The most common treatments for scoliosis are watching and waiting, bracing, and surgery. Alternative treatment options include physical therapy exercises, yoga, and chiropractic. It’s important to understand, however, that there is a very big difference between exercises and chiropractic treatment designed specifically for scoliosis, compared to regular physical therapy or traditional chiropractic treatment. Most experts agree that general exercises and chiropractic do not work in regards to scoliosis treatment. Scoliosis-specific approaches (treatments that have been designed specifically with the scoliosis patient in mind) hold much more promise.
Watching and waiting (or observation) is technically not a treatment for scoliosis. It involves taking x-rays at regular intervals, and monitoring the scoliosis for signs of worsening. If the scoliosis does get worse, the next step is often to prescribe a scoliosis brace.
There is a wide variety of scoliosis braces prescribed around the world. An excellent Cochrane Review was published in 2015 that describes the most popular scoliosis braces; if you are interested in reading it, click here. In the United States, the most common braces are the Boston brace and the Milwaukee brace. Most experts agree that bracing is usually successful in preventing the Cobb angle from progressing to surgical levels if it is worn for at least 12 to 16 hours every day. However, bracing is not always successful in every case.
If the scoliosis does continue to progress, scoliosis surgery is then typically recommended. Scoliosis surgery involves a combination of fusion and instrumentation, intended to prevent the spine from continuing to move and worsen over time.
General physical therapy is not regarded as effective in treating scoliosis. However, scoliosis-specific exercise approaches have begun to gather increasing evidence of their effectiveness. Most of these exercise programs originated in Europe, but are beginning to become available in the United States as well. Many of these programs involve the use of a scoliosis brace as well.
Yoga has helped many people with scoliosis, especially adults, to reduce their pain levels and improve their function. It is important again, just like with exercise, that the yoga instructor has developed a program specifically for scoliosis; some yoga maneuvers can be harmful for certain curve types or patterns.
Traditional chiropractic is ineffective in reducing the severity of mild cases of scoliosis. CLEAR advises against traditional chiropractic care for the management of moderate to severe cases, or those with a high risk of progression. CLEAR uses a scoliosis-specific protocol that has been in clinical use since 2000, and is currently taught through postgraduate courses at accredited chiropractic universities. This protocol shows much greater promise than what has been done in the past.