My Child was Diagnosed with Scoliosis. Now What?

When faced with the diagnosis of scoliosis in your child, a wave of confusion may sweep over you as you embark on the journey of exploring alternative treatments. Questions flood your mind: How should you proceed? Whose advice should you trust? Is inaction a viable strategy? Do you need a scoliosis brace, and if so, when? Which specialist is best suited for scoliosis, and what if surgery is recommended, but you adamantly oppose it?

The challenges extend beyond childhood, as many adult patients grapple with similar frustrations, seeking alternatives when conventional medical options fall short. For children and adolescents, the urgency intensifies due to the limited timeframe available for effective intervention. Doing nothing rarely leads to improvement in scoliosis, making it crucial to explore the right conservative measures that can enhance the quality of life.

As parents of children who initially followed traditional medical paths, only to learn through hardship, we have spent nearly two decades advocating for scoliosis treatment alternatives. Our mission has always been to share the insights we gained, and to that end, we have compiled a list of considerations and questions to aid you in formulating the most effective plan.

Timely implementation of a non-surgical approach can significantly impact adolescent idiopathic scoliosis (AIS) positively. The goals of treatment include stabilizing the curve, potentially correcting it to some extent, and improving posture. If scoliosis arises from another origin, such as Chiari malformation or connective tissue disorder, the primary focus shifts to stabilization.

Among various scoliosis exercise rehabilitation methods, we have found the Schroth Best Practice to be the most effective. Schroth Therapy, especially Schroth Best Practice, boasts a long history and a growing body of evidence supporting its protocols. However, as awareness of Schroth spreads in the US, discerning trustworthy practitioners becomes increasingly challenging.

Some practitioners advocate spinal manipulation as the sole alternative for AIS treatment. Regrettably, there is currently no supporting evidence for manual therapy alone in AIS. However, we support spinal mobilization as a valuable supplement to evidence-based exercise rehabilitation.

The Clear method, a passive therapy involving mechanical traction administered by select chiropractors, is not recommended. Other practitioners from various fields may propose benefits for scoliosis patients, but caution and skepticism are advised. Certain bodywork methods can complement Schroth treatment, while manipulation aids in mobility and pain relief. Yoga tailored for scoliosis, however, may not be optimal due to the unique configuration of each scoliotic body.

When navigating scoliosis treatment alternatives, exercising caution and critical thinking is paramount. Choosing the wrong advice or practitioner based on promises or proximity may incur significant costs. Our list of considerations stems from both clinical experiences and the extensive journeys of guided families. Many of these families explored the aforementioned alternatives but felt compelled to continue seeking help.

SCOLIOSIS TREATMENT ALTERNATIVES – WHAT TO CONSIDER:

Results: Before-and-after images and x-rays offer the most transparent insight into a treatment’s efficacy. Long-term photos/x-rays indicate the permanence of results and should be attributed to the practitioner in question.

X-ray Protocols: Are x-rays conducted on-site or independently? Frequency matters, and immediate post-exercise or post-brace x-rays may not accurately represent the spine.

Treatment Premise: Are techniques tailored to the individual’s spinal configuration? Is the approach active or passive? Is the treatment rationale logical, and does it equip the patient with skills for independent scoliosis management?

Treatment Goals and Objectives: Goals may differ for adolescents and adults. Stabilization is crucial for both, but Cobb angle reduction and improved posture are additional objectives for adolescents.

Evidence & Longevity: A track record and growing body of evidence are crucial. Many alternatives lack extensive research, emphasizing the significance of individual practitioner experiences and patient results.

Practitioner/Practice: Consider the practitioner’s experience, scoliosis knowledge, results, reputation, reviews, attitudes, and passion. Genuineness, competence, and full-time scoliosis practice distinguish practitioners.

Education/Understanding: Does the patient learn about their specific curve and scoliosis in general? Are detailed, individualized instructions or videos provided? Is there a focus on prevention and understanding?

Sagittal/Transverse Plane: Addressing the three-dimensional nature of scoliosis is vital for improved posture.

Customer Service (pre AND post-treatment): Assess the office staff’s demeanor, responsiveness, and guidance throughout skeletal maturity and beyond.

Individual vs. Group Instruction: Individual attention aids in a thorough understanding, considering the nuanced nature of scoliosis.

Ease of Use: Feasibility and integration into daily life are critical. Excessive time commitments or reliance on cumbersome equipment may hinder practicality.

ADLs for Scoliosis: Practical aspects like carrying a bag or backpack, sitting, and reaching should be addressed to prevent asymmetrical loading and progression.

Side Effects: Be wary of symptoms or side effects not aligned with the treatment’s goals.

Program Structure and Follow-through: Program duration, immersion options, repeat visits, and follow-up requirements should align with individual needs.

Unreasonable Promises: Realistic expectations are essential; skepticism is warranted when promises sound too good to be true.

EMPOWERMENT vs. BURDEN: Evaluate whether the technique empowers or burdens the patient. Trust your instincts if any pressure or uncertainty arises.

Every practitioner and program varies, and the rapport between practitioner and patient is crucial. Confidence in your choice and comprehensive education are key factors in the scoliosis treatment journey. The outcome is individual, influenced by curve severity, compliance, and the chosen philosophy.

Schroth Method Practitioners: The Schroth method is widely known, with practitioners possessing diverse training, experiences, and protocols. Schroth Best Practice, derived directly from Katharina Schroth’s grandson, offers advantages like clarity and a growing evidence base. However, disparities in philosophies, teaching styles, and support services necessitate thorough research before choosing a practitioner.

Scoliosis Bracing: Various practitioners may recommend or omit scoliosis bracing, emphasizing the importance of understanding the goals and philosophies behind each recommendation. The Cheneau Gensingen brace stands out as a Schroth method-compatible option, designed to improve posture and Cobb angle, providing hope for patients with severe scoliosis.

CHOOSING THE RIGHT SCOLIOSIS BRACE?

1. Goals of the Brace: Does the brace aim to improve or only halt the curve? Does it offer in-brace correction, and is it compatible with other treatment steps?
2. Ability to Overcorrect: Overcorrection potential is crucial, especially for flexible curves in the early growth phase.
3. 3D Correction: Does the brace strive for three-dimensional correction, influencing posture and the spine?
4. Weight and Material: Lightweight, moldable materials enhance comfort. Consider the ease of wearing and concealing the brace.
5. Custom Design: A brace tailored to the patient’s curve pattern is essential, with compatibility with Augmented Lehnert-Schroth classifications.
6. Front or Back Closure: Front closure simplifies independent management, crucial for sagittal plane influence.
7. Fitting Process: Custom fittings ensure comfort, and adjustments should be made until the fit is perfect.
8. Standardized or Individualized: Braces created via CAD-CAM offer consistency and reliability, with practitioner expertise playing a significant role.
9. Severe Curves: A brace’s history of successfully treating severe curves is vital, acknowledging that severe curves pose unique challenges.
10. Brace Closure: Lightweight materials and a minimalist design contribute to comfort and ease of use.
11. Developers’ Leadership: A brace’s origin and development history matter, with Cheneau Gensingen standing out as a leader.
12. Compression and Breathing: Comfortable breathing is crucial, and a well-designed brace accommodates Schroth corrective breathing.
13. Manufacture and Delivery: Fast turnaround is essential for growing adolescents. The Gensingen Brace system offers a swift response.
14. Suitability for Adults: Adults can benefit from the Gensingen Brace for pain relief and spinal improvement.

In conclusion, the right approach to scoliosis treatment alternatives can make a substantial difference, utilizing growth and time to the patient’s advantage. While outcomes are never guaranteed, choosing the right philosophy, practitioner, and brace can prevent wasted time, resources, and patient burnout. Wisely selecting a course of action from the outset increases the likelihood of effectively managing idiopathic scoliosis and offers hope for avoiding surgery in all but the most severe cases.