Not only are there different types of scoliosis a person can develop, there are also different ways to treat the condition. While in place for hundreds of years, the traditional approach to scoliosis treatment offers little proactive treatment, and takes more of a wait-and-see approach, followed by spinal-fusion surgery; a conservative approach, however, is proactive and combines multiple treatment disciplines for the best results.
As scoliosis is a progressive structural spinal condition, there is no curing it; however, it is highly treatable. When it comes to the best treatment options, a conservative chiropractic-centered approach can achieve corrective results while preserving the spine’s overall health and function.
Before exploring the specifics of different treatment approaches and the results they can offer, let’s first talk about the condition generally for a better understanding of why there is no curing scoliosis.
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As mentioned, scoliosis is a progressive structural spinal condition. It is a condition whose nature is to worsen over time, especially if left untreated or not treated proactively.
It also means that where a person’s scoliosis is at the time of diagnosis is not indicative of where it will stay; scoliosis is not a static condition. Even people diagnosed with mild scoliosis initially have to be aware that it can progress in severity at varying rates if not addressed.
As scoliosis is a structural condition, this means a structural abnormality causes it within the spine itself, so in order for treatment to be effective, it has to impact the condition on a structural level, in the form of a curvature reduction.
So when scoliosis is progressing, this means the abnormal spinal curvature that rotates and has a Cobb angle of 10+ degrees, is increasing in size.
Now, depending on a number of important patient and condition characteristics such as age, condition severity, condition type (cause, if known), and curvature location/pattern, patients will experience different progressive rates.
While we can look at these characteristics and address them in the crafting of a customized and comprehensive treatment plan, that plan only involves predicting a patient’s likeliest progressive rate as there is no 100-percent effective means by which we can tell just how fast, or slowly, a patient’s condition will worsen.
Condition severity is a particularly important variable because it tells us how severe a condition is at the time of diagnosis, and this guides the design of treatment plans moving forward.
Scoliosis can range from mild to moderate and severe to very severe and is determined by a measurement known as Cobb angle.
A patient’s Cobb angle is measured during X-ray and involves drawing intersecting lines from the tops and bottoms of the most-tilted vertebrae (bones of the spine) of the curvature, at the apex, and this involves multiple vertebrae.
The intersecting lines form an angle that tells us how far out of alignment a scoliotic spine is and places a condition on its severity scale:
As you can see, there is a wide range of severity levels, and while every case is different and will produce its own unique set of symptoms, as a condition progresses and the unhealthy spinal curvature gets bigger, related symptoms also tend to become more noticeable.
What’s important in an effective treatment option is that a treatment plan is proactive in trying to determine, and stay ahead of, a patient’s progressive line.
For a complete picture of the condition and related treatment options, it’s also important to understand that there are different types of scoliosis and that each type has their own unique treatment needs.
Scoliosis is so often described as a mysterious and complex condition, and that’s partly because there are so many different forms of scoliosis with different causative sources, some known, and some unknown.
In fact, 80 percent of scoliosis cases are classified as idiopathic, meaning not associated with a single-known cause. This doesn’t mean there is a complete absence of cause, but that a single causative source has yet to be identified.
Idiopathic scoliosis, instead, is considered to be multifactorial, meaning caused by multiple variables that can vary from one patient to the next.
Idiopathic scoliosis affects adults, and children and adolescents, but the condition’s most prevalent form is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18.
As AIS is the type of scoliosis most commonly diagnosed, we’ll focus on this form currently, but we should also touch on the other forms as, again, each has its own unique characteristics, causation, and treatment needs.
So with 80 percent of known diagnosed scoliosis cases not having a clear causative source, what types make up the remaining 20 percent?
While idiopathic scoliosis is far more common, there are certain types of the condition whose causation we fully understand, and these include neuromuscular, congenital, degenerative, and traumatic scoliosis.
In forms where causation is understood, it’s the underlying cause that drives the design of effective treatment plans; that being said, not knowing the cause of idiopathic scoliosis doesn’t mean I don’t know how to treat it effectively.
So when it comes to treating AIS, I have to remind patients, and their families, that while it can be difficult to hear that we simply don’t know why an adolescent’s scoliosis developed, what we do know is how to respond to its development proactively.
In addition, knowing the cause wouldn’t necessarily change the course of treatment, nor its outcome.
What’s equally important is being informed about the different treatment options available so patients, and their families, can fully understand the different results they offer, and ensure their treatment expectations are aligned with the reality of their potential outcomes.
Let’s now move forward with exploring the different treatment options delivered by the two main treatment approaches available: conservative and traditional.
As mentioned, there are two main approaches to scoliosis treatment, and a conservative chiropractic-centered approach is the more modern of the two; it has developed around what we have learned about the condition over the years, and how the spine responds to different forms of treatment.
Over the years, we have learned that while scoliosis progresses at different rates, at some point, virtually every case is going to progress, particularly if left untreated.
We have also observed that as a 3-dimensional condition, scoliosis has to be addressed as such in treatment, yet the traditional approach still treats it as a 2-dimensional condition.
We also know that scoliosis responds best to treatment plans that combine multiple treatment disciplines; this results in the most comprehensive customization possible, and as scoliosis is such a highly-variable condition, this is essential in terms of treatment efficacy.
As I’m trained and certified in multiple treatment modalities, I can combine different forms of scoliosis-specific treatment to craft the most customized and comprehensive treatment plans possible: chiropractic care, in-office therapy, custom-prescribed home exercises, and super-corrective bracing.
Together, these disciplines complement one another and work towards achieving a curvature reduction, first and foremost, and providing the spine with optimal support and stabilization.
While general chiropractic care has little to offer scoliosis patients other than short-term pain relief, scoliosis-specific chiropractic care has the potential to impact scoliosis on a structural level.
Although it’s not a simple process, through precise scoliosis-specific chiropractic adjustments, we can adjust the most-tilted vertebrae of the spine to encourage their realignment with the rest of the spine.
Our in-office therapy combines a number of therapies to work towards passively mobilizing the spine into a corrected position. Therapies can include traction and de-rotation, vibration, and can involve the use of equipment specifically designed to reduce a scoliotic curve.
For example, our scoliosis traction chair works by reversing a scoliotic curve into a mirror-image of itself and can augment and complement results achieved by other disciplines.
Other types of equipment known to be effective in mirror imaging a scoliotic curve include scoliosis flexion distraction tables, vibrating cervical traction, a thoracic mechanical drop piece, and more.
Through the integration of scoliosis-specific exercises (SSEs) in treatment, we can increase core strength so the muscles surrounding the spine are stronger and better able to support and stabilize it.
SSEs, when integrated into a customized and proactive treatment plan, can also make improvements to balance, coordination, and body position.
In addition, they can also activate certain areas of the brain to improve brain-body communication.
Scoliosis bracing has long been used as a form of treatment, particularly for AIS, but not all braces are created equal, and the two main treatment approaches rely on different types of braces as they offer different results that are aligned with their ultimate treatment goals.
Here at the Center, when appropriate, I turn to the ultra-corrective ScoliBrace to meet my patients’ bracing needs.
The ScoliBrace features a modern and ingenious design that reflects the culmination of what we have learned, not only about the condition over the years, but also how bracing can affect the spine over time.
The ScoliBrace is designed with correction as its end goal, and as it addresses the condition’s true 3-dimensional nature, it can work towards reducing a scoliosis by positioning the body and spine into an overcorrected mirror-image position; this can have a super-corrective effect and can improve related postural changes such as the presence of a rib arch, uneven shoulders, and the body’s overall symmetry.
The ScoliBrace uses state-of-the-art imaging software so that each brace is 100-percent customized to suit each patient’s body and condition type.
A poorly-designed brace is not only ineffective in terms of correction, it can also hinder the strides being made by other treatment disciplines and cause damage to the spine.
The ScoliBrace addresses the shortcomings of traditional bracing by customizing each brace so it is more effective, comfortable to wear, and results in better compliance, and unlike traditional braces, it addresses the condition’s 3-dimensional nature so actually has corrective potential.
As mentioned, the ScoliBrace can also reduce related postural deviation and improve the body’s overall symmetry.
Through close monitoring of how a patient’s spine is responding to treatment, I can adjust treatment by apportioning the aforementioned disciplines accordingly, and in doing so, stay ahead of patients’ progressive lines.
In the conservative approach, being proactive is valued, and this means responding to the condition’s development by initiating proactive treatment as close to the time of diagnosis as possible.
While there are never treatment guarantees, early detection comes with a number of benefits, in terms of treatment, but only if the diagnosis is responded to proactively, and this is one of the main differences between a chiropractic-centered conservative approach, and a traditional approach to scoliosis treatment.
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The traditional approach to scoliosis treatment has been in place for hundreds of years, but it has changed little over those years, despite our growing understanding of the condition.
As mentioned, particularly with AIS, being proactive with treatment is key; it’s particularly important with this form because adolescents are at risk for rapid-phase progression, and this is because growth is the condition’s number-one trigger.
With adolescents, or any patient who has not yet reached skeletal maturity, significant progression is more likely, so proactive treatment needs to be applied in order to counteract the condition’s tendency to worsen with growth and/or over time.
However, adolescents walking the traditional path of scoliosis treatment are not treated proactively; traditional treatment is more reactive than proactive.
An adolescent recently diagnosed with mild scoliosis, who has chosen traditional treatment, would likely be told that as their condition is mild, it should simply be monitored for further progression.
The patient will be told to return periodically for assessment, and depending on the doctor, that can be every 3, 6, or even 12 months.
Now, as we know that adolescents are in, or entering into, the stage of puberty characterized by rapid and unpredictable growth spurts, we know that this age group is at a high risk for progression.
Suppose in between those check ups, a patient has a significant growth spurt. In that case, their condition can progress significantly, but had proactive treatment been applied as soon as the condition was diagnosed, that patient might have never progressed to that point; I consider that wasting valuable treatment time, yet watching and waiting is a key feature of traditional scoliosis treatment.
If that same patient progresses from mild to moderate, even then, the only form of treatment applied is traditional bracing, which is associated with a number of shortfalls.
Unlike the conservative chiropractic-centered approach, the end goal of traditional treatment is not correction, but preventing further progression, and the design of traditional braces, like the most commonly used Boston brace, reflect this key difference.
The design of traditional scoliosis braces, like the Boston, has remained virtually unchanged over the years, even though we’ve gained in our understanding of the condition’s 3-dimensional nature.
As the design of the Boston is driven by its end goal of slowing/preventing further progression, it has little, if any, corrective potential.
The Boston brace works by forcing the spine into a straighter position by squeezing it from the sides; the goal is to make the abnormal spinal curve progress more slowly, or not at all.
The brace is a tight-fitting plastic brace that wraps under the arms and covers the torso, pelvis, and hips.
It uses strategically-placed pads to put pressure on the most-tilted vertebrae of the curvature, and an area of relief without a pad is positioned opposite the pressure-pads; the idea behind this is that the relief areas are where a healthy spine should be and the spine, due to being compressed, will naturally move away from the source of pressure, and into the relief zone.
As you can imagine, this isn’t exactly comfortable, which makes compliance a huge challenge when it comes to treating AIS.
Traditional bracing also treats the condition as 2-dimensional, which is why it only squeezes the spine from the sides, not addressing the rotational component, and over time, that squeezing can actually further weaken an already unhealthy spine.
In addition, it can actually exacerbate postural deviation associated with the condition, particularly rib arches, due to the squeezing pressure on the torso.
Unlike the ScoliBrace, which is 100-percent customized to suit each patient’s body and condition for optimal comfort, the Boston is mass-produced and mainly suited to a particular body type, making it bulky and cumbersome to wear.
When a brace of this nature is not worn by the ideal body type, it can be too tight, and this can cause issues with overheating, restricted breathing, and sore/raw skin under the brace.
Now, if a patient has progressed from mild to moderate, despite wearing the Boston full time, that patient would likely be funneled towards spinal-fusion surgery.
Commonly known as scoliosis surgery, the actual process is called spinal fusion, and while every surgery comes with its share of risks, spinal fusion is associated with some serious potential risks, side effects, and complications.
In addition, the way in which spinal fusion reaches its end goal of straightening the spine to prevent further progression can come at the price of the spine’s overall function and health.
While there are different types of spinal fusion, the procedure typically involves the fusing together of the most-tilted vertebrae at the apex of the curve, and then rods are attached to the spine with screws to hold everything in place while it heals.
What this does is eliminate movement in the affected area so the curve can’t progress further, but depending on the curvature location, plus how many vertebrae are involved, this loss of movement can also cause a loss in spinal flexibility.
While some patients retain enough spinal flexibility above and below the fusion site after surgery to avoid a substantial mobility loss, studies show that most post-surgical patients experience a significant loss in the spine’s natural range of motion and flexibility.
In addition, the procedure itself carries risk of infection, nerve damage, excessive blood loss, adverse reaction to hardware used, and more.
The bottom line is as successful as spinal fusion can be, although there are never guarantees, at straightening and stabilizing a scoliotic spine, the way in which it’s done is invasive, and life with a fused spine can pose extra challenges.
The spine’s natural curvatures give it added strength, flexibility, and facilitate its even distribution of shock from impact, and mechanical stress that’s incurred during movement.
In the event of a trauma, such as a car accident or fall, instead of the shock of impact being transferred to the spine itself, it goes to the rigid rods, and this can make a fused spine far more prone to injuries and breaks than an unfused spine.
Another factor to consider with spinal fusion is that there is a gap in the research on the long-term effects of the procedure. We don’t really know how long the hardware will perform optimally, and we don’t really understand the full effects of spinal fusion 10, 20, 30 years down the road.
Fortunately, a more natural and less-invasive treatment option works to reduce the curvature on a structural level and increase core strength for optimal spinal support and stabilization, preserving the spine’s health and function; this is the conservative approach that patients of the Scoliosis Reduction Center experience.
So when it comes to how to cure scoliosis, the truth is there is no curing it; instead, it needs to be treated proactively so progression can be managed effectively and the spine’s overall health and function can be improved upon.
As a progressive structural spinal condition, people with scoliosis will have it throughout their lives. Even after successful treatment, continued efforts will likely be needed to sustain the results. This can include continued chiropractic care, the use of scoliosis-specific home exercises, and living a scoliosis-friendly lifestyle.
While that can be hard to hear, especially for adolescent patients recently diagnosed, I remind them that scoliosis doesn’t have to define them, or the rest of their lives.
With the help of proactive treatment, significant improvements can be made to the curvature size and the muscles that surround the spine.
While there are two main treatment approaches to choose between, the traditional approach tends to funnel patients towards spinal fusion; even when successful in terms of straightening and stabilizing a scoliotic spine, the procedure can cost patients in terms of mobility loss post-surgery, not to mention its cost and potential side effects.
For those looking for a less invasive and more natural approach to scoliosis treatment and choose to forgo a surgical recommendation, the conservative chiropractic-centered approach I offer patients of the Scoliosis Reduction Center can offer a different potential outcome: one that delivers results that don’t come at the expense of the spine’s overall health and function.