When children are diagnosed with scoliosis, understandably, parents and caregivers have a lot of questions. They want to know what caused it, how bad it can get, and, most importantly, how to treat it. There are a lot of variables that go into deciding on the best course of treatment for a child, including bracing recommendations.
Scoliosis bracing has come a long way over the years. Modern scoliosis bracing has corrective potential and was designed with comfort and compliance in mind. The ScoliBrace® is an evidence-based 3-dimensional scoliosis brace that works towards improving the spine’s position and restoring healthy posture.
There are a number of scoliosis braces available, and understanding differences in brace design and treatment goals helps determine the best brace for a child.
Scoliosis Bracing
A scoliosis brace is an orthotic device worn around the torso to treat scoliosis nonsurgically in infants, juveniles, adolescents, and adults.
Adult brace wear is more about pain relief and stability than correction because an adult spine is no longer growing so is more rigid, and curve flexibility is an important factor for treatment planning.
Because a child’s spine is still growing, it’s more flexible, so can be more responsive in terms of curve correction, which is why bracing is often the first line of scoliosis treatment in children.
As one of the earliest treatment methods for scoliosis, bracing has evolved from rigid uncomfortable braces to flexible braces that are easily removed and concealed under clothing.
Parents and caregivers need to understand the difference between traditional scoliosis braces and modern 3D corrective braces. Because a scoliosis curve also twists, treatment needs to address the rotational component.
Brace comfort is important, not just in terms of a child’s quality of life during brace wear, but also because it shapes compliance and potential treatment efficacy.
Scoliosis Brace Compliance
A challenge to bracing success is compliance. When a brace is prescribed for full-time wear, this can mean up to 23 hours a day until a child’s growth stops. This can mean wearing it to school and sleeping with the brace.
While brace-wearing recommendations can be for part- or full-time wear, any brace, regardless of its design, needs to be worn for the time period recommended. Compliance is key.
In addition, the most prevalent type of scoliosis is adolescent idiopathic scoliosis that’s diagnosed around the start of puberty for most, and this age group is at a high risk for curve progression because rapid growth can trigger rapid progression.
So adolescents have a lot to gain from treating scoliosis proactively, but they are also the age group most likely to struggle with brace wear.
In general, teenagers don’t want to look different from their peers. They don’t want to move differently, and they don’t want to wear a brace all day, especially to school, but a brace that’s more comfortable and easier to conceal under clothes is more likely to be worn all day, instead of being taken off and put in a locker.
The modern ScoliBrace® factored the challenge of compliance into its design by using lightweight durable material with different colors, pattern choices, and padding for comfort. The brace also opens easily at the front so patients don’t need assistance getting in and out of the brace.
And because each brace is truly customized, the fit is bespoke to its wearer, further improving overall comfort and compliance.
ScoliBrace® Design and Correction
ScoliBrace® uses advanced design principles for corrective potential. Some traditional scoliosis braces are limited because they only address the spine’s unnatural curve to the side, but not its rotation.
Studies support the potential efficacy of ScoliBrace® as a nonsurgical childhood scoliosis treatment option, and in cases that require a broader treatment plan, when scoliosis-specific exercise is integrated with bracing, studies also show the potential efficacy of ScoliBrace increases.
The ScoliBrace® is a 3D brace customized around the specifics of each patient’s scoliosis and posture. Each ScoliBrace® is as unique as the patient’s curve.
ScoliBrace® is designed with 3D scanning software, digital X-rays, and postural images for true customization, which also contributes to compliance by increasing comfort. A brace that’s designed around the specifics of a patient’s body type, posture, and curve type is going to be more comfortable than a mass-produced standard brace.
Again, each brace is unique, but in many cases, an over-corrective approach is used by holding the body in a position that opposes the curve.
As the body moves into its new position, the spine also moves while the body and spine’s straighter alignment is supported. As this is happening, there are also some neurological effects as the connection between the brain and the body’s new posture is strengthened. The goal is strengthening the connection to the point where the body remembers to maintain its healthier position when not wearing the brace.
In some cases, brace wear recommendations are for nighttime wear.
ScoliNight®
A child’s treatment planning starts with a comprehensive scoliosis-assessment to determine the specifics of the curve.
In some cases of small flexible curves that are diagnosed early in young patients, a brace designed exclusively to be worn during sleep (peak growth time) may be recommended as early intervention.
The ScoliNight® uses a hypercorrective approach that’s more effective at night because it doesn’t have to account for movement while inside the brace.
For scoliosis braces that are recommended for full-time wear and/or are only worn at night, some tips to help with comfort are keeping the room cool to prevent overheating and wearing a lightweight breathable cotton fabric to prevent skin irritation.
Proper positioning can help too, and back sleeping is the best choice for the spine’s alignment, followed by side sleeping, and stomach sleeping should be avoided. Also, a thin pillow between the legs can help side sleepers maintain the spine’s optimal alignment, and a firm supportive mattress can also help children and teens get a good night’s sleep while wearing braces.
The ScoliNight® may also be recommended for postural scoliosis patients whose curves aren’t responding to scoliosis-specific exercise-based treatment. The ScoliNight® doesn’t have as much corrective potential, so if curve progression is still occurring, brace-wear recommendations may increase to a more powerful full-time brace.
Consistent monitoring is necessary during brace wear to see how a child’s spine is responding to growth and the chosen brace so treatment planning can be adjusted as needed.
ScoliBrace® and Movement
Another issue that impacts compliance and efficacy is movement. Many traditional scoliosis braces use intense pressure to squeeze the spine into a straighter alignment, but this can actually weaken the spine over time, cause skin chafing, and breathing difficulties.
In addition, this makes it difficult to move comfortably inside the brace, and this can also contribute to muscle weakness over time. Modern corrective braces like the ScoliBrace® use a different design (spinal coupling) to allow for movement.
In fact, some studies show the potential efficacy of scoliosis bracing increases when it’s paired with a scoliosis-specific exercise program. So it’s important for parents to understand that treatment decisions don’t just rest on the brace alone, but the type of approach it’s aligned with. Proactive nonsurgical treatment plans support integration.
For growing children, choosing the right brace, and using it at the right time, can shape the outcome of treatment, so it’s essential that parents and caregivers are educated on the different types of braces available and the importance of proactive treatment.
Because curve progression is triggered by growth, most cases of childhood scoliosis are progressive, and timely assessment and treatment are associated with positive outcomes.
While individual treatment results can vary, successful scoliosis bracing outcomes in children may include reducing the size of idiopathic curves, improving body symmetry and appearance (posture), pain relief, stability, and slowing progression.
Conclusion
Scoliosis bracing is used to address idiopathic scoliosis in patients of all ages, and when it comes to childhood scoliosis treatment, timing is important because curve progression is triggered by growth.
Children recommended for full-time brace wear will have to wear their brace to school and during sleep, and a thorough scoliosis assessment by a professional can help patients understand available bracing options, along with the differences between traditional and modern scoliosis braces.
Modern corrective bracing supports better posture, mobility, breathing, stability, and strengthens the connection between the brain and the spine and body’s improved position.
Luckily, bracing has become more comfortable and effective over the years, culminating with the patient-centered ScoliBrace® known for its advanced design, customization, and corrective potential.
Here at the Scoliosis Reduction Center®, patients and their families are guided through the treatment process from assessment to diagnosis, monitoring for changes, and when bracing is deemed appropriate, discussing the best type of brace for a patient’s specific curve.
