Non-Traditional Methods of Treatment

     While observation, bracing, and surgery are the main types of treatment for scoliosis there are a few other methods of treatment.  These methods are not proven to be effective as treatment methods and are not recommended by doctors.  Therapies, chiropractor, yoga, and strengthening exercises are the “non-traditional” forms of treatment.  In some cases these have been proven to provide sufficient treatment to those who have scoliosis, unfortunately they have not been proven in enough cases for doctors to truly believe they are good ways to treat.  There are some people, mainly those who are against invasive medical treatment, which would rather try these methods over observation, bracing, or surgery.  While in the end it does come down to what the patient wants in terms of what treatment option is pursued these non-traditional methods are not going to always work and therefore are not the best option for the patient.  While my parents and I did not find an abundance of information about different treatment options we knew that the non-traditional methods were not what we wanted.  When looking at different websites there was almost always only a sentence or two about these methods and that was just not enough to convince us that these were worth my time.  It did not make sense to us to pursue one of these options because there was no evidence to back them up that any of the non-traditional methods would work.  And even though there was not a ton of information about bracing, being in the study allowed me to help others in the future make an easier decision than I did as to which method of treatment they should choose.

Treatment 3: Surgery

     The third and most extreme type of treatment is a spinal fusion surgery.  Surgery is only performed if the other methods of treatment have been unsuccessful.  This surgery is normally only performed if the curve is 45° or larger and the patient is still growing.  The surgery involves taking metal rods and attaching them to the spine using screws, hooks, wire, and bone grafts.  The surgery itself takes several hours to complete and requires the patient to stay in the hospital for about ten days after the operation.  The patient can return to school a few weeks after the surgery and life should be back to normal a few months later.  Like with any major surgery there are risks involved.  Some of the risks include bleeding, wound infection, moving of the implants that would require additional surgery to fix, and in rare cases damage to nerves in the spine.  Even with these risks a spinal fusion surgery is a very successful method of treatment when the curve has become this large.  

BrAIST

     In 2007, a study was started to decide whether or not bracing was actually effective.  Up until this study there was never any hard evidence to say that if a person wears a brace it will prevent their scoliosis from progressing further.  The study was conducted by the University of Iowa and officially called Bracing in Adolescent Idiopathic Scoliosis Trial or BrAIST for short.  There were a total of 242 participants.  The participants could be either male or female between the ages of ten and eighteen.  Each participant was randomized to either the Boston Brace or observation.  Throughout the study participants had doctors appointments every six months where they had x-rays taken to measure any change in their curves.  The study ran until September of 2013.  After the results from all the participants were studied the doctors came up with a conclusion.  Based on the progression of all the curves from both those in the brace and observation they came to the conclusion that bracing is an effective method of treatment.  Wearing the brace twenty-three hours a day, seven days a week kept the curve in the position it was or in some cases it actually pushed the curve back towards the correct position.  This was rare but in almost all cases the curve did not progress further.  This is huge news in the world of scoliosis treatment because there is finally evidence that wearing a brace will help!  When I was starting my treatment the BrAIST study was in full swing.  I was actually one of the patients randomized to wear the brace.  Knowing that the brace was effective for more people than just me is very comforting to me.  I went into wearing the brace with no idea if it would help or not.  Knowing that someone else will be able to choose to wear the brace and know that it will help them means a lot to me.

Treatment 2: Bracing

If your curve is larger than twenty-five degrees but less than forty degrees you are probably a good candidate for a brace.  There are three different types of braces.  One type is not necessarily better than another, they are just used for different reasons.  The three types are described below.

1. The Boston Brace: This is the most commonly prescribed brace.  The brace is made out of plastic and modeled to fit the patient’s body.  It is worn under the clothes and is not very noticeable.  It is typically used to treat thoracic, lumbar, or double thoracic curves.  This is the type of brace I was prescribed.  They make a cast of the patients back as a model for the dimensions for the real brace.  I was also able to pick a design for the actual plastic of the brace to help personalize it.  While this was a small gesture it was nice to be able to have the brace different than just plain white since it was with me for so long

2. The Milwaukee Brace: The Milwaukee Brace is very similar to the Boston Brace but it includes a neck ring.  The neck ring is added to keep the neck in line with the spine.  It is also made out of plastic and modeled to fit the patient’s body.  It is usually used to treat thoracic curves.

3. The Charleston Bending Brace: This brace is only worn while the patient is sleeping.  It is modeled the same as the Boston Brace and the Milwaukee Brace but it applies more pressure to the curve in the opposite direction. 

Treatment 1: Observation

     The first treatment I want to talk about is observation.  This is how most people with scoliosis start. Observation consists of bi-yearly visits with your doctor for x-rays.  At the appointment your doctor will check that the curve is not progressing too fast and that it is not affecting any other part of your body (ex. hip alignment, shoulder evenness).  Observation is used normally when the curve is less than twenty-five degrees.  If the curve gets bigger your doctor might suggest another method of treatment that is better suited for a larger curve.  Observation is used for the long term treatment when the curve is not at risk of progressing past the twenty-five degree mark.  This is normally if you are almost done with puberty.  Observation does not require much of you as the patient and can be very effective, assuming your curve does not progress further.  For more information about observation see the resources post!

RESOURCES!

Here is a list of some good websites that can give you more information about the treatment methods I have talked about, the BrAIST study, and a great support group in the Cincinnati, Ohio area!

http://www.spine-health.com/conditions/scoliosis/types-scoliosis-braces
    This website gives an overview of the three scoliosis braces.

http://www.niams.nih.gov/health_info/scoliosis/#treatment
    This is a question and answer page with common questions about scoliosis.

http://orthoinfo.aaos.org/topic.cfm?topic=A00636
    This talks about the non-surgical methods of treatment.

http://orthoinfo.aaos.org/topic.cfm?topic=A00641
    This talks about the spinal fusion surgery.

http://www.nih.gov/news/health/sep2013/niams-19.htm
    This is an article written about the results from the BrAIST study.

http://www.srs.org/patients-and-families/conditions-and-treatments/adolescents/treating-scoliosis
    This gives a general overview about the treatment options for scoliosis.

https://www.clinicaltrials.gov/ct2/show/study/NCT00448448?term=BrAIST&rank=1&sect=X0156#locn
    This has all the information about the BrAIST study.

http://scolisupport.weebly.com/
    This is a support group in the Cincinnati, OH area.

A Little Backgroud

     Before I start giving advice I feel like I should tell you why you should listen to me.  I am not just some random person on the Internet writing about a topic I know nothing about.  Scoliosis and I go way back, I was diagnosed seven years ago.  As a sixth grader my mom had my doctor check my back because both her and my dad have scoliosis.  She wore a brace herself where as my dads was not that bad, he did not have to do anything.  She wanted to start checking my back just in case I did have scoliosis.  It is a very good thing that she had them check my back then because I did have a fairly significant curve and within six months it progressed ten degrees and made me a good candidate for wearing a brace.  I was braced from the spring of my sixth grade year until the spring of my freshman year of high school.  It was a very weird experience for me.  I was very open about wearing the brace and was not worried about other people seeing or knowing that I had it on.  It just become a part of my life, I got to the point that I found it weird if someone did not know I wore the brace.  Even though I was very open about wearing the brace I also found it very hard at times.  I knew I had to wear the brace but as time went on that got harder.  The brace was a perfect mold for me as a sixth grader but not so much for me as a high schooler.  It was very uncomfortable and made doing some simple tasks harder.  I wanted out of the brace but I also did not want my curve to progress.  In the end I fought through the bad times and just looked forward to getting it off.  Once that day finally came I rewarded myself for wearing the brace for three full years by breaking the brace in half.  It was a very powerful experience.  I was able to physically rip something that had caused me so much pain in three years.  After ripping it my mom made me throw it away because it was just taking up space.  Looking back I wish I would have kept it.  As much as I hated the thing while I was wearing it, it did me so much good that I never realized until it was gone.  
     I hope this helps give me some credibility to see that I am not some random person, but someone that really does care about the treatment that you choose.  It can make a huge difference in the rest of your life.  Good luck, I promise it might seem like a lot now but it will get easier.  It will not happen overnight, but one day you will come to the realization I did.  You can get through this.