Scoliosis is a complex spinal condition that has been around since ancient times. As our understanding of the condition has evolved over the years, so too has our knowledge of the best options for reducing a scoliosis curve. Following a diagnosis, the most important decision is how to treat the condition moving forward; different treatment approaches offer patients different potential outcomes.
When it comes to how to fix scoliosis, condition-specific chiropractic care can help reduce a scoliotic curve, so the spine is realigned, and therapies for increasing core strength can help with optimal spinal support, while corrective bracing can help to push the spine into a corrective position.
Before getting into the specifics of scoliosis treatment, and different treatment approaches, let’s first explore what it means to be diagnosed with scoliosis.
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When a person is diagnosed with scoliosis, it means their spine has developed an unnatural sideways spinal curve, but a scoliotic curve doesn’t just bend unnaturally to the side. It also has a rotational component that makes it twist from front to back, back to front, making it a 3-dimensional condition.
In addition, a scoliotic curve has to be of a minimum size to be diagnosed as scoliosis, and this involves a measurement taken during an X-ray that draws intersecting lines from the tops and bottoms of the curve’s most-tilted vertebrae (bones of the spine).
The resulting angle, known as Cobb Angle, is measured in degrees and places conditions on a severity scale of mild, moderate, severe, or very severe:
Condition severity is important not just as a classification point but also because as a progressive condition; this means it’s in the very nature of scoliosis to get worse over time, particularly if left untreated or not treated proactively.
Where a condition is at the time of diagnosis is not indicative of where it will stay, and this is why choosing a proactive treatment approach is important: mild scoliosis can progress to moderate, moderate to severe, and severe to very severe.
As a progressive structural spinal condition, effective treatment has to, first and foremost, impact the condition on a structural level, in the form of a curvature reduction, and includes managing its progressive nature.
What I want patients, and their families, to fully understand is that not all treatment approaches respond to a diagnosis in the same way, and how a condition is responded to, in terms of treatment, can have life-long effects.
Patients have to advocate for themselves in ensuring they are aware of all treatment options available so they can ensure their treatment expectations are aligned with the reality of their potential outcomes.
So let’s talk about the two main scoliosis treatment approaches available: traditional and conservative.
When a condition is first diagnosed, how a treatment provider responds is key. For many years, the traditional approach was the dominant one, and many patients, even now, are unaware of other treatment options available.
While each case is different, there is a common path for those opting for traditional treatment.
As adolescent idiopathic scoliosis (AIS) is the most prevalent condition type, we’ll focus on this form for the bulk of the article, and for an adolescent diagnosed with mild scoliosis by their general practitioner, the next common step involves a referral to a spinal surgeon.
While spinal surgeons are obviously experts when it comes to surgical treatment options for scoliosis, they are not trained in nonsurgical treatment options, which is why patients on this path commonly find themselves funneled towards spinal fusion surgery.
Under a traditional treatment approach, a mild case of scoliosis is responded to with watching and waiting: waiting for further progression.
This wastes valuable treatment time because, as mentioned earlier, scoliosis is progressive, so we know that, at some point, it’s going to get worse, and as growth and development are the biggest trigger for progression, children and adolescents are at risk for rapid-phase progression.
A traditional scoliosis treatment provider would recommend that the patient be brought back at periodic intervals (every 3, 6, or even 12 months) for checkups to monitor for progression, but as adolescents are in, or entering into, the phase of puberty with rapid and unpredictable growth spurts, what happens if in between checkups, they have a huge growth spurt and progress significantly?
As no forms of treatment have been applied, the mild curve was left to progress unimpeded, and if it becomes moderate, still, the only form of treatment applied under this approach is bracing.
Traditional bracing, like the Boston brace, is known to have a number of shortfalls, mainly related to its design that only impacts the condition on two dimensions rather than addressing its true three-dimensional nature.
So if a traditional Boston brace is prescribed to prevent further progression, and fails to do so, once that patient crosses the surgical-level threshold of 40+ degrees and shows signs of continued progression, spinal fusion is commonly recommended as the best treatment option available.
Spinal fusion involves fusing the most-tilted vertebrae at the apex of the curve together into one solid bone so movement (progression) in the area is limited, and the spine is commonly held in place with rods and screws.
What many patients are disappointed with post-surgery is their loss of spinal flexibility and range of motion, as this can greatly impact spinal function and quality of life.
Just as all surgical procedures come with their share of risks, spinal fusion is no exception, and if spinal fusion is unsuccessful at preventing further progression, the only recourse is subsequent surgeries.
There is also a gap in the studies and data on the long-term effects of living with a fused spine and hardware longevity that patients should be aware of.
While each case is different, some potential spinal fusion risks and side effects for patients to be aware of include:
So now that we have explored what commonly happens to adolescents diagnosed with mild scoliosis along the traditional path of scoliosis treatment, plus the nature of spinal fusion, let’s talk about how to fix scoliosis by less-invasive means.
Before delving into nonsurgical scoliosis treatment options, I’d like to first be clear on the terminology of fixing scoliosis because I feel when most people say fix, they mean cure, and as a progressive structural spinal condition, there is no curing scoliosis, at least not in the traditional sense.
Once a person is diagnosed with scoliosis, they will have it for life, but although we can’t cure it indefinitely, we can most certainly treat and manage it effectively, so it neither defines nor limits a person.
Even with successful treatment, patients will have to work to sustain those results, and this can commonly involve continued chiropractic care and scoliosis-specific exercises and stretches, not to mention living a scoliosis-friendly lifestyle.
A scoliosis-friendly lifestyle includes maintaining a healthy weight, staying active, understanding the ergonomics of heavy lifting, and practicing good posture.
In addition, knowing the types of exercises, sports, and activities that are safe, and unsafe, for people with scoliosis is important, and helping patients strike that ideal balance of maintaining a healthy scoliosis-friendly activity level that doesn’t strain an already-strained spine is a valuable part of my treatment.
Maintaining a healthy activity level makes the body more responsive to treatment because it keeps the spine and its surrounding muscles as loose and strong as possible, and as the spine’s very design is based on movement, a sedentary lifestyle can have serious consequences for the spine.
Most commonly, it’s the spine’s intervertebral discs that are the first spinal structures to show signs of deterioration.
As the discs help the spine maintain its natural curvatures and alignment by providing cushioning between adjacent vertebrae, enabling flexible movement and mechanical stress absorption/distribution, and acting as the spine’s shock absorbers, a lack of movement and natural age-related spinal degeneration can cause disc desiccation, a bulging, and/or a herniated disc, and can lead to the development/progression of degenerative scoliosis in adults.
So how exactly is scoliosis treated nonsurgically: through a proactive and conservative treatment approach.
Here at the Scoliosis Reduction Center, I believe in proactive treatment applied as close to the time of diagnosis as possible, and while there are no treatment guarantees, early detection does increase chances of treatment success, but only if that diagnosis is responded to proactively.
When it comes to how to fix mild scoliosis, I see these cases as a chance to keep them mild, and particularly with adolescents, we want to stay ahead of the curve and work towards counteracting the condition’s progressive nature.
The complex nature of scoliosis necessitates the customization of effective treatment plans, so I craft treatment plans around important patient/condition characteristics such as patient age and overall health, condition type (causation), curvature location, and condition severity.
Here at the Center, I integrate multiple forms of condition-specific treatment for the most specific results, and as I monitor how the spine is responding to treatment, I can apportion each discipline accordingly for the true customization.
As a CLEAR-certified scoliosis chiropractor, I know the spine, how scoliosis affects it and the rest of the body, and how best to treat it proactively.
While treating scoliosis specifically falls beyond the scope of general chiropractic, scoliosis-specific chiropractic care can impact the condition on multiple levels, increase spinal flexibility, and help address a misaligned spine.
Through a series of chiropractic adjustments and manipulation techniques, I can work towards adjusting the position of the most-tilted vertebrae back into alignment with the rest of the spine: restoring as much of the spine’s natural curves as possible.
As a curvature reduction is achieved on a structural level, the spine’s biomechanics are improved, and this helps improve the spine’s natural function and overall health.
There are a variety of therapies that can help, and the main goal of scoliosis-specific therapy is to passively mobilize the spine into a corrective position and reduce scoliosis.
There are multiple ways to work towards this, from vibration, traction, to de-rotation, and these involve the use of specific types of equipment we have access to here at the Center: traction chair, scoliosis flexion-distraction table, thoracic mechanical drop piece, vibrating cervical traction, and more.
Custom-Prescribed Home Exercises
While there was a time when the place of exercise in scoliosis treatment was questioned, we now know that there is a big difference between general physical therapy exercises, and scoliosis-specific exercises (SSEs) that when integrated into an effective treatment plan, can help augment corrective results.
SSEs are self-correction exercises that I customize for each and every patient based on their ability and curvature type.
These exercise regimes can involve a combination of active movement-based exercises, isometric exercises, and reflexive exercises but should never be performed unless prescribed by your scoliosis-treatment provider to ensure they are the right SSEs for a particular condition and won’t interfere with treatment.
Many of these SSEs involve the application of scientific concepts to exercise for improving spinal flexibility, increasing core strength, so the spine is optimally supported by its surrounding muscles, and activating certain areas of the brain to improve brain-body communication for postural remodeling and improved body positioning.
As mentioned earlier, there are a number of shortfalls associated with traditional bracing, and this is because traditional bracing doesn’t have correction as its end goal but focuses solely on stopping progression.
Modern corrective bracing represents the culmination of what we’ve learned about bracing as a scoliosis treatment option over the years, and addresses many of the shortfalls associated with traditional bracing.
The modern ScoliBrace works to impact scoliosis on all levels by addressing its true 3-dimensional nature, and instead of squeezing the spine unnaturally and weakening it, as the Boston brace is known to do, the ScoliBrace pushes the spine into a corrective position.
In addition, compliance is a huge issue when it comes to brace efficacy; if not worn as prescribed, it will be ineffective.
The ScoliBrace tackles the compliance issue by customizing each brace to the patient’s specific curvature and body type so they are less bulky, can be worn under clothes, are more comfortable, and can easily be undone at the front.
Now that we have defined the condition, addressed the differences between the two main treatment approaches, including the specifics of watching and waiting versus being proactive, let’s address how to fix scoliosis in adults.
When it comes to how to fix scoliosis in adults, the ultimate goal is similar to when treating younger patients, but the focus can shift a bit.
While reducing a scoliosis curve is the ultimate treatment goal, in adults, the focus can shift from significant curvature reductions to smaller ones, as spinal flexibility can be an issue, and pain management and spinal stabilization can become an equally-important focus.
In adults, significant curvature reductions can be harder to accomplish than in younger patients because natural age-related spinal degeneration can come into play, and as progression occurs, the spine loses its flexibility and becomes more rigid, making it less responsive to treatment.
This is another benefit to the treatment applied early in a condition’s progressive line; it’s easier to treat a scoliotic curve while it’s still small and flexible, before spinal rigidity increases, and the body has had time to adjust to the unnatural spinal curve’s presence.
In some cases of adult scoliosis, work has to be done to improve spinal flexibility prior to starting the most intense phase of treatment.
In children and adolescents, the condition isn’t commonly known as painful, and this is because it doesn’t become compressive until skeletal maturity has been reached in adulthood; once this happens, the spine has settled due to maturity and gravity, making it vulnerable to the compressive force of the curvature.
Compression of the spine and its surrounding nerves and muscles is what causes the majority of condition-related pain, so when treating adult scoliosis, pain management can be a focus of treatment, while this isn’t a common component of treatment in children and adolescents.
While bracing is a common component of treating scoliosis in patients who have not yet reached skeletal maturity, when it comes to adults, bracing is used more for short-term pain relief and for spinal stabilization rather than corrective results.
As growth is the condition’s big trigger for progression, you might think that once growth is no longer occurring, as in adult scoliosis, the progression would stop, but that’s not the case.
While each case is unique with its own equally-unique rate of progression, in general, progression slows once growth has stopped, but over time, even if it progresses incrementally, that increase can add up to a significant Cobb-angle increase.
In addition, the cumulative effect of certain lifestyle choices, plus natural age-related spinal degeneration, comes into play for adults with scoliosis, and these factors can account for continued progression even after skeletal maturity has been reached.
When it comes to how to fix scoliosis in adults, we are talking about reducing the scoliotic curve as much as possible, preserving the spine’s function, pain management, spinal stabilization, and trying to prevent further spinal deterioration to limit progression.
As is the case with all forms of scoliosis, the condition type shapes the design of effective treatment plans, so depending on the form an adult is diagnosed with (idiopathic, degenerative, or neuromuscular), treatment can include chiropractic care, therapy, custom-prescribed exercises, and bracing to increase spinal stabilization and provide short-term pain relief.
Regardless of age, the right time to start treatment is always now. Even if significant curvature reductions are harder to achieve, significant improvements can still be made in other areas, such as pain management and an optimally-supported and stabilized spine, which can greatly impact the quality of life.
When it comes to scoliosis treatment options, choosing the type of treatment approach to commit to will shape a person’s experience of life with the condition.
While the traditional scoliosis treatment approach was the dominant choice for many years, knowing how to fix scoliosis naturally has its benefits in terms of an approach that is less invasive, costly, doesn’t permanently affect the spine’s function/health, and can effectively reduce a scoliosis curve.
Here at the Scoliosis Reduction Center, I believe in the merits of proactive treatment applied as close to the time of diagnosis as possible; this is because even if a person is diagnosed with mild scoliosis, as a progressive condition, it won’t stay there unless proactive treatment efforts are made, and the earlier the better.
When it comes to options for reducing a scoliosis curve, we are talking about choosing between two main scoliosis treatment approaches: traditional and conservative.
As mentioned, traditional is more reactive than proactive and tends to funnel patients towards a surgical recommendation, while conservative is chiropractic-centered, proactive, and for patients who choose to forego a surgical recommendation, it can be a highly effective and more natural treatment option for reducing a scoliosis curve.