This article will explain the different treatments for scoliosis, as well as the criteria used to decide which treatment might be best.
Because adult bones don’t grow, observation is generally necessary only when nerve symptoms accompany scoliosis.
Bracing is no picnic at the beach for a growing child—it may affect their self-esteem, as well as other things. Just the same, it may be necessary for avoiding pain and/or surgery later on.
The AANS reports that when the brace is worn according to instructions given by a doctor, it may slow curve progression.
Talk to your child’s doctor about convenient ways to incorporate bracing and be patient with your child as they voice their concerns and learn to adjust.
Curve magnitude has no role in surgical decision-making for adults. In adults, surgery is recommended for persistent pain, neurologic issues, and instability.
The goal of having scoliosis surgery is to prevent it from progressing any further.
What can you expect from the surgery? Usually, it involves putting metal implants and rods into your spine. These implements reduce or eliminate the curves, and keep the spine like that until fusion occurs. Fusion is the knitting together of the spinal elements.
Sometimes, adults who had scoliosis surgery require revision surgery down the road.
Long spinal fusions, which were common years ago make for extra wear and tear and load on the vertebrae just above and below the fusion. This may lead to adjacent segment disease, where degenerative changes cause arthritis in discs, facet joints, and/or ligaments. Revision scoliosis surgery may involve another fusion and decompression surgery, which is done to relieve pressure on nerves.
In Europe, and more recently in the U.S., several physical therapy approaches, most notably the Schroth method, have provided anecdotal evidence that they may be able to stop curve progression in adolescents. However, scientific studies have not demonstrated this to be true.
No form of physical therapy has shown any efficacy in changing curve magnitude in adults with scoliosis.
As far as evidence-based medicine goes, there’s no proof that chiropractic care is an effective scoliosis treatment. A 2013 review of studies published in the journal, Scoliosis, looked at a number of case series studies that reported decreased Cobb angles after chiropractic adjustments. The studies were weak: Most involved adults whose curves were not in danger of progressing, and teen/adolescents whose curves were at low risk of progressing.
The review authors also suggest that the reported reductions in Cobb angle following the chiropractic adjustments could have been temporary.
