For adults recently diagnosed and/or adults who have been living with scoliosis, it's important to understand the different treatment options available. Bracing for adult scoliosis can improve the spine's position and body posture, and becomes more effective when paired with a scoliosis-specific exercise program.
Scoliosis bracing is an evidence-based nonsurgical treatment option customized around the specifics of a patient's scoliosis. Risk of curve progression and severity are important variables, and adult scoliosis braces focus more on increasing stability, postural restoration, and pain relief than significant curve reductions.
There is a big difference between traditional squeezing braces and modern corrective scoliosis braces..
Adult scoliosis is diagnosed if an unnatural sideways spinal curvature with rotation develops in a patient who has reached skeletal maturity.
Scoliosis affects all ages, but is most often diagnosed during childhood. Adolescent idiopathic scoliosis is the most common type diagnosed mainly around the onset of puberty, and the two main types of adult scoliosis are idiopathic scoliosis and degenerative scoliosis.
Idiopathic scoliosis has no known cause, but if cases of adolescent idiopathic scoliosis go unnoticed, undiagnosed, and untreated during adolescence, it can progress into young adulthood.
Most cases of idiopathic adult scoliosis are pre-existing from adolescence and are diagnosed as adolescent scoliosis in adulthood (ASA).
As a progressive condition, scoliosis can increase in severity over time, and in children, it's growth that causes scoliosis progression, and in adults, changes to spinal health can trigger progression.
A focus of diagnosing and assessing adult scoliosis is determining whether or not the scoliosis is pre-existing from adolescence or has developed with no prior history.
When an adult's scoliosis is preexisting from adolescence, there may have been a lot of progression prior to reaching a diagnosis, and the effects can be well established, but it's never too late to start treating scoliosis.
After idiopathic scoliosis in adults, the most common type of scoliosis to affect adults is degenerative de novo scoliosis.
Degenerative scoliosis affects older adults, usually over the age of 45, and unlike idiopathic scoliosis, has a known cause: degenerative changes to spinal health.
Most degenerative changes to spinal health start with the spinal discs that sit between adjacent vertebrae (bones of the spine).
If the discs are experiencing uneven pressure and loading, they can change shape, lose height, and this can disrupt the position of vertebrae attached and cause instability.
Poor posture can develop as we age due to weakening muscles and the downward pull of gravity that becomes harder to resist over time, and if a prominent lean forward or to the side develops, this causes uneven weight distribution over the spine and its structures and can cause uneven wear; if left unaddressed, a cycle of poor posture and uneven degeneration may develop that's difficult to disrupt.
Early detection is helpful because a treatment plan can be started that may interrupt the cycle before it becomes well established.
So when it comes to treating scoliosis in adults, bracing can be an effective nonsurgical treatment option.
In children and adolescents facing a lot of future growth, there is a high risk of curve progression. There was a time when adult scoliosis progression wasn't fully understood. It was thought that once growth stops, progression stops, but this isn't the case.
While idiopathic scoliosis in adulthood can progress slower because growth is no longer occurring, the cumulative effect of certain lifestyle factors and changing spinal health can also cause progression, and if a cycle of poor posture and uneven wear is initiated, degenerative changes to spinal health can occur quickly and cause fast progression.
In fact, the actual rate of scoliosis increases among the aging population due to degenerative scoliosis.
Traditional scoliosis braces, such as the Boston brace, are limited in their potential efficacy due to their squeezing design and the fact that they don’t address the spine’s rotational component, but modern corrective bracing has more to offer in terms of correction.
Bracing for adult scoliosis is more about pain relief, stability, and postural improvement than it is about significant curve reductions. While the goal of treating scoliosis in all ages is restoring as much of the spine's healthy curves as possible, growing spines are flexible so there is more potential for correction, and significant reductions are necessary to counteract the constant progressive trigger of growth that's occurring in children.
Increasing spinal rigidity is an effect of scoliosis, so the longer scoliosis is left untreated, the more rigid the spine may become, making it less responsive to treatment.
Because scoliosis becomes compressive once growth stops, adult scoliosis is more closely associated with pain, particularly radiating pain caused by compression, and because adult scoliosis involves more degenerative instability, support and pain relief are needed.
Bracing for childhood scoliosis can be particularly effective because the spine is still growing, is more flexible, and responsive to attempts to improve the spine's position, but in adults, the spines are more rigid, and flexibility of the curve is a treatment-outcome shaping factor.
Bracing for adult scoliosis is more about moderate curve reductions, pain relief, stability, and postural improvement.
ScoliBrace® is a modern corrective scoliosis brace that when combined with a scoliosis-specific rehabilitative exercise plan, can be an effective treatment option for both childhood and adult scoliosis.
A brace can help with back pain by stabilizing the spine. The spine is designed for movement, but if there is too much movement within the spine and its individual structures, the instability can cause friction during movement, degenerative changes, and pain.
ScoliBrace® can help slow/stop progression by holding the spine in a straighter alignment, and because bracing maintains the torso's straight and upright position, postural correction can also be happening.
Because childhood scoliosis bracing is working towards significant curve reductions and counteracting growth, they are usually recommended for full-time wear, but adult bracing is more commonly worn for part-time (4 - 12 hours a day).
The brace is most often recommended to be worn during the second half of the day; this is when posture tends to decline as it becomes harder to resist gravity's effects.
When a corrective adult scoliosis brace is combined with an evidence-based scoliosis-specific exercise program, moderate curve reductions may also be within reach as the spine's alignment, stability, support, and body posture is improved.
As the brace stabilizes the spine and improves posture, scoliosis-specific rehabilitative exercise is targeting the spine's surrounding muscle strength and balance for more support, pain relief, and increasing stability.
While a traditional treatment approach for adult scoliosis doesn't focus on bracing, this is largely due to the limitations of traditional bracing, but modern corrective braces like the ScoliBrace® hold the spine in an overcorrective position while scoliosis-specific exercise simultaneously targets building core and back muscle strength for uniform support.
A well designed corrective brace becomes more effective when combined with a customized scoliosis-specific rehabilitative exercise program working to improve the spine's surrounding muscle strength and balance, and because no two cases of scoliosis are the same, treatment plans need to be fully personalized.
The ScoliBrace® for adults can offer short-term pain management, moderate curve reductions, improved spinal alignment, spinal stabilization, postural balance, improved sagittal and coronal balance, postural realignment, and most importantly, improvements to quality of life.
Adult scoliosis behaves differently than in children and adolescents, but seeking treatment is important to ensure patients' symptoms don't increase over time due to increasing spinal degeneration.
Here at the CLEAR Scoliosis Institute, patients are guided through their initial assessment, diagnosis, discussing treatment options, and personalizing a treatment plan around key scoliosis factors and treatment goals.
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