Watch and Wait (Would you wait for a Tsunami to hit if you could do something now?)
Generalized Exercise program such as Yoga, Pilates or other Exercise Therapy
Chiropractic, Physical Therapy, Manual Muscle Therapy or Traction and Acupuncture
SpineCor Dynamic Bracing, Schroth Method, SEAS Method, Vestibular Retraining and Gyrotonics
Hard Bracing (Not Recommended)
Pain Management with Medications & Injections (Not Recommended)
Scoliosis Surgery (Last Resort)
Often times these can be used as a singular treatment approach, but more commonly a combination of the less invasive therapies options will yield the best results.
Watch and wait sounds straight forward, but also strange. Usually they will recommend a follow up x-ray with children in 4-6 months and adults in 1 year. But if there is a problem why would you not be proactive?
In general with scoliosis there are overactive muscles and under active muscles that generalized exercise programs can’t address. They are helpful in general to strengthen the body which can have great benefit, but typically can’t have the affect that these tissues need.
More research is showing that most scoliosis is neurologic problem. So finding a therapy that addresses the nervous system is going to have a greater impact on outcomes for scoliosis. Finding a provider that specializes in working with scoliosis will be important to help in the management of scoliosis. Neurologically based chiropractic care is probably the best resource in this list. Please see our past article here that outlines some of the differences between scoliosis therapy techniques here.
Dynamic bracing has been around for 20 years and from what has been published probably has the best long term outcomes to date. Schroth can be helpful to strengthen targeted areas in the back, but can take time. Retraining the vestibular system impacts the nervous system and is an important aspect that should not be over looked as part of a balanced approach to scoliosis management.
Hard bracing may be why the watch and wait idea is so popular. This is because it appears that even if it is successful that a rapid progression of scoliosis is often times seen after the brace is discontinued. This is on top of poor compliance with patients wearing hard braces and their impact on quality of life.
Pain management through medication and injections is not addressing the cause of the symptoms with scoliosis. This only offers temporary relief and has no real long term benefit.
Scoliosis surgery should only be used as a last resort after most other options above have been followed through on without the desired therapeutic result. It may sound appealing, but from the data most scoliosis surgeries have about a 15-20 year shelf life and will most likely need to be performed again depending on the individual’s age at the time of the procedure.
Unfortunately most pediatricians, primary care doctors and even scoliosis orthopedists have not been exposed to dynamic bracing. The only company that I am aware of that offers the dynamic brace is Scoliosis Systems and we are proud to be a local Denver partner with them and offer the ScoliBrace System.