Tag: bracing

Should I remove my brace before a progress X-ray?

Posted on February 17, 2023 by - Blog

X-rays are the gold standard when it comes to diagnosing scoliosis and tracking the progress of treatment for the condition. Scoliosis is notoriously difficult to gauge from a visual inspection alone, meaning that regular X-rays are critical to ensuring that treatment is progressing as expected and that any adjustments to a patient’s brace are made at the correct time. In the usual course of treatment, Scoliosis professionals take X-rays every 6-12 months with these goals in mind – which often leaves patients asking, should I take my brace off before the X-ray?

 

In-brace vs out of Brace correction

What’s important to understand is that a Scoliosis Brace provides better correction while being worn than not being worn – that might sound obvious but it’s important to remember that the role of the brace is to correct, or often, over correct Scoliosis, in order that over time the spine is corrected when the brace is removed.

When you put a Scoliosis brace on, research suggests that it takes around 2 hours[1] to reach the maximum correction that can be obtained by using a brace. After removing, the correction obtained is gradually lost over around 2 hours, after which the curve/spine stabilizes[2]  Over time, the goal of Scoliosis treatment is to reduce the amount that correction is lost when the brace is removed – over corrective braces, such as ScoliBrace achieve this by adding corrective force to he spine to help to move it towards its proper position.

 

Braces and X-rays

So, should you remove your brace before a progress X-ray?  Taking the brace off, perhaps even days before the X-ray gives a truer picture of what’s “really” happening with the spine – but tells us little about how much correction the brace itself is providing. By contrast, leaving the brace on during the X-ray, or removing it right before gives us an excellent idea of how well the brace is working (and whether it’s time to adjust it), but isn’t as good at showing us how the spine might look after hours, or days of no wear. A good compromise is often an in-brace X-ray, followed by an out-of-brace X-ray after a short break which can give an idea of in-brace correction, and allow us to approximate an out-of-brace figure.

Nonetheless, it’s a complex issue, and for these reasons, at present, there’s no defined standard for the best way to carry out progress X-rays – generally speaking, it’s up to the Scoliosis practitioner to decide how to perform X-rays, based on the specific needs of the patient.

But let’s not forget the most important fact about Scoliosis bracing – it’s a treatment method which works over time – for this reason, we’re often less concerned with the exact method used to take progress X-rays, and more with the fact that the x-rays are performed in a consistent way. That is to say, during treatment, we care less about the exact degree of correction and more about the direction of travel.

 

Should I remove my brace before a progress X-ray?

The answer to the question is simply… do as your practitioner suggests! When to remove, or not remove the brace isn’t an issue that you as a patient need to worry about – but you should make sure that you comply with the instructions you’re given, and that you do so each time you visit for a progress X-ray. Rember, it’s consistency which matters!

 

 

 

[1] Katarzyna Zaborowska-Sapeta et al. The Duration of the correction loss after removing cheneau brace in patients with adolescent idiopathic scoliosis Acta Orthopaedica et Traumatologica Turcica 53 (2019)

[2] Meng Li  1 , M S Wong, Keith D K Luk, Kenneth W H Wong, Kenneth M C Cheung, Time-dependent response of scoliotic curvature to orthotic intervention: when should a radiograph be obtained after putting on or taking off a spinal orthosis?  Spine (Phila Pa 1976). 2014 Aug 1;39(17):1408-16.

Does bracing reduce quality of life?

Posted on September 1, 2022 by - Blog

While modern Scoliosis bracing represents a huge leap forward in the non-surgical treatment of Scoliosis it’s no secret that wearing a brace can be taxing, especially for young people. Modern braces like ScoliBrace have the additional benefit of being low profile, easy to move in and almost invisible under clothing, but no doubt wearing a brace is an additional stressor for a young person to cope with.

 

The Psychology of bracing

Although clinical evidence regarding bracing effectiveness continues to strengthen, there is still uncertainty regarding the impact of brace wear on psychosocial well-being, as well as the impact of psychological well-being on brace wear adherence. We’ve reported on numerous studies which have argued the case both ways on this issue – overall, it’s fair to say that the majority of research suggests that bracing can be a stain for patients, but that interventions designed to support them during the process are also effective in reducing any possible harm.

Some research has found that full-time brace wear can indeed negatively impact a patient’s, emotional, and social well-being, including a significant worsening of body image.[1] In addition, research has found that the adverse effects on a patient’s psychosocial well-being induced by brace treatment can then result in poor brace wear adherence[2]  – on the flip side, some studies have confirmed that interventions aimed at improving poor psychological outcomes can improve brace adherence.[3]

While we might naturally expect these results, other research has found no negative impact on psychological well-being induced by brace treatment[4].

 

Recent study

A recent study has now added to the debate, by going beyond just the obvious question of wheather bracing has negative psychological impacts or not. Rather, the authors noted that some of the discrepancies in the brace wear adherence research could well be due to the type of brace wear data used to assess adherence. It’s an (unfortunate) fact that the majority of research on brace wear adherence is based on subjective reports, such as self-reports through brace wear diaries and logs – even at our clinic, were mostly reliant on patients accurately self-reporting their brace wear (or their parents doing so) in order to continue to tailor and tweak treatment as bracing progresses.

The new paper[5] points out that in many studies bracing adherence rates have ranged from 41% of wearing hours/prescribed to as high 100% of wearing hours prescribed – making it very difficult to make an accurate assessment of the linkage between actual brace wear and any potential negative effects. This study, therefore, addressed this limitation, by using body heat monitor data from the landmark BrAIST study, rather than self-reports to assess relationships between body image, quality of life (QOL), and brace wear adherence. The use of temperature monitors during the BrAIST study was one of the factors which made the research so impactful and the data is considered reliable.

Using this data, the study analyzed relationships among brace wear adherence, body image, and quality of life. Thanks to the BrAIST data, it was possible to compare those patients who wore their brace most consistently, for the longest time – and those who only wore it periodically. If the groups who were more adherent to the brace-wearing time experience more psychological issues than those who wore the brace very little, it would seem reasonable to suggest the two are correlated. When looking at differences between the least-adherent and the most-adherent brace wear groups, however, the findings from the study actually supply no evidence that the amount of brace wear negatively impacts body image or QOL, or that poor body image and poor QOL negatively impact brace wear adherence.

 

Important takeaway

This is perhaps not the result that many parents, in particular, would expect to see – nonetheless, the outcome of the study was to say that those patients who did not wear their braces as prescribed were no better off Psychologically for doing so – they did, however, most likely have a lower curve correction than otherwise would have been the case. Conversely, those who wore their braces as instructed and received the best curve correction possible faced no additional stress or strain for doing so – they simply gave themselves the best chance at an excellent result.

As a Scoliosis clinic, it’s easy for us to repeat the message on the importance of sticking to brace wear time – we’ve pointed out in many articles that doing so directly correlates with better outcomes – as a parent, of course, it’s harder to coerce a child into wearing their brace if you’re also concerned about the stress it might be causing them. This article isn’t to say that bracing isn’t hard (although we try to make it as easy and fun as possible!) but do keep these results in mind!

 

 

[1] Pham VM, Houlliez A, Caprentier A, et al. Determination of the influence of the Cheneau brace on quality-of-life for adolescent with idiopathic scoliosis. Ann Readapt Med Phys. 2007;51:3–8.

[2] Rivett L, Rothberg A, Stewart A, et al. The relationship between quality of life and compliance to a brace protocol in adolescents with idiopathic scoliosis: a comparative study. BMC Musculoskeletal Disorders. 2009;10:5.

Chan SL, Cheung KM, Luk KD, et al. A correlation study between in-brace correction, compliance to spinal orthosis and health-related quality of life of patients with adolescent idiopathic scoliosis. Scoliosis. 2014;9:1.

Donnelly MJ, Dolan LA, Grande L, et al. Patient and parent perspectives on treatment for adolescent idiopathic scoliosis. The Iowa Orthopaedic Journal. 2004;24:76–83.

[3] Donnelly MJ, Dolan LA, Grande L, et al. Patient and parent perspectives on treatment for adolescent idiopathic scoliosis. The Iowa Orthopaedic Journal. 2004;24:76–83.

Matsunaga S, Hayashi K, Naruo T, et al. Psychologic management of brace therapy for patients with idiopathic scoliosis. Spine (Phila Pa 1976). 2005;30:547–550.

[4] Hasler CC, Wietlisbach S, Buchler P. Objective compliance of adolescent girls with idiopathic scoliosis in a dynamic SpineCor brace. J of Children’s Orthop. 2010;4:211–218.

Schwieger T, Campo S, Weinstein SL, et al. Body Image and Quality-of-Life in Untreated Versus Brace-Treated Females with Adolscent Idiopathic Scoliosis. Spine (Phila Pa 1976). 2016;41.

Danielsson AJ, Wiklund I, Pehrsson K, et al. Health-related quality of life in patients with adolescent idiopathic scoliosis: A matched follow-up at least 20 years after treatment with brace or surgery. Eur Spine J. 2001;10:278–288.

Merenda L, Costello K, Santangelo AM, et al. Perceptions of self-image and physical appearance: Conversations with typically developing youth and youth with idiopathic scoliosis. Orthop Nurs. 2011;30:383–390.

Olafsson Y, Saraste H, Ahlgren R. Does bracing affect self-image? A prospective study on 54 patients with adolescent idiopathic scoliosis. Eur Spine J. 1999;8:401–405.

[5] Traci Schwieger, PhD,corresponding author* Shelly Campo, PhD,* Stuart L. Weinstein, MD,* Lori A. Dolan, PhD,* Sato Ashida, PhD,* and Keli R. Steuber, PhD Body Image and Quality of Life and Brace Wear Adherence in Females With Adolescent Idiopathic Scoliosis J Pediatr Orthop. 2017 Dec; 37(8): e519–e523.

I think my Child has Scoliosis – 3 things NOT to do

Posted on April 14, 2022 by - Blog

As parents, we all want to do the best for our children – and when you suspect Scoliosis it can be hard to know what to do. Despite efforts from the Scoliosis community the condition is still widely unknown in the general population which can lead to confusion and that feeling of not knowing where to turn. The most important step to take if you do suspect scoliosis is simply to get active – reach out for help and get the ball rolling.

There are however, a few things you should definitely not do – these three issues are, in our experience the biggest pitfalls for parents of children with scoliosis, so wherever possible do not:

 

1 – Be passive

Because Scoliosis is a lesser known condition, you may well not know anyone who has suffered with the condition. The reality is that Scoliosis should be treated as quickly as possible, as treatment is much easier with a smaller curve, however the lack of awareness in the community can lead to a false sense of lack of urgency. Even amongst those who do know about Scoliosis, many are still unaware that new, non-surgical treatment options now exist. 10- 15 years ago, it was thought that surgery was the only effective option for treating scoliosis, so even many medical professionals were simply taught that the best approach to scoliosis is to “wait and see” if the curve becomes bad enough for treatment. The problem is that scoliosis almost never resolves on its own[1] so while it’s possible it may not progress further “wait and see” is never a good option – at the very least see a scoliosis specialist and ensure the condition is being monitored.

 

2 – Ignore the costs

Unfortunately, very little non-surgical Scoliosis treatment is available in the UK through the NHS. This means that if you’re looking for non-surgical treatment, you’ll probably be taking about private care. Please do see your GP to find out what is available in your area, but you should expect that Scoliosis treatment will cost you money.

It’s easy to react to these costs by either ignoring them (which isn’t responsible) or failing to contextualise them properly (which isn’t realistic). There are two major factors to consider here. Firstly, if you are seeking help for a scoliosis case which is already severe, the chances for successful treatment without surgery are lower – the larger the existing curve, the higher the chance non-surgical approaches will fail. A reputable scoliosis practitioner will give you the best indication they can as to the possible outcomes of treatment and what you might expect in a best or worst case scenario – you should base your decision on the cost of treatment on your own expectations for outcomes, and how likely they are. In some cases, you may be paying simply to delay surgery which will be required anyway and this is important to remember.

At the other end of the scale, it’s critical to remember that Scoliosis treatment is a long process – the totality of your scoliosis treatment will extend from discovery of the condition through until your child has reached adulthood – it’s therefore essential to remember that the costs for treatment are spread over a very long period of time. The price of a Scoliosis brace, for example, is therefore best considered as a monthly one over duration of the brace, rather than a single one off cost.

 

3 – Forget about mental health

Scoliosis can be stressful for everyone involved – and since it’s a condition which commonly affects teens and young adults, it comes at a time of life which is already delicate for many. There are two main approaches to scoliosis treatment plans to choose from – one is group based treatment, and one is individual treatment. Group based settings offer no privacy, but can potentially foster a ready made support group, whereas private one to one settings offer privacy without peer support.

The right kind of environment for you will of course depend on your own child’s preferences – so try to keep this in mind when choosing a clinic. At the UK Scoliosis clinic, we provide a private one to one environment, although we welcome as many relatives or friends that your child would like to have around them to attend consultations, exercise sessions and treatment reviews. Research has shown that having a calming and private environment to discuss and perform treatment can actually lead to better clinical outcomes, although this won’t be ideal for every child. [2]

 

Getting help

If you’re concerned about Scoliosis, please don’t hesitate to get in touch with us – we offer Scoliosis consultations online as well as at the clinic with no obligation to take up treatment, whatever you do – be active!

 

 

[1] Angelo G Aulisa et al. ‘Brace treatment in juvenile idiopathic scoliosis: a prospective study in accordance with the SRS criteria for bracing studies – SOSORT award 2013 winner, Scoliosis 2014 9:3

[2] Elisabetta D’Agata et al. Introversion, the prevalent trait of adolescents with idiopathic scoliosis: an observational study Scoliosis and Spinal Disorders (2017) 12:27

What is the most common treatment for Scoliosis?

Posted on March 14, 2022 by - Blog

If you look around online, you’ll quickly see that lots of people are looking for advice on what the most common treatment for scoliosis is – in fact, “what is the most common treatment for scoliosis” is one of the most popular asked questions on google search!

 

 

The problem with “common” treatment as a concept…

We understand why this is – but for us, this question speaks to a real problem with most people’s understanding of Scoliosis! It’s essential to understand that Scoliosis is a highly individualised condition – yes, it has common hallmarks whenever it is present, but almost every aspect of the condition will, in fact, vary between patients. Because of this, treating scoliosis successfully requires a treatment approach which is personalised, rather than common or generic.

Usually, it’s not even enough to describe a broad treatment pathway when treating a Scoliosis case – simply saying that an exercise-based approach is used, for example, does not mean much – since a scoliosis specific exercise routine will be (or should be!) designed from the ground up to counteract the specific scoliosis which the patient is experiencing.

Furthermore, it’s rare that only one approach will be used in treating scoliosis. Surgery is a possible exception to this, but even in this case, most surgeons do recommend some form of physiotherapy post-surgery to speed recovery and promote health after the operation. It’s therefore much more helpful to think about the possible components of scoliosis treatment and to speak to a scoliosis professional about your specific case and how a treatment plan can be put together.

 

Components of scoliosis treatment plans

With that said, let’s look at a high level, at some of the most common options for treating scoliosis.

 

Wait and see

Wait and see used to be a common refrain amongst GP’s encountering scoliosis cases – for many years, surgery was thought to be the only option for correcting scoliosis (it’s now been shown that this is not the case), therefore the only real option was to watch a scoliosis case and see if it got bad enough to require surgery. It goes without saying that this is not a treatment, and today there is almost no circumstance where “wait and see” is truly a good approach.

 

Surgery

Spinal fusion surgery is the most common surgical treatment for severe scoliosis in adolescents. Using metal rods, hooks, screws, and wires (known as instrumentation), the procedure straightens the spine and solidifies the bone to prevent further abnormal curving. Such a procedure will stop scoliosis from progressing and can typically straighten the spine to a considerable degree. The main downside is the risk of complications from surgery as well as the longer-term issues associated with living with a fused spine. For those with large scoliotic curves, however, these issues are often far preferable to living with severe scoliosis.

 

Bracing

Scoliosis bracing has come a long way over the last 10-20 years. Once thought of as a way to potentially slow scoliosis progression, modern “over corrective” scoliosis braces can be effective in reducing and even totally eliminating scoliosis cases given the right conditions. For bracing to be effective, the patient typically needs to be young enough for their spine to remain flexible and have not yet reached spinal maturity. Luckily, this window aligns perfectly with the 10-15 age range where the majority of scoliosis cases are first spotted. Modern scoliosis braces are relatively comfortable to wear, low profile and effective when used as prescribed. Today, bracing is the best option for those with scoliosis cases over roughly 30 degrees and under 60 degrees. Larger curves may still be treated with bracing, but the degree of correction possible is likely to be less.

 

Exercise-based approaches

Also commonly used today, exercised based approaches utilise specialist disciplines within physiotherapy to allow a patient to actively oppose scoliosis with their own body – exercise-based approaches require commitment to show results, but can be effective in reducing smaller scoliotic curves when applied diligently. Exercise is very often used alongside bracing, as it has an especially noticeable effect on muscular strength and tends to oppose some of the muscular weakening which can occur with bracing.

 

Complementary approaches

There are many other complementary approaches which have been shown to have supportive benefits for scoliosis sufferers – these include disciplines such as massage, yoga or Pilates. None of these approaches have been shown to actively correct scoliosis, but they may play a valuable role in helping to reduce pain or discomfort associated with the condition.

 

Experimental methods  – more research required

Scoliosis treatment is an area where a great deal of research has been taking place recently, and there are a number of other approaches being investigated with a view to determining their effectiveness as scoliosis treatments. Some approaches, such as vibration-based therapy show promise in augmenting existing methodologies – at least one study has suggested that combining a vibration plate with scoliosis specific exercise may improve results.

Other areas not currently seen as effective treatments for scoliosis, such as chiropractic, are being actively investigated by organisations such as CLEAR. Indeed, some of these experiments have published promising results. Programmes such as CLEAR have not yet met the bar in terms of demonstrating efficacy for scoliosis treatment, but may do so in the future. At the UK Scoliosis Clinic, we stay on top of many developing methodologies and will be open to incorporating new ones if and when the literature supports this step.

 

Which scoliosis treatment is right for me?

This article is intended as a quick overview of some of the approaches which can go to make up the unique course of scoliosis treatment that all patients deserve. The critical thing is to find a clinic that has the breadth and depth of experience to provide the treatment which best fits you. At the UK Scoliosis clinic, we provide all of the non-surgical options listed above (except the experimental ones) and work closely with expert and highly respected spinal surgeons to refer those cases which would not benefit from non-surgical intervention.

For more information about any of these approaches, please browse our website and articles, or feel free to get in touch.

 

 

 

 

Bracing vs Exercise – Which Scoliosis Treatment is Cheapest?

Posted on March 1, 2022 by - Blog

When it comes to treating scoliosis, you shouldn’t just be trying to find the cheapest option – it’s critical to consider the likely outcome of treatment over the long term, and to remember that in many cases the cost of treatment will be spread out over many years. Quality treatment is always going to be more expensive, and the sad fact is that “cheap” treatment may not have any positive impact at all. This being said, it’s also only right that you do consider cost as part of your treatment selection process. Let’s look at some of the considerations to keep in mind when choosing between exercise-based, or bracing based treatment.

 

Bracing

Scoliosis bracing is the most effective way to treat Scoliosis, in terms of Cobb angle, without undergoing surgery. Bracing has the best chance of any treatment to not only stop the development of scoliosis but also to reverse the condition. Bracing is typically recommended for curves between about 30 and 60 degrees, but certainly can be used to treat smaller curves.

Scoliosis braces (at least ones worthy of the name) are custom made for the wearer and are expensive – the average brace will cost anywhere between 3000 and 4000 Uk Pounds. Some braces, such as the ScoliBrace we offer at the UK Scoliosis Clinic are adjustable within a certain degree, meaning you can get more life out of the brace.

While bracing does come with a high upfront cost it should be kept in mind that a brace will, in the vast majority of cases, last for many years. In adolescents with larger curves, more than one brace may be needed, since eventually, the scoliosis could improve to a point where a new brace would need to be fitted in order to keep up the reduction, but in many cases an adjustable brace such as ScoliBrace can cover an entire course of treatment. In younger children requiring bracing either to correct scoliosis or prevent a relapse multiple braces will be needed, but this will still be spread out over 10-15 years. On the other hand, when buying a brace as an adult, you can (assuming you do not go through significant weight loss or gain) essentially consider it as a lifetime investment.

Bracing also has the benefit of incurring next to no ongoing costs – it’s advisable to have check-up appointments at scheduled intervals, but other than this the treatment is paid for.

In real terms then, the cost of bracing in those not having reached skeletal maturity should be considered as between £1000 and £2000 per year. For those buying a brace as an adult, the cost would be considerably less when annualised.

Exercise-based approaches

Scoliosis specific exercise approaches are often offered alongside bracing as additional support but are mostly used to treat smaller scoliotic curves, at or below 20 degrees. There are essentially two ways to approach this – either through a “Bootcamp” style intensive course, which seeks to teach the patient how to establish and maintain an exercise program or through regularly scheduled appointments over the period of treatment.

Bootcamp style classes can be an attractive prospect – lasting only a few weeks to a month, however, they do not address the need for scoliosis specific exercises to be constantly evaluated and adjusted to keep the correction going. For those looking simply to prevent a small scoliotic curve getting worse, a Bootcamp may work well – but for longer-term treatment, regular appointments with a therapist are usually preferable.

A critical factor to consider with exercise-based approaches is the ability of the patient to perform the exercises correctly – either SEAS or Schroth exercises are not easy, and require physical strength, this means this many younger children may struggle to perform the techniques correctly, even if their compliance with the schedule is 100%.

Scoliosis specific exercise boot camps can cost anywhere from £2000-£5000, depending on the location and whether accommodation is included. Individual sessions range from £50 to £100 per session, based on 1 session per month this comes out to roughly £600 – £1200 per year, plus ongoing travel costs.

As you can see, in real terms, the annualised cost of bracing compares favourably with a Bootcamp style approach and bracing is likely to be only slightly more expensive than a session-based approach to treatment. Taking a Bootcamp type introduction to scoliosis specific exercise, and then following up with periodic appointments with a specialist to review will probably cost more than bracing.

 

Which should I choose?

Although the figures above represent rough guides  (the cost of any treatment will always be individualised and could be more or less than this) it’s hopefully clear to see that there is not likely to be a huge difference in cost when considered over a period of years.

The main factor to consider should, therefore, be the most appropriate treatment for your case. Certain situations are easy to determine – very large curves in young people require bracing in order to have a chance of avoiding surgery, Small curves in adults with a stable spine, without any pain can be easily managed with an exercise approach and curves of say, 45 degrees in young people require bracing for the fastest possible reduction before skeletal maturity is reached and the spine is too ridged to correct.

Often, convenience is more of consideration – for example, the parents of a young teen with a small curve may consider wearing a brace part-time a better investment than paying for ongoing exercise therapy, given that it’s much more effort to comply with an exercise prescription and almost no effort at all to put on a brace. Similarly, an older person might prefer to treat a smaller scoliotic curve which is not too bothersome with the session-based exercise approach, since raising a large amount of cash up-front for the purchase of a brace may not be justifiable.

Unfortunately, there is no easy answer as to which treatment ends up being the cheapest since treatment for scoliosis is always as individual as the patient, but in many cases, you will find that the real terms cost between the two isn’t that great.

 

 

My child has Scoliosis: Top 10 things to do right away

Posted on September 11, 2018 by - Blog

 

If you have recently discovered that your child has scoliosis, or you suspect that scoliosis might be an issue it can often be a stressful and confusing time. There is a great deal of new information to consider and often it can seem there simply isn’t enough time.

To help out with this, here’s out top 10 list of things that you should do when first considering scoliosis treatment.  Get these 10 done, and you’ll be well on your way!

 

 

1 – Screen for scoliosis at home

If you have already had your child screened for scoliosis, either at home or by a professional you can skip this step. If you have not yet performed a scoliosis screening however, begin here.

Scoliosis screening is easy to do at home using our ScoliScreen tool. ScoliScreen was developed in Australia by our partner ScoliCare, who spent years researching and designing the easiest home screening tool available. Screening with ScoliScreen takes about 10 minutes – you don’t have to take any pictures or upload any information, just follow the steps on screen and note down your results. ScoliScreen isn’t an alternative to a professional consultation, but it’s a highly effective tool to use as a starting point.

 

2 – Get a professional consultation

Screening and consultations are always available at the UK Scoliosis Clinic

We can’t stress enough that getting a professional consultation with a scoliosis specialist is a must. Many parent’s natural reaction is to take their child to see their GP about their concerns– but this isn’t always the best step.

There are a few reasons for this – Firstly, while no question that GP’s do fantastic work, with so many different conditions to recognise and treat most GP’s simply don’t have time to research the latest options for scoliosis treatment. Years ago, it was thought that surgery was the only effective option for treating scoliosis, so many medial professionals were simply taught that the best approach to scoliosis is to “wait and see” if the curve becomes bad enough for treatment. The problem is that scoliosis almost never resolves on its own[1] so “wait and see” is never a good option. If your GP tells you to “wait and see” please bear in mind they aren’t trying to be dismissive, they just aren’t experts on the non-surgical options which are available today (but scoliosis clinicians are!).

Secondly, properly diagnosing scoliosis requires taking X-rays to fully understand the position of the spine – since GP’s have to justify any referral it can be difficult to argue for x-rays to be taken when “wait and see” is the standard recommendation.

Finally, scoliosis has often been a condition which hasn’t received the attention it really should, so many people think that the GP is their only option. One child in each class at school will develop scoliosis[2], so a significant number of people are affected, but most people are unaware of the condition. If you are reading this blog as a first port of call, please know there are numerous specialist clinics out there waiting to help!

At the UK Scoliosis Clinic, scoliosis screening as well as consultations for those with scoliosis are always available.

 

3- Get X-rays

Scoliosis is a complex Three Dimensional condition which can be successfully treated only with a thorough understanding of the condition of the spine. X-rays are the best way to properly establish the situation and also to rule out any other underlying conditions which might be causing or contributing to scoliosis. At the UK Scoliosis clinic, we have a brand-new state of the art digital X-ray machine on site for instant results – other clinics might refer you to another provider to get X-rays taken in advance of your consultation.

Some clinics offer what is often marketed as “radiation free imaging” – this simply means they do not provide X-rays and use an alternative, less effective imaging method. In real terms, this means that practitioners simply cannot get as good a picture of what is going on with the spine, which increases the risk of treatment failure, misdiagnosis or even injury from inappropriate treatment.

Are X-rays dangerous? The short answer is a handful of X-rays are far less risky than requiring major spinal surgery due to failed scoliosis treatment. The longer answer is that in fact, we are all exposed to a small amount of background radiation everyday without ill effect. For context, an average lumbar X-ray exposes you to only about as much radiation as 2 months of normal background radiation in the UK. An average airline pilot is exposed to about an eighth as much radiation as an x-ray on each transatlantic flight, meaning that most pilots are exposed to about the same amount of radiation as found in your x-ray every other week.

 

4 – Understand your treatment options

Scoliosis SEAS treatment

Specialist exercises can reduce Scoliosis

Today the non-surgical scoliosis treatment field is growing fast and there are many different approaches which can be utilised, these include treatments backed up by extensive research, such as Schroth and SEAS exercise methodologies and bracing as well as some emerging approaches which might or might not be effective, but currently lack enough research – such as chiropractic approaches.

Many clinics, like the UK Scoliosis Clinic offer a range of treatments and will tailor your treatment options based upon your needs, but some clinics only offer one approach. In this case, be sure that the treatment being offered is actually the right one for your case – and get a second opinion if you feel unsure.

 

5 – Chose a clinic which conforms to the SOSORT guidelines

Like all professions, the scoliosis treatment field has a guiding body – for us it’s the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment, otherwise known as SOSORT. SOSORT is an International organisation that guides health professionals on the most up to date, evidence-based recommendations in relation to the conservative treatment of idiopathic scoliosis. SOSORT’s ongoing mission is to constantly evaluate new treatment methodologies and to publish guidelines for best practice for patient outcomes[3].

Reputable clinics are run by clinicians who follow the SOSORT guidelines and stay in touch with the latest research – check that your clinician is keeping up to date by attending the yearly conference or contributing to the journal for example.

 

6 – Get the best brace

In many cases, bracing is going to be the most effective, fastest and easiest way to correct scoliosis. However, not all braces are created equal – be sure to quiz your scoliosis care provider about the braces they offer and the features they provide. Many braces (including those available in some areas through the NHS) are designed to hold the spine in its already scoliotic position. This kind of brace might stop the scoliosis progressing, but it wont help to improve it.

At the UK Scoliosis Clinic, we recommend ScoliBrace – a totally custom brace designed with 3D imaging and computer aided design. The ScoliBrace is an active correction brace – meaning it actually guides the spine back into the correct position, rather than just holding it still.

 

7 – Consider mental health

While everyone’s scoliosis experience is varied and depends much upon personality, some research has shown that children and young adults are more at risk of stress and even depression as a result of scoliosis. At the UK Scoliosis clinic, we provide a private one to one environment, and welcome as many relatives or friends that your child would like to have around them. Research has shown that having a calming and private environment to discuss and perform treatment can actually lead to better clinical outcomes[4].

When considering bracing, try to also take into account the impact wearing a brace could have on a young person’s life. This is one of the reasons we are so confident in our ScoliBrace – unlike many braces ScoliBrace is low profile and is easily hidden under normal clothes. Additionally, ScoliBrace does not impede a child’s ability to participate in sports and physical activities and was designed specifically with maximising mobility in mind. ScoliBrace is also customisable in a range of colours and patterns to suit your tastes!

 

8 – Ask questions

Dr Paul Irvine and Dr Jeb MacAviny at the SOSORT conference 2018

Ask questions, ask lots of questions – and encourage your child to ask questions. A scoliosis consultation appointment is a great opportunity to do this, but feel free to phone our clinic for more information. Scoliosis treatment is a fast-moving field in which new research is always being published, so as scoliosis clinicians we spend much of our time asking questions and keeping up with research too. Avoid a clinic who can’t (or wont) answer your queries and opt for one that shows they are up to date with the latest information.

Whenever you speak with a scoliosis practitioner, consider making a list of things you would like to know and make sure you get answers! Reputable clinics will be able to answer any queries you may have, and back these answers up with the latest published scientific research papers.

 

9 – Consider the cost of treatment carefully

When considering the cost of scoliosis treatment, its important to remember that a scoliosis treatment program is not a “quick fix” – time is required to initially correct scoliosis, and then further maintenance treatment of some kind is then required to keep the spine properly aligned until the end of growth. This means that parents need to ensure that the treatment options they choose represent a sensible choice over the long term.  To give an example, this might mean that a more expensive scoliosis brace, which is adjustable to last for a long period of time may be more cost effective than two or three cheaper braces. Similarly, for small curves a ScoliNight brace might be a better long-term investment than continued scoliosis specific exercise sessions.

This decision depends to a great extent upon your own preferences and your child’s– but keep the long term in mind.

 

10 – Get on with your life!

Scoliosis does not need to be an impediment to life – and if treated properly and early on can usually be corrected without any serious impact on the young person concerned. If properly treated and corrected scoliosis will not affect your child’s life going forward, so plan for tomorrow!

 

[1] Angelo G Aulisa et al. ‘Brace treatment in juvenile idiopathic scoliosis: a prospective study in accordance with the SRS criteria for bracing studies – SOSORT award 2013 winner, Scoliosis 2014 9:3

[2] Gutknecht S, Lonstein J & Novacheck T ‘Adolescent Idiopathic Scoliosis: Screening, Treatment and Referral’ 2009, A Pediatric Perspective, vol. 18, no. 4, pp. 1-6.

[3] Information about SOSORT and their guidelines can be found at http://www.sosort.mobi/index.php/en/

[4] Elisabetta D’Agata et al. Introversion, the prevalent trait of adolescents with idiopathic scoliosis: an observational study Scoliosis and Spinal Disorders (2017) 12:27