Bracing for idiopathic scoliosis gets a boost from a NY Times article, but there may be a better option.

Bracing for idiopathic scoliosis gets a boost from a NY Times article, but there may be a better option.

The yearly ritual of having our children screened to find out if they are developing idiopathic scoliosis, a potentially debilitating condition that can cause years of pain or in the worse cases, difficulty with standing and breathing. For years, doctors had recommended the ritual of bracing, where a brace is custom fitted (at a high price) to the body of a growing teenager to prevent further progression of a curve.

This common medical practice just received an endorsement in a study that was cited in a NY Times article as seen here

Study Affirms Benefit of Back Braces as Scoliosis Treatment

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A new study provides the best evidence yet that wearing a back brace will slow the progression of the most common form of scoliosis in adolescents, helping them avoid painful spine surgery.

Physicians have recommended bracing for more than 50 years, but until now, studies of its effectiveness had produced mixed results. The United States Preventive Services Task Force recommended against scoliosis screening in schools partly on the grounds that there was insufficient evidence that bracing and other conservative treatments relieved back pain or improved quality of life in these children.

The new randomized study, published on Thursday in The New England Journal of Medicine, should end the longstanding debate, several experts said, and may spur the task force to reconsider its position.

The trial is “very convincing,” said Dr. B. Stephens Richards, a pediatric orthopedic surgeon at Texas Scottish Rite Hospital in Dallas. “It scientifically proves that brace treatment works for adolescents with scoliosis who are at risk of curve worsening to the point of needing surgery.”

Adolescent girls are more likely than boys to have idiopathic scoliosis, or curvature of the spine from no known cause. Rigid bracing is worn to restore spine alignment by external force.

It is a demanding treatment at a vulnerable time of life. read more here

A better way forward.

There is a problem with this approach though. Typically, most medical providers have advocated watching and waiting, something the chiropractic profession has suggested as watching a curve worsen. The other problem is the use of the word idiopathic which is medical language for (cause unknown).

Most chiropractors take a more hands on and active approach. Dr. William Charschan, author of the book Cheating Mother Nature, what you need to know to beat chronic pain has suggested in his book that there is nothing idiopathic about idiopathic scoliosis. “All the patients over the years who have had advanced curves are built asymmetrically and it is the asymmetry, combined with growth and a widening pelvis in adolescent girls which increases forces on the spine that causes the problem. It is not dissimilar to placing a brace on a tree as it grows and seeing it distort as it heads to the sky. If the common finding (more studies need to be done) seems to be body asymmetry, why is this condition idiopathic and if all that is necessary to be done during regular school scoliosis screenings is to take one further step and look at the feet of the students who are screened, why don’t we take that further step.”

Perhaps this is why the idea of watching and waiting should be suspect and why chiropractors feel that early intervention with chiropractic methods, proper footwear or inserts in the shoes to create symmetry and perhaps myofascial release to reduce tension along a growing spine may make more sense than bracing. Treat the cause or treat the symptom with a brace; is the curve as symptom of mechanical aberrations that are inherited and need to be better understood and evaluated by the medical community at large?

Chiropractic may have a better model moving forward. Should we re-label Idiopathic scoliosis as Asymmetry induced developmental spinal curvature.

An effective chiropractic model for this type of scoliosis is likely to include:

1. The use of foot orthotics (off the shelf since the patient is still growing), advice on proper footwear.

2. Myofascial release to the core muscles, legs and pelvic muscles to reduce the myofascial adaptation to body asymmetry. This is invaluable to a developing child with suspected scoliosis.

3. Spinal manipulation to restore normal joint movement and flexibility with or without flexion distraction methods sometimes used on more advanced curvatures.

4. Appropriate corrective exercises to stabilize the pelvis and the core.

5. Referral for bracing “if” curve progression continues.

What do you think? As always, I value your opinion.

Cheating Mother Nature is available through Amazon.com in both regular soft cover and Kindle formats.