Does Your Child Need a Scoliosis Back Brace?
You may never even see it coming. During a routine doctor’s visit or annual school screening, someone noticed something abnormal. You’ve heard the word, but you still can’t believe it…scoliosis.
Perhaps, you’re familiar with the term. Maybe you even knew someone with scoliosis when you were growing up. But this is different.
This is your child.
Of course, the knee-jerk reaction of any parent is to do as much as possible to make it okay. But where do you even begin?
A scoliosis back brace can be an effective way to prevent your child’s condition from worsening. But when is it necessary? And, when is it most effective?
Let’s take a closer look at scoliosis and when treatments like back braces can help.
Scoliosis: What You Need to Know
The spinal column is a series of bones that run from the base of the skull to the hips. More specifically, these bones are called vertebrae. The spinal column (i.e. the vertebrae) houses the spinal cord—a bundle of nerves that connects the brain to the rest of the body.
In addition, the spine itself contains natural curves. These curves aid in supporting our body weight and play a key role in balance and posture. To maintain balance, the normal curves of the spine move inward and outward. This results in a kind of “S” shape when viewed from the side of the body.
Abnormal curves, however, are also possible. Sometimes, a spinal deformity involves an exaggerated inward or outward curve. In the case of scoliosis, however, the spine twists and rotates sideways. When viewed from the back of the body, the spine may look like an “S” or “C” instead of a straight line.
Where in the spine does this occur?
Most cases of childhood scoliosis involve the middle and upper back—the area known as the thoracic spine. Sometimes, these curves also develop in the lower back (or lumbar) region. While not as common, some children go on to develop scoliosis in both areas of the spine.
Types of Pediatric and Adolescent Scoliosis
Scoliosis can occur for several reasons. The main types of childhood scoliosis include:
- Idiopathic scoliosis: The most common type of childhood scoliosis. Literature suggests the prevalence of this spinal condition can be as high as 5 percent of school-age children. Girls tend to develop this abnormality even more often than boys. Almost 90% of idiopathic scoliosis occurs in children 11 to 18 years old. The cause of idiopathic scoliosis is not known. It is usually diagnosed when other types of scoliosis are ruled out.
- Congenital scoliosis: An abnormality of the spine that occurs prior to birth or in utero. Congenital scoliosis may not, however, be detected until a child reaches adolescence. Studies suggest this may be due to genetics.
- Neuromuscular scoliosis: Curvature occurring when the muscles supporting the spine are insufficient. Children with cerebral palsy, spina bifida, and muscular dystrophy tend to develop this condition.
- Mesenchymal scoliosis: When passive stabilizers of the spine—vertebrae, facet joints, etc.—don’t properly support the spine. This includes children with Marfan’s syndrome, mucopolysaccharidosis, and osteogenesis imperfecta.
What are the Symptoms of Childhood Scoliosis?
For those with minor cases of scoliosis, the abnormality may not show symptoms. In fact, small curves may go unnoticed until a growth spurt occurs during puberty.
Children with more pronounced scoliotic curves may have symptoms including:
- Sideways body posture, i.e. leaning to one side
- One shoulder raised higher than the other
- Prominence of ribs on one side of the body
- One hip higher than the other
- Clothes that don’t fit properly
- Local muscle and ligament aches
- Uneven waistline
- Decreased pulmonary function for more serious cases
Without treatment, scoliosis can worsen as a child becomes older. In fact, untreated scoliosis can lead to major spinal deformities that affect cardiac and lung function.
Diagnosing Scoliosis in Your Child
As mentioned earlier, sometimes a routine doctor’s visit or school screening is all you need to uncover your child’s condition.
How do they do this?
It’s actually quite simple.
The standard for scoliosis screening is the “Adam’s forward bend test.” It only takes a few moments and is painless. Your child bends forward with knees straight and feet together. His or her arms hang freely at the sides. Viewing from the back, a doctor or other trained professional can easily see the difference in the shape of the ribs on each side.
As your child stands up straight, the doctor can also determine if the shoulder and hips are level and the head is centered over the hips.
If a spinal deformity is noted, your doctor will rule out other causes like uneven legs or contributing physical issues. Also, X-rays will be used to measure the severity of the curve.
When Can a Scoliosis Brace Help?
A scoliosis brace won’t help everyone. Luckily, some children still in the growing process can benefit. A brace is most effective when the abnormal spinal curvature falls between 25 and 45 degrees.
It’s important to note that scoliosis bracing won’t straighten a curve that already exists. It does, however, keep the curvature from becoming worse. In fact, using a scoliosis brace may reduce the chances of your child needing surgical correction such as spinal fusion surgery.
Every child’s spinal curvature and body structure is different. As you can probably guess, there are a variety of scoliosis braces available to cater to these differences. An orthotist will customize each brace based on your child’s condition.
Types of Scoliosis Braces
There are a few types of commonly used scoliosis braces on the market today. Some of them are worn throughout the day. Other scoliosis braces may only need to be worn overnight.
Let’s take a look at some of the more common scoliosis braces.
This rigid scoliosis brace covers the torso from the armpits down to the hips. The Boston brace applies corrective pressure on the outer side of the scoliosis curve. It also uses cut-out areas of relief on the inner side of the curve for added comfort.
The Boston brace starts with a preformed mold. Then, the orthotist customizes it to your child’s size and type of curve. This can include trimming the mold and adding corrective pads.
The Boston brace is meant to be worn between 12 to 20 hours a day. Since it closes in the back, your child may need help putting the brace on and off.
The Wilmington brace is similar to the Boston brace. The Wilmington brace, however, is created by taking a cast of the child while lying down. Once the cast is made, your child will have a unique, snug brace similar to a tight jacket.
The Wilmington brace is another full-time brace that requires your child to wear it for most of the day. It closes in the front, so it may be easier for your child to put on and remove.
Charleston Bending Brace
The Charleston Bending Brace is also custom-fitted using a cast of the child’s torso. This hard plastic brace, however, is meant for overnight use only. Given the fact that it should only be worn while lying down, the brace applies more pressure on the curve. It actually can overcorrect the spinal position.
Using this type of brace during the day would be difficult, to say the least. But, as your child lies down and sleeps, the extreme position is generally easy to maintain.
The Charleston Bending Brace works best with C-shaped curves in the lower back.
Another overnight scoliosis brace that overcorrects the spine while laying down is the Providence brace. It works by slightly elevating one shoulder. As a result, it applies rotational and lateral forces on the curve(s).
Full-Time or Overnight Scoliosis Brace: Which is Better?
Both types of scoliosis braces show promising results when treating certain types of scoliosis. So, which is better?
The jury is still out on that decision.
Some believe that the more you wear the brace throughout the day, the more effective it is for treating scoliosis. Others, however, think patients—especially children and adolescents—are more likely to ritually use overnight braces. After all, they don’t have to wear it around others and run the risk of strange looks and comments from peers.
Generally speaking, full-time scoliosis bracing is recommended for curves of 35 degrees or more as well as double curves. Children with single curves less than 35 degrees may benefit more from an overnight brace.
What About Soft Scoliosis Braces?
Wearing a rigid scoliosis brace can certainly be uncomfortable—even if it is custom fit. Some companies have developed soft braces made of flexible fabric and tight straps. The braces are marketed as being a more comfortable—yet still effective—means of treating scoliosis.
Unfortunately, to date, research doesn’t support this theory. If you are considering soft scoliosis bracing, it’s best to talk to your doctor or specialist about it being an effective treatment option.
Your Child and Scoliosis Bracing
Once scoliosis bracing is determined to be the most effective treatment option for your child, the real work begins.
Let’s face it, children and adolescents face so many stressors and societal pressures these days. Even though most braces can easily fit under loose-fitting clothing, your child may still feel self-conscious. Others may still notice the brace under the clothes.
While, deep down, your child understands the importance of this brace, he or she wants to fit in and appear normal. For some children, an overnight brace may be a happy compromise. Of course, an overnight scoliosis brace isn’t right for every child.
So what do you do when your child doesn’t want to wear their scoliosis brace?
It’s a difficult question. As a parent, you always want to remain supportive and empathetic to your child’s situation. This doesn’t mean jumping in with solutions. Simply listen to your child’s concerns. Validate what they are feeling and don’t minimize what they are going through. After all, you were young once. You probably remember how even minor issues seemed to be monumental at times.
Your child’s doctor and care team may have some great resources and ideas for children struggling to wear a scoliosis brace. Use them as a much-needed resource.
Get Expert, Caring Help for Your Child Today
Our multidisciplinary team at The Advanced Spine Center specializes in surgical and nonsurgical treatments for a variety of spinal disorders, including scoliosis.
Our award-winning doctors can empower you with the best decisions regarding your child’s scoliosis. We will take time to sit down with your family, discuss options and concerns, and answer any questions. We can suggest the best types of scoliosis bracing for your child and examine if other options are available.
Why not schedule a consultation today?