About scoliosis bracing
Of all the patients who come to Boston Children’s Hospital for treatment for scoliosis, most have minor scoliosis that does not require treatment other than regular monitoring. The second largest group are patients with moderate scoliosis. Of these patients, about 75 percent are successfully treated with scoliosis bracing. The other 25 percent go on to need spinal fusion surgery.
Orthopedic doctors typically recommend scoliosis bracing for kids and teens who are still growing and have a curvature of 25 degrees or more. The primary goal of a scoliosis brace is to keep the curve from progressing to the level that surgery is required. Some patients achieve curve reduction with bracing.
How to support your child who has to wear a brace
Experts at Boston Children’s answer questions about what it’s like to wear a brace and how a parent can support their child when they have to wear one.
How long do I have to wear the scoliosis brace?
The most important time for brace wear is during periods of rapid growth. This is when you have an opportunity to have a positive effect on your scoliosis. Your doctor will monitor your growth at each visit and create an individualized schedule for brace wear that takes your unique growth pattern into account. This schedule will include how many hours you need to wear your brace each day. It will be based on the degree of your curve and your stage of growth. Generally, people with moderate scoliosis wear their brace between 12 and 20 hours a day.
Night-time bracing is used in some patients for mild curves or when full-time bracing is not possible.
A scoliosis brace is like medicine: it only works if you use it as prescribed. Studies have shown that patients who wear their brace for the recommended number of hours a day are less likely to need surgery.
How will bracing affect my daily life?
It will probably take time to get used to wearing your scoliosis brace. Many of our patients tell us their brace became more comfortable after they wore it for a couple of weeks.
Most braces for scoliosis can be worn under normal clothing. It will be up to you to decide whether or not to tell other people you are wearing it. However, many people find their brace easier to deal with when they can talk openly with their friends about what it’s like to wear a scoliosis brace.
If you participate in a sport or other physical activity, talk with your doctor about how the brace will affect your performance. You may be able to take the brace off for practice and competitions, as long as you put it back on as soon as you’re finished exercising.
How does a scoliosis brace work?
The primary purpose of a scoliosis brace is to prevent your spine from becoming more curved as you grow. As the spine curves, the vertebrae sometimes also twist toward one side of the body.
The brace will be molded to hold your spine in a straighter, unrotated position. It does this by putting pressure on the outer edge of your curve. This will cause you to stand up straighter as you pull away from this pressure.
How can I tell if I’m wearing my brace enough?
Each scoliosis brace contains a compliance monitor that provides an accurate record of the time the brace is worn. This will help you self-manage your schedule while achieving the greatest benefit from the brace.
If the monitor shows you are not wearing the brace for as many hours a day as you think, it’s a good idea to talk with your parents, doctor, and school about anything that makes it hard for you to wear your brace. They may be able to help you find a solution.
How will I be fit for my scoliosis brace?
Your doctor will refer you to an orthotist, a professional who specializes in fitting and making braces. During your first visit to the orthotist’s office, they will measure you so they can make a brace for you and your curve. You may have to return to the orthotist’s office several times for adjustments until the brace fits you properly. In total, the process can take several weeks.
The orthotist’s skill and experience will make a big difference in the comfort and effectiveness of your brace. At Boston Children’s, we work closely with Boston Orthotics & Prosthetics.
What if I grow out of my scoliosis brace?
Many kids grow out of their braces, especially since braces for scoliosis are worn during growth spurts. If this happens, your doctor may recommend that you get fitted for a new brace.
Can I do physical therapy instead of wearing a scoliosis brace?
If your curve is severe enough to require a scoliosis brace, physical therapy (PT) alone will probably not be enough to stop your curve from progressing further. For most people with moderate scoliosis, wearing a brace is both more effective and more practical than PT alone. Nevertheless, PT is an important part of many bracing programs. Your bracing program may be supplemented with exercise programs under the instruction of a physical therapist.
The physical therapist will evaluate your posture, muscle strength, and flexibility, and design an exercise program for you to do at home. These exercises will help to stretch and strengthen your muscles, and help you feel more comfortable in your brace. They will also help keep your back strong and ready for the day you can stop wearing your brace. Your doctor or physical therapist may also recommend a more comprehensive scoliosis-specific exercise program.
What is Schroth therapy?
Schroth therapy is a form of scoliosis-specific exercise developed in Germany in the late 1800s. When the spine curves from side to side, the muscles on one side of the back often become weaker while the muscles on the other side grow stronger. Schroth therapy combines strength-building and breathing exercises with posture awareness to balance the muscles and tissues of the back.
Many physical therapists today combine Schroth therapy with other exercises. Your program will be tailored to you and your specific curve.
Are there different kinds of braces for scoliosis?
There are several different types of braces for scoliosis. Your orthopedist will recommend a brace based on your age, stage of growth, and the degree and type of your curve. An orthotist will then design a brace specifically for you.
One of the most popular types of brace is the Boston Brace 3D. It is a vest-style brace made of rigid lightweight plastic that closes in the back. It is a type of Boston Brace, which was developed at Boston Children’s Hospital in the 1970s. The brace has evolved with technology to its present form with three-dimensional spinal correction.
The Rigo-Cheneau Brace is a custom-made brace made of lighter material than some other braces. The Rigo-Cheneau Brace places an emphasis on de-rotation of the spine with customization of design.