Answers to common questions about scoliosis bracing.
When should my child be fit with a scoliosis brace?
Doctors hold varying opinions on this topic. Most orthopedics surgeons follow SRS (Scoliosis Research Society) Guidelines which state that children with curves of 25º or greater with substantial growth potential should be fit with a scoliosis brace. Insurance companies often adhere this guideline as well. In the case of juvenile scolioisis, bracing may begin sooner.
When a scoliosis patient is visibly decompensated, or unbalanced, many parents prefer to “get ahead of the curve,” and may opt for bracing sooner rather than waiting for scoliosis to progress to the 25º bracing threshold. In clinical practice, those skeletally immature patients who opt for bracing sooner rather than later nearly always achieve excellent results because most immature spines are fairly spinal flexibility and bracing can have a greater impact when the goal is curve improvement. This can be especially beneficial in families with history of scoliosis.
The decisions regarding “when to brace” requires the consideration of several factors. Postponing bracing to “watch and wait” rarely results in spontaneous regression or lack of progression. When there is significant potential for growth, a decompensated spine will likely progress without the intervention via bracing, Schroth exercise, or both.
If no interventions are undertaken, parents must be extremely vigilant and avoid letting too much time pass before reevaluating their decision to defer bracing. No parent wants their child to have to wear a scoliosis brace; however, it’s only prudent fact for the successful management of scoliosis in adolescents.
Scoliosis rarely just stops, or improves spontaneously, once scoliosis is diagnosed.
What evidence is there in support of scoliosis bracing?
There is a significant body of evidence in support of scoliosis bracing, and growing evidence in support of Chêneau-style braces for scoliosis.
Please see our Scoliosis Bracing Research page.
Is the scoliosis bracing suitable for adult patients?
Yes. Absolutely. Adults who currently wear Chêneau braces report improvement from a variety of symptoms that may be related to scoliosis. Goas are pain reduction or relief, postural improvement, and spinal support and stabilization. Unlike adolescents, adults typically wear the brace part-time at their own discretion. Many adults use the brace during certain times of the day when they feel as if they are collapsing into the curve, others wear it for support when they are working at the computer or doing housework and some choose to wear it fairly regularly.
A recent, long-term retrospective study from France found that adult scoliosis bracing may slow the rate of curve progression. Although more prospective studies are needed to confirm the result, scoliosis bracing provides an alternative to adults with scoliosis who are seeking non-surgical scoliosis treatment.
What results can be expected when a child/adult is fit with a scoliosis brace?
Stage of development, age at diagnosis, current age, spinal flexibility, in-brace correction attained, curve-pattern, compliance, practitioner management, as well as other factors influence bracing outcomes. In general, those with more immature spines correct more easily than children who are closer to skeletal maturity when there are comparable curves. Then again, spinal flexibility, the right brace fit by a dedicated practitioner, careful monitoring, and brace compliance are significant factors that can make a difference when it comes to outcomes.
Adults are braced for spinal support and stabilization, improved posture, and pain management. Adults should not expect an improvement of the curve in terms of the Cobb angle.
As you would expect, results will vary by individual.
How many hours per day will my child have to wear a brace?
Daily brace wear is determined according to the patient. As a rule, 18 to 20 hours is the norm for progressive curves and for those with moderate and severe scoliosis. Children who are braced earlier–before the 25º threshold–may have the opportunity for fewer hours of wear per day, or wearing their brace only at night. Always consult an experienced professional.
What is the purpose of the openings in Chêneau Concept Braces?
A properly designed brace should be made per an individual’s scoliosis curve pattern. The openings consider that curve pattern and are placed accordingly to allow for Schroth breathing while the patient wears their brace. In essence, with a Schroth-compatible brace, each breath taken while in the brace is a “corrective” breath.
How long will it take my child to adjust to their scoliosis brace?
Becoming adjusted to a scoliosis brace varies by individual and will depend on the brace and the fitting process. Patients who wear a properly fitted Chêneau brace should be able to sleep through the night on the very first or second night in their new brace. At the very least, it should be a faster process than occurred with braces of the past. We recommend consecutive fittings for two or three days to allow for the fastest adjustment period possible.
The comfort factor is key which is one more reason why Chêneau braces have grown in popularity in recent years. There are a few patients with special circumstances (sensory issues, etc.) who may take up to a week or two weeks to fully adjust to the brace. If it is any longer than that we recommend contacting your practitioner.
Is scoliosis bracing painful?
A well-designed, well-fit scoliosis brace should address the curvature without inducing pain! If a child has been wearing a brace successfully for a few months and then begins to complain of pain or discomfort then the brace may need to be adjusted, or replaced.
Other than wearing the brace, what else can be done?
Schroth method exercise can enhance the effect of a properly fit brace for the best possible outcomes.
