Tag: scoliosis

Need to know more about Scoliosis? Sign up for our free information series!

Posted on February 1, 2023 by - Blog

At the UK Scoliosis clinic, one of our primary goals is to help educate people about Scoliosis, the symptoms it causes, how to spot its signs and most importantly, how we can treat it. With this in mind we’re always looking for effective ways to bring usable and easy-to-access information about scoliosis together for those who need it. This week, we’re pleased to launch our new information series, which you can now receive for free, via email.

 

Get the facts, for free!

Our new Scoliosis information series is aimed at those just learning about Scoliosis – whether you’re a parent who has just learned your child has Scoliosis, a young adult who has just been diagnosed, or an older individual experiencing the effects of degenerative or de-novo Scoliosis, the aim of this series is to help you learn the essential facts about the condition and what you can do about it.

 

What is Scoliosis anyway?

Scoliosis is a condition of the spine which, left untreated, can be a life-limiting condition which will often worsen and may require major spinal surgery. Thankfully, today there are a number of effective non-surgical options for treating scoliosis.

Like many conditions, scoliosis is much easier to treat when it is spotted early [i] and the best way to spot it early is to help people understand what to look for. It’s for this reason that scoliosis screening is considered a beneficial stage of treatment amongst the Orthopaedic community, as reported in the Consensus Paper which has been published by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT)[ii].  Indeed, numerous studies have suggested that school screening can reduce the number of cases which eventually require treatment – despite this, school screening has still not been implemented in UK schools, although in some countries screening is now widespread. Similarly, most people in the UK have never even heard of Scoliosis, much less the more modern approaches to treating it which exist today.

 

What you’ll learn

Over the course of this easy-to-access series you’ll learn:

  • What Scoliosis is, and what causes it
  • The types of Scoliosis, and who they affect
  • How you can screen for the signs of scoliosis, at home, in less than 5 minutes
  • How we can treat Scoliosis, and how treatment has improved over time
  • What the best treatment for Scoliosis is
  • The answers to the most frequently asked questions we hear about Scoliosis

Finally, we’ll let you know how to get in touch with us if you’re concerned about Scoliosis, or just need more information.

 

How to sign up

You can access this totally free series by signing up here

Please feel free to share this page with any friends or family – the more awareness we raise about Scoliosis, the more people we can help!

5 Tips to Help Reduce Scoliosis Pain

Posted on January 14, 2023 by - Blog

For most of the history of Scoliosis treatment, the widely held view has been that Scoliosis does not cause pain. It’s certainly true that many Scoliosis patients present at our clinic with no pain nor discomfort – but recent research, as well as our experience, has shown that in many cases Scoliosis can be painful.

At least one research study suggests evidence of a possible 35-42% prevalence of lower back pain in adolescents with idiopathic scoliosis[1] (AIS), in another study of 2400 patients with AIS, 23% reported back pain at their initial contact[2]. Chronic non-specific back pain (CNSBP) also seems to be frequently associated with AIS, with a greater reported prevalence (59%) than seen in adolescents without scoliosis (33%)[3]  – in addition, patients diagnosed with AIS at age 15 are 42% more likely to report back pain at age 18.[4]

In patients under 21 treated for back pain, scoliosis was the most common underlying condition (1439/1953 patients)[5] and Scoliosis patients have between a 3 and 5-fold increased risk of back pain in the upper and middle right part of the back[6].

While this does not mean that everyone with Scoliosis will experience pain – in fact the numbers roughly support about a 50/50 chance – there are still a significant number of individuals for whom the management of Scoliosis & pain is a factor. At the UK Scoliosis Clinic, we utilise a number of approaches to help manage the pain associated with scoliosis – but there are also some steps you can take yourself.

 

1 – Keep active, Keep fit

Being physically active and reducing the amount of time spent in sedentary positions is very important, not only for pain management but for your overall health and well-being. While it’s true that Scoliosis can make some activities more difficult, and there are some exercises (especially “one-sided” activities, like racket sports) which we might advise against – there’s no reason why Scoliosis should stop you from being as active as possible. If pain is already a significant issue, low-impact activities such as Yoga or Pilates  can be an excellent way to keep moving, and may even provide some additional pain relief. Swimming, once thought to treat Scoliosis (sadly, based on current research, does not[7]) is nonetheless an excellent way to stay fit with almost no risk or injury.

 

2 – Improve your posture.

While it’s not true that poor posture causes Scoliosis – poor posture can cause pain, both for Scoliosis sufferers and those without Scoliosis.

A huge part of Physiotherapy based approaches to Scoliosis is increasing awareness of posture – when sitting and standing and to take note of the position of your spine. Are you collapsed to one side or slouching? Try to straighten & lengthen your spine and keep balanced, avoid leaning to one side as this can aggravate pain – instead, try to remain in a neutral or corrected position. Many people with Scoliosis pain find that regular movement helps to reduce pain too.

 

3 – Avoid extended sitting/extended standing

Where possible, avoid extended sitting when working, studying or at school. Regular postural changes/breaks (every 20-30 minutes) are very important and can be as simple as standing up, walking to the other side of the room, or stretching, before sitting back down.

This is, like most of these tips, a good idea to do regardless of your Scoliosis status as long periods of sitting encourage imbalances in muscles and ligaments – in fact, it’s the cause of a huge percentage of back pain cases treated by Chiropractors every year.

 

4 – Light Stretching or Massage

Stretching or Massage, either as a targeted activity or part of something like Yoga can be highly beneficial for Scoliosis suffers –focussing on elongation and decompression of the spine is likely to help relieve pain for many, and can often be performed at home using a tennis ball, foam roller or massager. That being said it’s best to consult with a Scoliosis expert when it comes to stretching or flexibility routines, for example many people with AIS will have reduced spinal curves or flat backs, so it is important that significant hyper-extension/arching backwards is not performed as it may increase the flattening of the back which may in turn progress the scoliosis.

Repetitive one-sided movements, or exercises & stretches leading to excessive spinal rotation may actually worsen pain – due to the 3D nature of scoliosis. Repetitive twisting or one-sided movements can potentially put your spine into an unfavourable position or even counteract an ongoing treatment program, so use with care.

 

5 – The Best Option, Scoliosis Specific Exercise

The best option to address Scoliosis pain is, of course a professional plan. A Scoliosis professional can design a series of Scoliosis Specific exercises, that will help improve posture, manage pain and slow the progression of your condition. These scoliosis-specific exercises, once mastered, can be incorporated into your day-to-day life or form part of an active treatment program.

In some cases, the part-time use of a Scoliosis brace could also be considered – for example, while bracing in adults is not likely to reduce the Scoliotic curve itself, research does indicate that bracing can be effective in reducing chronic pain.[8]

 

 

 

 

[1] Théroux, J., et al.Prevalence of low back pain in adolescents with idiopathic scoliosis: a systematic review. Chiropractic & manual therapies, 25(1), 1-6.

[2] 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

[3] 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

[4] 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.

[5] 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.

[6] 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

[7] Berdishevsky H, Lebel VA, Bettany-Saltikov J, et al.: Physiotherapy scoliosis-specific exercises—a comprehensive review of seven major schools. Scoliosis Spinal Disord, 2016, 4: 1.

Zaina, F., Donzelli, S., Lusini, M., Minnella, S., and Negrini, S. (2015). Swimming and spinal deformities: A cross-sectional study. The Journal of Pediatrics, 166(1): 163-167.

Gonen Aydin C, Oner A, Hekim HH, Arslan AS, Oztas D, Akman YE. (2020) The prevalence of scoliosis in adolescent swimmers and the effect of swimming on adolescent idiopathic scoliosis. Turk J Sports Med.;55(3):200-6.

[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.

Online Booking available now – which consultation is right for you?

Posted on January 5, 2023 by - Blog

As part of ongoing efforts to make accessing services at the UK Scoliosis Clinic easier than ever, we have now introduced an option to book either an online or in-person consultation right here through our website. With two options to pick from you might be wondering which consultation type is right for you?

 

Online consultation

An online consultation is an excellent way to speak to a Scoliosis expert from the comfort of your own home and at a lower cost than an in-person consultation at our clinic. Our online option includes the taking of an essential Scoliosis specific medical history, a review of any x-rays which you may have, movement assessment, a visual postural assessment (if desired) and time for Q & A.

An online consultation generally lasts approximately 20-30 Minutes and takes place via our secure online platform, which means your consultation remains totally private.

An online consultation is ideal for someone who wants to speak to an expert, get a second opinion on a diagnosis or treatment recommendation or is simply seeking some advice about the first steps when learning they have Scoliosis. The major drawback of an online consultation is that we cannot take X-rays nor physical measurements of your spine, nor see you in person – this means that in most cases we cannot formally diagnose Scoliosis during an online consultation, although we can usually give our professional opinion. If you already have X-rays, a web consultation can be an excellent option, although it’s important to keep in mind that our diagnosis and advice in this situation relies on the currency of the X-rays you provide.

Since a web consultation is also cheaper, they’re a good choice for people who want to explore scoliosis treatment, without incurring larger costs – for example, an older person considering bracing to help manage Scoliosis related pain.

Perhaps the biggest benefit of the online consultation option is the fact that you can participate from anywhere in the world – allowing you to access world-class Scoliosis advice wherever you happen to be located. Please note, that we currently offer consultations in English only.

 

In-person consultation

An in-person consultation at our clinic is the most comprehensive option designed to provide not only a formal diagnosis of Scoliosis but also practical advice on treatment steps and the options which would be applicable for you.

Scoliosis consultation at our clinic is the fastest and most efficient way to get answers on Scoliosis. Our consultations can include X-rays (for a additional fee), which are taken here at the clinic enabling you to get a professional diagnosis and a plan to move forward with treatment if appropriate for your case.

Our In-clinic consultation lasts between 1.5 and 2 hours, and includes a detailed, Scoliosis specific medical history, Scoliosis impact assessment, Postural Assessment, Scoliosis measurement and evaluation and a detailed report outlining your case, diagnosis and recommended options for treatment. We can also provide a report to your insurance provider (if required).

Your appointment can include a full set of Diagnostic X-rays utilising our state-of-the-art digital X-ray machine, allowing Scoliosis to be definitely diagnosed and understood. You will also receive a digital copy of your X-rays to take away.

Our in-clinic consultations are most suitable for those who are concerned that they may have scoliosis but do not have X-rays or other documentation to rule the condition in, or out. It’s also ideal for those who know they have Scoliosis and are actively looking to take up non-surgical treatment or are wanting to change treatment, perhaps from another provider.

 

Next steps

All of our consultations are standalone options – meaning there’s no obligation to take up treatment with us after your consultation. In some cases, it might be determined that Scoliosis isn’t the correct diagnosis, or it may be the case that more appropriate treatment can be obtained through another provider – in this case, we’re often able to recommend suitable practitioners close to you.  Where Scoliosis is determined to be an issue for you, an in-person consultation can lead directly into the formation and beginning of a treatment plan should you want to take action as soon as possible.

For those consulting with us from overseas, we work with a network of other Scoliosis treatment providers across the globe and can often recommend a practitioner in your general area – but should you wish to visit our clinic you’ll still be very welcome!

 

 

 

­­­­Scoliosis – some posture tips

Posted on October 26, 2022 by - Blog

Contrary to popular belief, poor posture cannot give you Scoliosis – the known causes of Scoliosis include degenerative changes in the spine (associated with ageing), neurological conditions and some genetic conditions. It’s also possible to end up with Scoliosis as the result of an accident or injury, or perhaps due to complications during surgery for another issue. All other scoliosis cases are considered idiopathic, meaning the exact cause is unknown – however, there is no evidence to suggest that bad posture causes Scoliosis.

 

Nonetheless, posture is an important thing for Scoliosis sufferers to keep in mind – now that it is more widely recognised that scoliosis can cause pain and discomfort, many people naturally wonder if there are ways we can reduce discomfort and support treatment during scoliosis correction. While everyday postural changes designed to correct scoliosis are a critical part of approaches such as Schroth therapy, there are also some small changes which one can make in order to potentially improve their overall quality of life.

 

Sitting and standing

When standing or sitting; good posture uses less energy than poor posture – this is true whether you have scoliosis or not! Some people with scoliosis might find sitting or standing with good posture difficult, either because of the spinal deformity or because of tiredness associated with scoliosis exercise treatment (this is normal!).  Because of this, it’s not uncommon for scoliosis patients to sit or stand with weight shifted more to one side than the other – either trying to overcompensate, or simply leaning on the strong side due to tiredness.

The ideal posture when standing is to have weight evenly spread – the neck should be straight with no tilt, the hips level, and the pelvis neutral (this means not tilting forward or backwards). The knees should be straight or alternatively, one knee straight, the other slightly bent. It can help to check your posture regularly in the mirror or get others to check it for you. Imagine yourself as a puppet with a string attached to the top of your head pulling you straight. The important thing to remember is not to overcompensate – if you lean slightly to one side, try to aim for this neutral posture – but don’t go further the other way!

When sitting, it’s easier to centre yourself correctly – the key is to allow the chair to take your weight evenly, which a normal char will. Try to sit back in a chair with your weight on your buttocks and thighs and your back straight. Try not to sit forward on the edge of your seat and keep the pelvis neutral (not tilting forward or backwards). Try to select a chair that allows your knees to be bent at roughly a 90 – 75 degree angle when sitting so that your knees are level with, or slightly lower than your hips. Keep feet flat on the floor and shoulder-width apart. Try not to sit for too long at any one time. It is best to move every 30 minutes to avoid getting stiff, whether you have Scoliosis or not!  Low soft sofas, chairs without arms, chairs that are too low or too high, bucket chairs and deep chairs can all be especially uncomfortable for those with Scoliosis.

Some patients find that lumbar (lower back) supports, cushions or memory foam can assist with any pain when sitting – for the most part these are safe to use, but t’s worth checking with your scoliosis practitioner if possible.

 

Exercise

Exercise is an essential part of everyday health and may well also form part of your Scoliosis treatment – if you are using an exercise-based approach to Scoliosis you will be well aware of the importance of maintaining a balanced and symmetrical spine unless you are specifically performing a corrective exercise.

It’s easy for people with scoliosis to get sore, stiff or tired when using the gym or exercising due to the additional strain which the spine is already under. Similarly, it’s not always a good idea to perform stressful exercises after a scoliosis specific exercise session, as parts of your back will feel tired.

If you do want to perform any kind of weight-bearing exercise, be sure to discuss the best way to do this with your scoliosis practitioner – and always work within your limits, especially during treatment. Very often, low impact and symmetrical exercises, such as swimming are an excellent way to augment scoliosis treatment while keeping fit and with a very low risk of injury or strain.

 

Beds and sleeping

Choosing the right bed is very important as you spend around 8 hours of the day in it. If you are comfortable you are more likely to sleep well. Getting enough is critical for mental as well as physical health.

As with a chair, it’s recommended to have a bed that allows you to sit on it with your knees at or just below 90 degrees – this should make it easier to lie down and get up.

The mattress should not be too hard or too soft. It needs to support your weight without sagging or giving way at the hips and shoulders – many Scoliosis patients find that a memory foam mattress is more supportive for them – don’t forget that these can be bought separately and added to your bed!

Some patients, especially those with Lumbar curves can experience discomfort when sleeping and laying in bed – this is, in fact, the case for many people, scoliosis sufferer or otherwise, since sleeping flat on your back with your legs straight can put a strain on the lumbar spine. Sleeping on your back, with your knees bent, on your side with your leg bent forward or on your side with a pillow between your legs or under your knees for better support can all help to relieve this discomfort. While not a universal rule, we also find that most scoliosis patients find sleeping on their front somewhat uncomfortable – so you may want to avoid this!

 

Paul at SCOSYM, 2022

Posted on September 1, 2022 by - Blog

One of the most enjoyable aspects of working in a field which is growing and innovating as fast as the Scoliosis treatment space is getting to interact with, and learn from, a huge variety of specialists from different backgrounds, all working towards the common goal of developing the most effective Scoliosis treatment approaches possible. With this in mind, our founder, Paul Irvine will be in Greece next week to attend the 3rd SCOSYM Symposium.

Just one of many such events which are fast becoming critical landmarks for Scoliosis professionals everywhere, this meeting represents the 3rd SCOSYM Symposium in a series of successful meetings.

SCOSYM, like several non-surgically oriented events, recognises the tremendous contribution the traditional medical disciplines have made to scoliosis treatment, but also notes that the medical societies that specialize in this ailment have, to quote the organisers “tended to focus their efforts on the study of the epidemiology, aetiology, pathobiomechanic and laboratory, clinical and imaging documentation and treatment, either non-operative or operative.”  Critically for those attending SCOSYM then, it’s vital to recognise that the advent of new technologies is key to the study and advancement of our insight into these diseases, with a goal to improve the quality of life of this group of people.

This year, the conference is focused on these emerging technologies and the opportunities they bring, with a special view to recognising the impressive developments in the implementation of scoliosis school screening programs, physiotherapeutic-specific scoliosis exercises and new surgical approaches for growth modulation for the surgical treatment of early onset scoliosis (read more about all of these on our blog!)

Another key focus, and one which we’re pleased to see being recognised as an essential aspect of treatment for scoliosis, is quality of life – according to the organisers “These developments have led to better patient quality of life compared to what was experienced in the past. However, this topic is still under development and new instrumentation systems are being introduced.

When proper management is not implemented, spinal disorders may lead to significant social problems and to enormous economic losses. Therefore, treatment decisions based on the recent evidence-based literature will result in the optimum outcome. Proper management, including prevention and non-operative or operative treatment, must be tailored and implemented.”

Raising awareness is a core aspect of what we do at the UK Scoliosis clinic and SCOSYM is yet another fantastic event helping to do this, the conference notes that “It is, therefore, very important to increase awareness and advocacy for a social mission regarding the early detection of scoliosis and prevention of progressive spinal deformity. It is imperative to raise awareness about scoliosis and to inform the public, healthcare and policymaking communities about the individual, familial and societal burdens of spinal deformity, as well as the benefits of proper detection, diagnosis and optimal care for all patients.” – we couldn’t agree more!

Paul will be spending his time learning about the best and most promising new research to integrate into our own processes in the clinic, and perhaps enjoying a spot of good weather too!

 

 

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.

Scoliosis Awareness Month – Raising Awareness of Adult Scoliosis

Posted on June 1, 2022 by - Blog

Scoliosis is a condition which affects people of all ages – patients right from birth to old age present at scoliosis clinics around the world, seeking help for many forms of the condition every year. Despite this, there is somewhat of a bias toward thinking of scoliosis as a “young persons” condition – while there are some legitimate reasons for this perception, it’s not an accurate one. As many as one in three over 60’s actually suffer from Scoliosis, struggling with issues such as pain and discomfort which, in many cases, could be treated. This Scoliosis awareness month the UK Scoliosis clinic is focusing on raising awareness about scoliosis in adults – a lesser discussed, but equally important condition.

 

What is adult Scoliosis?

Scoliosis, for those who don’t know – is a condition in which the spine “curves” from side to side. A normal spine can and should have a natural curvature – however, this should be “Front to back”, so that when viewed from the side the spine looks something like an “S”. This natural curvature is not only normal but is actually critical to allowing us to move and remain balanced properly! Scoliotic curves, in which the spine looks like an “S” when viewed from behind are the opposite – they destabilise the spine causing pain, discomfort, aesthetic problems and, in serious cases, can even interfere with breathing. Scoliosis is a condition which tends to progress over time, meaning it usually gets worse without treatment.  Very often, scoliosis is diagnosed in younger teenagers – with girls between the ages of roughly 10 and 15 being the “classic” risk group. This group also attracts the attention of much of the scientific literature, and almost all of the “social” content relating to the condition – but in fact, far more adults, especially older adults, suffer with scoliosis than do younger people.

Adult Scoliosis then, is technically any scoliosis case that exists either in those over 18, or those having reached skeletal maturity, either definition is valid but most scoliosis specialists would prefer the latter since we are focused more on the condition itself than an arbitrary point of “adulthood.”

There are two main types of adult scoliosis. Pre-existing adult scoliosis is essentially a case of scoliosis which is continuing from an earlier age (usually adolescent scoliosis). In adulthood, a continuing case of scoliosis typically becomes known as Adolescent Scoliosis in Adults or ASA. ASA can be discovered in adults of any age, but many ASA cases are already known from treatment earlier in life.

The second type is Degenerative De-Novo Scoliosis (sometimes noted as DDS) – this is the development of a new scoliosis case, usually as a result of spinal degeneration.

 

What causes Scoliosis in Adults?

ASA – that was scoliosis carried into adulthood from adolescence, isn’t caused in adulthood – it may or may not worsen depending on a number of factors, but the condition originated at an earlier point in life. Degenerative scoliosis is somewhat unusual in the scoliosis world since we understand its cause well – it’s due to wear and tear on the spine, but it is also strongly associated with a variety of conditions. Osteoporosis, degenerative disc disease, compression fractures and spinal canal stenosis have all been implicated in the development of degenerative scoliosis.

Since De-Novo scoliosis is a consequence of spinal degeneration with age, it rarely presents before 40 years of age – although, in patients with no known history of scoliosis, differentiation from degenerative idiopathic scoliosis may be difficult. It is thought that as many as 40% of over 60’s suffer from de-novo scoliosis[1], although a percentage of these cases will be undiscovered scoliosis from earlier in life. In fact, a good number of adult scoliosis cases are discovered through an investigation for another condition (such as back pain).

 

What is the prognosis and treatment for Adult Scoliosis?

ASA can be considered both stable (progression is very slow or non-existent) or unstable, progression is continuing. Whether an ASA case will progress quickly, slowly, or not at all may well depend on the size of the curve itself when adulthood is reached. Research has suggested that simply put, large curves tend to get worse – smaller curves may well be stable. Weinstein et al. and Ascani et al. have reported results showing that children with curves < 30° at skeletal maturity did not demonstrate curve progression into adulthood, while the majority of curves > 50° progress at approximately 1° per year.[2] The degree of progression will be the best guide for treating ASA cases – bracing, exercise or even just periodic monitoring could all be the right approach, depending on the case.

De-Novo scoliosis is a condition related to ageing – and since we can’t stop ageing itself, De-Novo Scoliosis always continues – however, the impact upon a person’s life can be greatly minimised with the correct treatment. Patients with de-novo or degenerative scoliosis will often experience constant back and leg pain which makes it difficult for them to walk or stand for any period of time. They may become aware that they cannot stand up straight and lean towards one side, this becomes more noticeable the longer they are upright. Frequently they don’t find relief with medication, or through more standard conservative treatment (such as chiropractic or physiotherapy) and they are not suitable for surgery due to osteoporosis i.e. bone weakening.

The good news is that recent advances in non-surgical treatment have shown significant improvement in terms of reduction of pain and symptoms in those with adult scoliosis.  One approach involves the patient learning how to self-correct their abnormal posture, not just strengthen their lower back or core –  indeed, studies show that simple, exercise based approaches can reduce pain in adult scoliosis cases.[3]

The most effective approach would be the use of a customised brace, such as a ScoliBrace which helps to support the posture in a more comfortable position, pain is reduced (even with part-time bracing)[4] and quality of life is improved. Indeed, De-Novo Scoliosis patients often respond well to a gentle supportive brace, which helps to keep them upright and less tilted thus they can walk or stand more comfortably for longer periods of time.

 

Treatment for adult scoliosis

The main takeaway from this blog, and from our Scoliosis awareness efforts this month, should be that treatment options for adults with scoliosis do exist and, if you’re within travelling distance, they’re available at the UK Scoliosis Clinic!

 

 

 

[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.

[2] 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.

[3] ‘Scoliosis-Specific exercises can reduce the progression of severe curves in adult idiopathic scoliosis: a long-term cohort study’
Negrini A, Donzelli S, Negrini M, Negrini S, Romano M, and Zaina F 2015,, Scoliosis Jul 11 10:20

[4] 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

‘Effects of Bracing in Adult With Scoliosis: A Retrospective Study‘
Palazzo C, Montigny JP, Barbot F, Bussel B, Vaugier I, Fort D, Courtois I, Marty-Poumarat C, Arch Phys Med Rehabil. 2016 Jun 22. pii: S0003-9993(16)30256-8. doi: 10.1016/j.apmr.2016.05.019

 

June is Scoliosis Awareness month

Posted on May 23, 2022 by - Blog

The UK Scoliosis Clinic recognizes June as Scoliosis Awareness Month – as usual, it’s an important opportunity for us to reflect on the importance of ongoing developments in scoliosis treatment as well as to advocate for further research. Critically, scoliosis awareness month is an opportunity to raise awareness of scoliosis, and, the words of the scoliosis research society “Speak Up For Scoliosis”

 

What is Scoliosis?

Scoliosis is a condition that causes the spine to abnormally curve sideways. Although many people have not heard of the condition it is surprisingly common, impacting infants, adolescents and adults of all races, classes, and all genders. Despite this, adolescents (of which a majority are female) and those over 60 are the most commonly diagnosed and should be especially vigilant.

According to the Scoliosis Research Society, Approximately one out of every six children diagnosed with scoliosis will have a curve that requires active treatment, sometimes involving surgery. Early diagnosis is the key to taking important first steps to providing treatment that may prevent more serious problems. Today there are more non-surgical treatment options (such as bracing or exercise based therapy) than ever, but to have the best chance of success early detection is key.

 

What is Scoliosis awareness month?

Every June, National Scoliosis Awareness Month highlights the growing need for education, early detection and awareness about scoliosis and its prevalence.  The campaign also unites scoliosis patients, families, physicians, clinicians, institutions, and related businesses in collaborative grassroots networking throughout the month.

Around the world, Scoliosis screening as a public service is not uniformly provided – in the UK, there’s no provision at all and in the US, on about two-thirds of states mandate or recommend scoliosis screening in schools – this means it is important that friends and family members learn to recognize the signs and symptoms of the condition and know that help is available. It is often parents or primary care providers who first identify the issue. Fortunately, an examination and X-ray can confirm the diagnosis and an expert can recommend treatment, if necessary.

 

About the UK Scoliosis Clinic

The UK Scoliosis Clinic is one of the UK’s most well established specialist scoliosis clinics, we focus on non-surgical treatment of scoliosis in Children and Adults primarily through bracing with the unique ScoliBrace system supported by complementary approaches. To learn more about scoliosis, or how to screen for the condition please see our website at https://scoliosisclinic.co.uk

 

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.