosis Clinic after your consultation.

 

What does an online consultation cost?

Your online, private consultation with Dr Irvine is £120 for a 30 minute appointment.

Fees are payable in advance when you book your consultation. We accept all major credit /debit cards as well as bank transfer.

 

Book your online consultation

To book your scoliosis consultation please phone the clinic to arrange an appointment at a time which is convenient for you.

 

 

 

Does scoliosis always get worse?

Posted on May 14, 2020 by - Blog

One of the first questions which many people ask when they are diagnosed with scoliosis is “will it get worse?” There’s also a lot of misconceptions around this issue to deal with. It’s true that some scoliosis cases do simply stop developing – but despite what you might read on the internet, this is very rare. Today, we understand scoliosis much better than ever before, and so while we can’t fully explain the condition, we can now make some very sensible assumptions about its likely progression.

This week, let’s look at some of our current best information on this question.

 

Scoliosis development

Firstly, it’s important that we outline exactly what we mean by “worse” in this situation.  Scoliosis is a condition which causes a host of unpleasant symptoms, ranging from physical deformity to problems breathing and, perhaps most impactful for most people, a drastic impact on self-confidence. While these are all perfectly valid ways of understanding how ”bad” scoliosis is, in a clinical setting we tend to focus on an accepted measurement called  a “cobb angle”.  A Cobb angle measures the deviation of the spine from normal, such that a more pronounced scoliotic curve is said to have a greater cobb angle, or be of a greater magnitude. It is generally true that as cobb angle increases, symptoms will also become more severe. So, what do we understand about the factors which seem to predispose individuals to a greater increase in this regard?

 

Growth potential

Growth potential – that is to say, how much growing a skeleton has already done, and (roughly) how much more it has to do has been strongly correlated with curve progression.  This has been established since the early ’70s , when it was predominately believed that scoliosis progression was fastest during adolescent growth spurts.[1] More recently, however, we have come to understand that in fact, aspects such as the riser sign (an indication of skeletal maturity) and the onset of menstruation are closely correlated with the potential for curve increase.  Immature children

(Risser sign 0 or 1) with larger curves (20–29°) at initial diagnosis demonstrated a 68% risk for curve progression, whereas mature children (Risser 2–4) with similar curves at initial presentation had a 23% risk for curve progression. Conversely, immature children with smaller curves (5–19°) demonstrated 22% chance for curve progression, while mature children with smaller curves had only a 1.6% risk for curve progression. [2]

        The younger the child or the more growth left in the spine the greater the risk of progression.

 

Size of curve

Perhaps intuitively to most of us, the size of the curve at the point of discovery is also a factor in predicting its growth. Much research has examined the relationship between age and curve magnitude – for example, Nachemson et al, and Weinstein et al, correlated curve progression with age and curve magnitude,[3] however, today we also understand that curve magnitude can be an independent predictor of curve progression – that is to say that generally speaking, larger curves tend to get larger, and can also progress after skeletal maturity. Weinstein et al. and Ascani and colleagues reported that children with curves < 30° at skeletal maturity did not demonstrate curve progression into adulthood, while the majority of curves > 50° progressed at approximately 1° per year[4]

The larger the curve the more likely the curve will progress into adulthood.

 

Family History

A family history of scoliosis is a major indicator for the development of scoliosis – research indicates that those with a family member who has scoliosis go on to develop scoliosis in between 11.5 and 19% of cases – considerably more than the 2-3% average in the population as a whole. Research also suggests that those who have family members with severe curves are likely to develop more severe curves themselves, although the correlation is not total.[5] Other factors clearly influence scoliosis, which can also impact the severity of a curve, but those with family members with larger curves should be especially aware.

              If a family member has scoliosis and the bigger their curve is, the more likely other family members will have scoliosis.

 

Gender

On average, girls are up to 5 times more likely than boys to develop scoliosis and hen you also consider that many activities which are popular with young women and girls, such as gymnastics, have scoliosis rates up to 12.4 times as high as the general population. [6] While this is a complex area, since boys can, and do, get scoliosis – it’s important to note that 70% of scoliosis cases are girls. If you perform a home screening, or someone mentions that your child may have scoliosis, you should be especially cautious of that child happens to be a girl.

                      Girls and ballet dancers or gymnasts are more likely to have scoliosis.

 

And here’s the key takeaway

We now know a lot about the progression of scoliosis – far more than we ever did in the past. This means that we are far better able to predict the outcome of a case and to treat it appropriately. The keyword here is treat – since there’s one common theme which runs through each of these points – most of the time, scoliosis will progress, and often, it will progress quickly. While there is a chance that some curves may stop growing, it’s highly unlikely – research shows that juvenile cases, for example, almost never resolve spontaneously.[7]

Today, scoliosis treatment is highly advanced – if caught early, surgery can be avoided and most cases can be corrected quickly and in a non-invasive way. The longer cases are left to progress, however, the more difficult they are the treat, and the longer this will take.

At the UK scoliosis clinic, we see far too many young people in particular who have developed scoliosis and which has been allowed to progress. Sometimes the curve progression is sadly just too large for us to help – but each of these cases would have started out as a relatively small curve which, while certainly not desirable for a young person, would have been relatively simple to treat.

Please, do not wait to screen for scoliosis – do it today and if you have concerns get in touch!

 

 

[1] Duval-Beaupere G: Pathogenic relationship between scoliosis and growth. In Scoliosis and Growth Edited by: Zorab P. Edinburgh, Scotland: Churchill Livingstone; 1971:58-64.

[2] Bunnell WP: The natural history of idiopathic scoliosis before skeletal maturity. Spine 1986, 11:773-776.

Lonstein JE, Carlson JM: The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg (Am) 1984, 66:1061-1071.

[3] Nachemson AL, Peterson LE: Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. J Bone Joint Surg (Am) 1995, 77:815-822.

Peterson LE, Nachemson AL: Prediction of progression of the curve in girls who have adolescent idiopathic scoliosis of moderate severity. Logistic regression analysis based on data from The Brace Study of the Scoliosis Research Society. J Bone Joint Surg (Am) 1995, 77:823-827.

Weinstein SL, Ponseti IV: Curve progression in idiopathic scoliosis. J Bone Joint Surg (Am) 1983, 65:447-455.

Weinstein SL, Zavala DC, Ponseti IV: Idiopathic scoliosis: longterm follow-up and prognosis in untreated patients. J Bone Joint Surg (Am) 1981, 63:702-712.

[4]Weinstein SL, Ponseti IV: Curve progression in idiopathic scoliosis. J Bone Joint Surg (Am) 1983, 65:447-455.

Weinstein SL, Zavala DC, Ponseti IV: Idiopathic scoliosis: longterm follow-up and prognosis in untreated patients. J Bone Joint Surg (Am) 1981, 63:702-712.

Ascani E, Bartolozzi P, Logroscino CA, Marchetti PG, Ponte A, Savini R, Travaglini F, Binazzi R, Di Silvestre M: Natural history of untreated idiopathic scoliosis after skeletal maturity. Spine

1986, 11:784-789.

[5] ‘ Carol A Wise, Xiaochong Gao, Scott Shoemaker, Derek Gordon, and John A Herring, Understanding Genetic Factors in Idiopathic Scoliosis, a Complex Disease of Childhood’
Curr Genomics. 2008 Mar; 9(1): 51–59. doi:  10.2174/138920208783884874

[6] ‘ Carol A Wise, Xiaochong Gao, Scott Shoemaker, Derek Gordon, and John A Herring, Understanding Genetic Factors in Idiopathic Scoliosis, a Complex Disease of Childhood’
Curr Genomics. 2008 Mar; 9(1): 51–59. doi:  10.2174/138920208783884874

[7] Charles YP, Daures JP, de Rosa V, Diméglio A,  Progression risk of idiopathic juvenile scoliosis during pubertal growth‘ Spine (Phila Pa 1976). 2006 Aug 1;31(17):1933-42. DOI:10.1097/01.brs.0000229230.68870.97

Telehealth consultations – Now available!

Posted on May 1, 2020 by - Blog

The COVID-19 Crisis sweeping the world is making everyday life hard for all of us. While there are many issues which can be put “on the back burner” a scoliosis consultation should not be one of these. For patients at a high risk of progression – for example, those between 10 and 18 – scoliosis can evolve very quickly, which means a swift consultation is a must.

Effective immediately, Dr Paul Irvine, Dr of Chiropractic and founder of the clinic, will be offering Scoliosis consultations online in a highly secure, private environment. While a teleconsultation is not a replacement for an in-person appointment, it represents an excellent way to get an initial diagnosis and further information about next steps.

We will be posting more information about this option shortly – in the meantime, if you are urgently seeking an appointment please get in touch via our normal phone number and we will arrange an appointment with you, and answer any questions you have.

Scoliosis and Kyphosis, what’s the difference?

Posted on May 1, 2020 by - Blog

Given our name being the UK Scoliosis clinic you would expect or focus to be on the non-surgical treatment of scoliosis, however, we also work with many patients suffering from another common spinal condition – Kyphosis. But what’s the difference between Scoliosis and Kyphosis?

 

Kyphosis

Kyphosis is the condition which causes what’s sometimes called a “hunchback”, people with this condition tend to hunch forward, and, as you may have already realised, it’s getting far more common today than ever before.

But isn’t the spine supposed to bend forward slightly? – yes, it certainly is, however, when this forward bend becomes too pronounced it can become an issue. As a general guide,  it’s normal to have a mid-back kyphosis (backward c-shape curve) at approximately 40 degrees. Above this, unpleasant symptoms may result.

Typically, patients complain of aching and stiffness in their mid-back and lower back. It worsens when weight-bearing, especially when doing activities that require repeated bending such as gardening. Often, teenagers are noticeably hunched from spending hours on their phones, tablet’s or PC’s – a trend which often worsens into adulthood. Most age groups are at risk of Kyphosis, although there is probably a stronger link with lifestyle than with age per se.

 

Causes of Kyphosis

Like scoliosis, there can be different underlying causes of kyphosis, but unlike scoliosis, we understand these potential causes well. There are 4 main underlying issues which can lead to Kyphosis, these are:

 

Postural Kyphosis – is the most common form and the one which is increasing faster than ever before. Postural kyphosis is noticeable, in that it will appear when standing and sitting and disappear when laying face down. Postural kyphosis isn’t a structural problem caused by an abnormal shape of the vertebra that make up the spine, but rather by the supporting muscles and tissues. Over time, as we remain in a slouched position (such as sitting at a desk all day or hunched forward gaming for hours on end) certain muscles become too tight, others become weak and loose, leaving us with a “hunchback” look. Postural kyphosis, disappears when laying face down as the spine is able to return to its normal position, without the need the need for the surrounding muscles muscles to work and support the spine against the force of gravity.

 

Scheuermanns kyphosis

Scheuermann’s disease – is far less common, and results in an increased kyphosis throughout the teenage years whilst growth is occurring. It is a growth plate disorder in the vertebrae themselves, which causes them to become more wedged and compressed at the front, hence the increase in kyphosis. This will result in structural deformity as the bone formation is altered. Scheuermann’s cannot be “cured” or reversed, however, the right treatment at the right time, can help to significantly reduce the progression of the deformity. Bracing in the right cases has been shown to be a very effective treatment when combined with specific posture exercises.

 

 

 

 

 

Osteoporatic fracture, and kyphosis

Osteoporosis of the spine – is a common cause in older individuals – here, the fundamental cause is vertebrae undergoing compression fractures due to a loss of bone strength. Osteoporosis of the spine can cause a large increase in the kyphosis in people over 60. It will often continue to progress with age, thus it is vital that patients keep their posture upright and keep their bones strong for as long as possible. While again, this condition is not “curable” the right management can make a huge difference to the quality of life.

 

 

 

 

 

 Spinal malformations & birth defects – account for the majority of the remaining Kyphosis cases – there are a number of conditions which can cause the vertebra to not develop properly. Depending on the underlying condition and the severity, it may need surgical intervention.

 

Treatment Of Kyphosis

In most cases of Kyphosis, the condition can be treated effectively with specific postural correction exercises & stretches, postural traction and kypho-bracing when necessary. Advanced manual approaches such as Chiropractic Biophysics can be highly effective in resolving Kyphosis cases. Beyond initial treatment, the same approach can be used to manage and reduce the severity of symptoms, often so that the impact on daily life is very little. Only in very severe cases is surgery typically required, and this is usually due to the risk of progression and further complications. Many cases of postural kyphosis can be improved or resolved.

The pictures below show the correction in an adult male with hyper-kyphosis, through the Chiropractic Biophysics technique. The pictures are approximately 1 year apart.

Scheuermann’s disease, and cases related to osteoporosis in particular, can often benefit from part-time bracing with a specialised Kyphosis brace, such as Kyphobrace – in these cases, a “cure” is not possible, but with proper management, it is entirely possible to live a normal and healthy life with Kyphosis.

In senior’s with kyphosis, caused by underlying osteoporosis, further compression fractures become more likely as the spine becomes progressively more hunched. Hence, treatment & exercise programs need to be gentle and designed to help keep patients more upright, improve balance to resist falls, and include nutritional support to help maintain bone strength. Gentle supportive bracing in senior’s can also be effective in helping them stay upright when whey are standing and walking.

 

 

Scoliosis

Whereas Kyphosis causes “forward hunching” posture, related to an excessive forwards bend in the spine, scoliosis causes a side to side curvature of the spine resulting in a distinctive scoliosis profile.

Unlike Kyphosis, Scoliosis tends more often to be a serious condition which, in most cases, progresses (sometimes rapidly) without proper treatment. While Scoliosis can cause pain, it does not always, and in many cases it is only detected through screening or is noticed by friends of family members during a trip to the beach or when changing clothes. Whereas Kyphosis is quite easy to spot. Scoliosis can progress to a significant degree without any obvious signs, so screening is a very good idea to enable early detection.

 

Causes of Scoliosis

Whereas the causes of Kyphosis are well understood, and (with a bit of planning) you can reduce your risk through targeted exercise and fitness approaches, most cases of scoliosis have no known cause – in a large number of cases, the condition is described as ”idiopathic” – literally meaning “without known cause”.  The underlying pathologies are therefore:

 

Idiopathic scoliosis – Idiopathic scoliosis is most commonly found in younger teenagers, with the most at-risk group thought to be between the ages of roughly 11 and 16. Girls are affected more often than boys, but boys can and do develop scoliosis.  While the cause is not currently known, research suggests that genetics may play an important role. It’s also believed that participation in some activities such as ballet or gymnastics, in which there is a contortion of the spine, may hasten or promote the development of scoliosis.

 

Degenerative Scoliosis – Degenerative scoliosis is a condition typically seen in people over the age of 60. In this case, we do know the cause – degenerative or “de novo” scoliosis is simply caused by wear and tear as we age, involving changing in the shape of the vertebrae and weakening of the spinal ligaments and muscles enabling the vertebrae to twist and turn.

 

Scoliosis from other causes – Other, less common causes of scoliosis include congenital deformities and problems with the formation of the spine such as hemi-vertebra or butterfly vertebra, and are usually present from birth. Other cases may be caused by underlying neurological and syndromic conditions that may or may not have already been diagnosed.

 

Treatment for scoliosis

Scoliosis in older individuals (de novo scoliosis) cannot be “cured”, in the same way as kyphosis in older individuals cannot be “cured” – however, similar approaches can be used to significantly reduce the impact of scoliosis on one’s life, and in some instances, it is also possible to reduce the scoliotic curve itself. Scoliosis bracing can be highly effective as a means to achieve this and has also been shown to reduce pain where it exists.

Scoliosis in younger individuals is almost invariably a case of idiopathic scoliosis – the treatment for this depends on the severity of curve at time of diagnosis, but in all cases, the objective is to straighten the spine as much as possible. In cases which are caught very early, when the curve is still small, scoliosis can sometimes be corrected using scoliosis specific exercises – a regime of scientifically based movements and stretches designed to counteract the scoliotic curve. In very young patients (who are not able to perform scoliosis specific exercise) or in larger curves, scoliosis bracing is the preferred method of treatment. While bracing results vary according to the brace type that is used, today a very high number of cases treated with corrective bracing achieve a reduction of the curve down to a “normal” scoliosis value.

 

Is it Scoliosis, or Kyphosis?

If you’re unsure about an unusual posture or spinal issue you have noticed, an excellent place to start is a professional consultation at the UK Scoliosis Clinic, just get in touch!

5 scoliosis facts that may shock you!

Posted on April 11, 2020 by - Blog

If you’ve been reading this blog for a while, or if you have an interest in scoliosis, you will certainly have noticed some themes which come up again and again. Even a quick browse through the recent research in the field, demonstrates that the main areas of interest are fairly constant – adolescent idiopathic scoliosis, the genetic links for scoliosis and the most effective methods for reducing cobb angle come up more often than not. There’s more to scoliosis treatment than just these factors however – so this week, we look at some lesser-known but potentially surprising scoliosis facts.

 

Surprising scoliosis fact number 1

The group most at risk from scoliosis is older adults.

Because of the risk of progression, and the potential consequences if treatment is not forthcoming, much research, advertising and awareness campaigning in the scoliosis field concentrates on adolescent idiopathic scoliosis – next in line is probably juvenile scoliosis. The fact is, only about        2-3% of the population in these groups will develop scoliosis. That’s still a very large number of cases, all with a significant risk of progression, but when you crunch the numbers, its clear that older people are, in fact, the most likely to suffer from scoliosis – the risk is nearly 10 times higher!

Research indicates that approximately 30% of those over 60 suffer from scoliosis[1] – the majority of cases are termed “de-novo” which is a scoliosis that develops due to spinal degeneration and can respond well to treatment.

 

Surprising scoliosis fact number 2

Scoliosis is sometimes more common in males 

It’s true that 75% of adolescent idiopathic scoliosis cases are females, and since this gets the lions share of attention in the field, it’s little surprise that most screening campaigns and tools are targeted at young girls. That being said, in some instances scoliosis is actually more common in boys. Specifically, this is the case in cases of infantile scoliosis. Infantile scoliosis is the least common of all forms of idiopathic scoliosis and comprises only about 1% of all idiopathic scoliosis in children. However, about 60% of patients in this group are boys. Infantile scoliosis can sometimes resolve spontaneously, but presents the highest possible risk for progression, so should be monitored and treated urgently.

 

Surprising scoliosis fact Number 3

Which is better, bracing or exercise? …. Actually, it’s both!

When it comes to treatment methodologies, it’s usually a case of picking the best approach and sticking with it. As it concerns scoliosis treatment, a multiple studies have confirmed that when bracing and exercise approaches are combined the results are greater than the sum of the parts. Curve correction with a dual approach is superior to either approach alone.[2]  What’s more, it seems that using exercise approaches before and after bracing can speed correction, and then prevent loss of correction after bracing.[3]

 

Surprising scoliosis fact Number 4

Your GP knows a lot less about scoliosis treatment than you might hope.

This point isn’t about criticising GP’s – they do a fantastic job, but there’s only so much any one person can know, and as it goes, scoliosis is fairly low down the list of major concerns for the general population. The situation is especially difficult in the UK, since the National Health Service (NHS) is (understandably) not in the business of recommending private companies, and the best bracing technologies on the market today are only available privately. It’s for this reason, that you must seek a specialist scoliosis consultation whenever possible – the braces on offer through the NHS are still mainly “passive” options, which don’t correct scoliosis, just try to stop it progressing.

 

Surprising scoliosis fact number 5

Active bracing is often the most cost-effective option.

Active scoliosis braces, like ScoliBrace, are advanced medical devices and aren’t cheap – and while no one would claim that the cost of a scoliosis bracing treatment is insignificant, in many cases it can be substantially less financially impactful than many other options.

Lets briefly consider the main treatment methodologies available:

Surgery – Through the NHS in the UK, surgery for scoliosis is of course free. So naturally the issue here isn’t a financial one, but rather the cost of surgery is often in terms of complications after the event – or with the disruption that it can cause to a young persons’ life. The UK Scoliosis Clinic isn’t anti-surgery – on the contrary, we know that spinal surgeons can do fantastic work for patients who have no other option – we do, however, believe that surgery should be the last resort since for many, recovery is long and complicated. While it won’t be the case for everyone, recent meta-analyses of published research have suggested that the complication rate could be as high as 89%.[4]

Exercise – Exercise-based treatment plans are only supported by research  for small curves with a low risk of progression and while exercise might initially seem cheaper than bracing, this is only true if the treatment is appropriate. In young growing spines, the risk of scoliosis progressing in moderate to large curves is high, thus a curve must be constantly straightened via a brace rather than through the intermittent use of scoliosis specific exercise. In cases where a brace has been required and only scoliosis specific exercise used, curves will often progress and surgical correction will be required.

Other forms of bracing – Regular readers will know that Scoliosis braces are not created equal. Passive models, which don’t correct scoliosis but attempt to hold the curve in its current position, do absolutely nothing to “treat” the condition.  Other braces on the market, while still active in nature, unlike Scolibrace are often not adjustable – meaning that their corrective capacity is limited, thus a new brace is frequently required as the curve changes. This means that in many cases, an advanced adjustable brace, like ScoliBrace will be cheaper in the long term.

 

 

 

[1] Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender‘
Kebaish KM, Neubauer PR, Voros GD, Khoshnevisan MA, Skolasky R, Spine 2011 Apr 20;36(9):731-6.

‘The prevalence and radiological findings in 1347 elderly patients with scoliosis‘
Hong JY, Suh SW, Modi HN, Hur CY, Song HR, Park JH.,  Journal of bone and joint surgery 2010 Jul;92(7):980-3

 

[2] ‘The effectiveness of combined bracing and exercise in adolescent idiopathic scoliosis based on SRS and SOSORT criteira: a prospective study‘
Negrini S, Donzelli S, Lusini M, Minnella S and Zaina F 2014, BMC Musculoskelet Disord. 2014; 15: 263, Published online 2014 Aug 6. doi:  10.1186/1471-2474-15-263

‘Adult scoliosis treatment combing brace and exercises‘
Papadopolous D 2013, Scoliosis 20138(Suppl 2):O8, DOI: 10.1186/1748-7161-8-S2-O8

 

[3] Negrini S, Negrini A, Romano M, Verzini N, Parzini S: A controlled prospective study on the efficacy of SEAS.02 exercises in preparation to bracing for idiopathic scoliosis. Stud Health Technol Inform 2006, 123:519-522.

 

[4] Hans-Rudolf Weiss and Deborah Goodall, Rate of complications in scoliosis surgery – a systematic review of the Pub Med literature, Scoliosis, 2008, 3:

What is Night Time Bracing?

Posted on April 1, 2020 by - Blog

Today, Scoliosis bracing is recognised as the most effective non-surgical scoliosis treatment to reduce cobb angle in scoliosis cases – and to do so relatively quickly. This isn’t to say that bracing is a total solution – scoliosis also creates muscle and posture imbalances which are best addressed by methods such as scoliosis specific exercise, however, we now understand that Bracing is far more effective than exercise in reducing cobb angle itself. [1]

Research also shows that the longer scoliosis braces are worn, the more quickly the underlying cobb angle can be corrected[2] – this means that typically, bracing will be almost full time with a view to achieving rapid change. However, for some smaller curves night time bracing, a part-time bracing option, maybe a viable way to go – so what’s the evidence for night time bracing?

 

Night time bracing

Whereas most scoliosis bracing takes place on a nearly full-time basis, night time bracing is a part-time approach – which, as you may have guessed, takes place in the evening and at night.

Night time bracing is one approach which has been considered as a way of addressing concerns relating to poor patient compliance, which is often noted with the use of full-time bracing. Night time braces will, by their nature, tend to correct a curve more slowly than a full-time brace – however, based on the clinical results available, a recent study concluded that night time braces constitute an attractive option for single-major lumbar/thoracolumbar curves not exceeding 35 degrees in magnitude. [3]

Like all approaches, night time braces have some pros and cons, however, and it’s a decision that should be discussed with a scoliosis professional. Some factors to consider are:

 

Advantages of night-time braces

More attractive wear time – many patients find that wearing a brace in the evening or at night is easier for them to manage from a social point of view, and it’s an attractive option for parents who are worried about bracing their children during school hours.

Higher compliance – Compliance with prescribed brace wear time is one of the most critical aspects of scoliosis treatment, and with young children and adults, in particular, maintaining compliance is perhaps the most difficult part of treatment. Higher compliance rates, even at a slower correction speed, may prove better in the long term than a full-time brace which is not worn properly.

Ideal for maintaining results – Night time braces represent an excellent option for preventing scoliosis returning in patients who have successfully completed treatment, but need to maintain curve correction until skeletal maturity has been achieved. Unlike an exercise-based approach, a night time brace requires very little effort from the user.

Suitable for early intervention – Night time braces may be a good choice for patients who have a curve unsuitable for exercise-based treatment, or for those who are too young or weak to be able to perform exercise properly.

 

Disadvantages of night-time braces

Slower curve correction – cobb angle correction correlates with brace wear time, so a lower wear time means a longer duration of treatment. In some situations, a shorter course of more intensive bracing may be preferable.

Not suitable for large curves –  larger curves require full time bracing, meaning that night time braces are not likely to be effective for more serious scoliosis cases. Our ScoliNight brace is recommended for curves less than 25 degrees.

Less cost-effective –  night time braces achieve less correction over the same course of time than a full-time brace. In growing children, this may mean multiple braces need to be purchased, rather than just one full-time brace.

 

In most cases, we recommend a full time (or near full time) brace for scoliosis treatment, especially for larger curves. In most cases, correcting the curve as soon as possible is the main concern – however as suggested above, night time bracing could be an excellent option for correction maintenance over the longer term.

It’s also important to stress that modern scoliosis braces do go quite some way to alleviate the main issues associated with low compliance – the model we prefer, the ScoliBrace, is designed using a fully individualised CAD/CAM process to fit the wearer snugly but comfortably. ScoliBrace comes in a wide variety of colours and can be virtually invisible under clothes if this is the look you prefer. Similarly, it’s flexible enough to allow the wearer to participate in sporting activities and normal play with no significant hindrance.

 

Want more information about night time Bracing?

To find out if night time bracing might be the right option for you, book a consultation today! The UK Scoliosis Clinic offers consultations at our clinic, or online, via webex

 

 

[1] Yu Zheng, MD PhD et al. Whether orthotic management and exercise are equally effective to the patients with adolescent idiopathic scoliosis in Mainland China? – A randomized controlled trial study SPINE: An International Journal for the study of the spine [Publish Ahead of Print]

[2] ‘Effects of Bracing in Adolescents with Idiopathic Scoliosis’
Stuart L. Weinstein, Lori A. Dolan, James G. Wright, and Matthew B. Dobbs, N Engl J Med 2013; 369:1512-1521 October 17, 2013DOI: 10.1056/NEJMoa1307337

[3] Grivas TB, Rodopoulos GI, Bardakos NV. Biomechanical and clinical perspectives on nighttime bracing for adolescent idiopathic scoliosis. Stud Health Technol Inform. 2008;135:274-90. PMID: 18401098.