Spinal Bracing: A Treatment Option for Scoliosis in Children
Kids May Need to Wear a Brace to Stop the Spinal Curve
When your child is diagnosed with scoliosis, you may immediately be filled with visions of him or her wearing a spinal brace to correct the curve. You may start thinking about how long the brace will need to be worn, how your child will react, and if it will actually stop the curve.
Before you get to that point, though, there are a few things you should know about spinal bracing for scoliosis.
Observation Sometimes Recommended First for Scoliosis
After running various exams and tests, your doctor will develop a treatment plan for your child's scoliosis. Often with a small curve, the first step is observation—giving the curve some time to see if it progresses.
Your child will be examined every 3 to 4 months, and during that examination, the doctor will order an x-ray if it seems that the curve has increased. It's important to minimize the number of x-rays that are taken (because of the radiation exposure), and in most cases, one x-ray per year should be sufficient.
With more severe curves or with curves that are likely to progress (get worse), bracing is a terrific non-surgical treatment option to try to stop the curve from getting worse.
Before recommending bracing, the doctor will determine:
- how much growing your child has left to do.
- where the curve is—because a curve in the mid-back (thoracic spine) is much more likely to get worse than a curve in the low back (lumbar spine).
- how severe the curve is and how the curve is affecting your child's life.
- how likely it is that the curve will get worse—because if the curve is already rather severe and your child hasn't gone through his or her adolescent growth spurt, it will most likely get much worse when he or she does grow.
Bracing is the usual treatment for children with curves greater than 20° and at least two years of growth remaining.
Bracing is usually not prescribed when the curve is greater than 40°. In that case, surgery may be necessary.
It's important to remember that a brace can help stop the curve from progressing, but it generally won't fix the curve that's already there.
Wearing a brace is a big commitment, one that parents and children need to work together on. Here are some key points to remember if you want bracing to be as effective as possible:
- Just what the doctor ordered: Your doctor will decide what type of brace is best for your child's curve and how long he or she should wear it every day. Some children must wear their brace up to 23 hours a day, and while that's an intimidating number, it's absolutely crucial that your child wear the brace for the full time. Your doctor will work with you to figure out when your child doesn't have to wear his or her brace. If he or she likes swimming, for example, the doctor will probably arrange the brace schedule so that he or she is out of the brace during your swim team practices.
- Wear it well: Your child may be in and out of your brace a few times during the day—during gym class, for example. It's important that every time he or she puts the brace back on, it's tight enough and properly positioned. If it isn't, it won't do as much good.
- Watch what you wear: Underneath the brace, your child should wear a shirt that fits well and doesn't wrinkle. This will help protect his or her skin because otherwise, it can get irritated from the brace. Over the brace, your child can wear normal clothes, although you might have to get clothes a size or two bigger in order to fit over the brace.
Bracing can be uncomfortable—both physically and emotionally. At a time when kids don't really want to be different, a brace is a very noticeable difference. But with support from family, friends, and medical professionals, kids get through it just fine—and usually with a healthier back at the end of it!