Treatment for Scoliosis | The Guide to Relief

Scoliosis treatment depends greatly on the patient’s age, curve severity, cause, and risk of progression. Fortunately, there are many effective options now available for managing scoliosis spanning observation, braces, surgery, medication, alternative therapies and more.

This guide outlines the core treatments used at various stages of scoliosis progression to stop curve advancement and spinal deformity in children while also improving pain, posture, and quality of life for teenagers and adults.

Observation and Monitoring

Watchful waiting is often the first line for newly diagnosed scoliosis, especially in skeletally immature children under 10 years old. It involves:

Routine Clinical Visits

Every 4-6 months, pediatricians manually assess spine alignment, shoulder/flank asymmetry, flexibility. Scoliometer readings quantify rotational deformity, monitored for changes.

Serial Imaging Tests

Low-dose EOS X-rays show curve degree measurements in coronal & sagittal planes. Repeated at 6-12 month intervals based on risk, previous films compare progression.

Bracing Interventions

Bracing is the leading non-operative treatment approach for managing progressive scoliosis during juvenile and adolescent growth phases. External braces work by applying corrective forces to the spine to prevent further worsening of curvature.

TLSO – Thoracolumbosacral Orthosis

The most widely used custom brace style is the TLSO, encompassing the thoracic, lumbar and sacral regions of the spine. Made of rigid plastic, it is contoured to push against lateral curves along the ribcage, flank and pelvic areas in a three-point pressure system. For lumbar and lower thoracic curves.

Milwaukee Brace

This traditional design uses a neck ring attached by vertical bars to a pelvic girdle to exert corrective upward traction on the entire thoracic and cervical spine simultaneously. Often prescribed for high thoracic curvatures in the upper vertebral column.

Charleston Bending Brace

Worn only at night, this Providence-style brace uses lateral padding to encourage the body to bend toward the concave side, harnessing gravitational forces to achieve dynamic overcorrection of the curve during sleep. Latex-free.

SpineCor Brace

Utilizing a more flexible, elastic design from breathable fabric, SpineCor braces are less rigid than hard plastic braces. Based on the SpineCor principle of guiding proper movement and posture to encourage neuromuscular retraining of core support muscles over time.

The type of custom brace constructed for a scoliosis patient depends on factors like curve location, degree of flexibility, and age/stage of skeletal growth. With advancing technology, additional options are emerging beyond traditional bracing.

Surgical Treatment Options

For those with curve magnitudes exceeding 40-50° or bracing failures, surgery is often indicated to permanently stabilize progression and straighten spine.

Pre-op Preparation

Thorough examinations assess curve rigidity/location, bone age, lung/heart capacity for surgery planning. Advanced imaging like MRI further details anatomy. Nutrition optimization boosts healing capacity.

Common Procedures

Spinal fusion surgery is the primary treatment for scoliosis. It uses bone grafts and metal instrumentation to solidly join together vertebrae in the curvature, preventing further progression. More recent growth guidance techniques aim to halt progression while allowing more spinal mobility compared to traditional fusion.

Post-op Recovery

5-10 day hospitalization allows close monitoring of vitals, fluid/nutrition levels, pain control. Gradually increasing movement & upright positioning prevents complications like pneumonia before discharge.

Physical Therapy and Exercise

There are several treatment options available to help relieve scoliosis pain and discomfort. Customized exercise programs that focus on flexibility, core strength, and posture can also be helpful in managing symptoms. Therapeutic techniques like physical therapy, chiropractic care, massage, acupuncture, and bracing may provide relief as well. The goal is to find a tailored approach that keeps the body as active and comfortable as possible.

Modalities for Pain Relief

Gentle chiropractic mobility work, massage, electric muscle stimulation, hot/cold packs target musculoskeletal tension and neurological irritation.

Postural and Balance Training

Specialized exercise programs for scoliosis use a variety of positions and movements to improve posture, alignment, and symmetry. Patients learn to do controlled stretches, visualization techniques, and retraining exercises designed to rebuild proper movement patterns and biomechanics. Therapists also guide patients through assisted exercises to improve sensory-motor control and coordination – skills needed for balanced posture and movement. The focus is on reinforcing proper alignment not only for standing, but also for transitional movements like sitting, walking, and reaching. This helps reestablish activation of key muscle groups.

Home Exercises

Simple stretches, posture drills, core & back strengthening routines learned via physical therapy help maintain flexibility, function during observational period.

Strengthening Weak Areas

Certain targeted exercises can help strengthen the weak areas affected by scoliosis without worsening spinal curves.

• Isometric exercises that apply force against resistance without joint movement are often used. This avoids over-stretching the concave areas of curvature.
• Concentric muscle contractions that shorten the muscle length can build supportive tone along convex portions of abnormal curves.
• Exercises bringing the shoulder blades together help stabilize uneven scapular positioning and prevent shoulder asymmetry common with progressive scoliosis.

The goal of a tailored strengthening program is to protect vulnerable aspects of the curvature while strategically rebuilding supportive muscles compromised by scoliosis. A physical therapist can guide the optimal routine based on the patient’s specific spinal curve patterns to avoid increasing deformity. Gradually restoring muscular strength balance is the key.

Alternative Medicine Approaches

While there is limited clinical evidence about their effectiveness, some integrative therapies may help provide pain relief or a sense of empowerment for those with scoliosis. Options like massage, acupuncture, chiropractic adjustment, mindfulness practices, or herbal supplements could offer additional support for some patients. More research is still needed, but incorporating approaches that reduce tension or address quality of life factors may have value as complementary treatments. An open discussion with your care provider can help determine if any such therapies are right for your individual needs.

Yoga and Pilates

Gentle programmed poses improve core strength, shoulder flexibility, spinal mobilization – adapted as needed. Emphasizes breathwork for relaxation.

Acupuncture

Thin sterile needles placed along energetic meridians may modestly reduce musculoskeletal discomforts from chronic postural asymmetry.

Nutritional and Herbal Supplements

Anti-inflammatories like curcumin, boswellia, omega-3s tout relief benefits. Nutrients aid bone density. But regulating agencies do not endorse claims fully. Caution advised.

Prognosis and Follow-Up

With comprehensive treatment, the prognosis for scoliosis is often favorable in relation to signs, symptoms, and progression risk depending on each patient’s specific diagnosis. Care continuing into adulthood focuses on preserving function and managing any associated pain or arthritis as needed through the years. Those treated with surgery must remain vigilant to assess for potential complications like infections, failed fusion, or hardware issues to ensure the best outcome over their lifetime. But with attentive teamwork between patient and doctor, quality of life can remain high as they address scoliosis-related issues that come up over the lifespan. The key is tailoring the management approach to the individual and following through on the treatment plan at all ages.