How to Fix Scoliosis? Can Scoliosis Be Fixed Without Surgery?

Scoliosis can be treated in different ways, and it's important for patients and their families to understand how the different options can affect long-term spinal health. Scoliosis can be treated with or without surgery, and while each case is unique and there are never treatment guarantees, scoliosis treatment that's conservative and non-invasive is better for long-term spinal health and function.

Scoliosis is a structural spinal condition that's also progressive; while scoliosis is incurable, it can be highly treatable, and many cases of scoliosis don't require surgical treatment, particularly with early detection and intervention.

There are different scoliosis treatment options for patients to choose between, and this is the most important decision to be made.

Understanding Scoliosis

Scoliosis is a highly-prevalent and complex spinal condition; not only does it involve the development of an unnatural sideways-bending spinal curve, the curve also rotates, making it a 3-dimensional condition.

There are three main spinal sections, and scoliosis can develop in any one of them, and/or in more than one spinal section as a combined scoliosis.

The cervical spine refers to the neck; the thoracic spine consists of the middle and upper back, and the lumbar spine refers to the lower back.

Scoliosis can also affect all ages, but is most commonly diagnosed in children. Babies can be born with the condition (congenital scoliosis), infants (infantile scoliosis), juveniles (early-onset juvenile scoliosis) adolescents (adolescent idiopathic scoliosis), and adult scoliosis is diagnosed once skeletal maturity has been reached.

Not only can scoliosis range widely in severity and affect all ages, there are also different types of scoliosis that can develop, and type is determined by causation.

Part of the diagnostic process involves comprehensively assessing conditions and further classifying them based on key patient/condition variables: patient age, condition severity, curvature location, and condition type.

Different Types of Scoliosis

There are also multiple different types of scoliosis a person can develop, and the majority of known cases, approximately 80 percent, are classified as idiopathic scoliosis.

Idiopathic means not clearly associated with a single-known cause, and the remaining 20 percent are associated with known causes: neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis.

Type is determined by causation, and idiopathic scoliosis causation isn't fully understood and is thought to be multifactorial, meaning caused by a combination of variables that can change from patient to patient.

Neuromuscular scoliosis is caused by the presence of a larger neuromuscular condition such as muscular dystrophy, cerebral palsy, and spina bifida, so in order to be treated effectively, treatment plans have to be shaped around the larger neuromuscular condition, and this complicates the treatment process.

Degenerative scoliosis is known to affect older adults and is more common in females than males; this is thought to be the result of bone density and hormone changes related to menopause.

Congenital scoliosis is caused by a malformed spine that develops in utero, and this is a rare type affecting approximately 1 out of 10,000 babies; spinal malformations can include the failure of vertebrae to form into distinct and separate vertebral bodies and/or one or more vertebrae being more triangular in shape, rather than rectangular, as they are in a healthy spine.

Different types of scoliosis can have different treatment needs because in order to correct scoliosis, its underlying cause has to be addressed, when known, or only symptoms of the condition are being treated.

Correcting scoliosis means the size of the unnatural spinal curve has been reduced on a structural level, and core strength has been increased so the spine can receive optimal support and stabilization from its surrounding muscles.

The most prevalent type of scoliosis overall is adolescent idiopathic scoliosis, diagnosed between the ages of 10 and 18, so this is the type we'll focus on.

The key to understanding the pros and cons of scoliosis treatment is to understand the condition's progressive nature which is to get worse over time.

Scoliosis is Progressive

As a progressive condition, the nature of scoliosis is to get worse over time, and that means the condition is getting more severe, and condition severity is determined by a measurement known as Cobb angle.

A patient's Cobb angle measurement is necessary to diagnose scoliosis, classify it in terms of severity, and to customize treatment plans around.

Cobb angles are determined during X-ray by drawing lines from the tops and bottoms of the curve's most-tilted vertebrae at its apex, and the resulting angle is expressed in degrees.

In a spine that has its natural and healthy curves in place, its vertebrae (bones) are stacked on top of one another in a straight and neutral alignment, but if an unnatural spinal curve has developed, some vertebral bodies have become excessively tilted, shifting them out of alignment with the rest of the spine.

The further out of alignment a scoliotic spine is, the more severe the condition, and the more noticeable its effects are likely to be:

• Mild scoliosis: Cobb angle measurement of between 10 and 25 degrees
• Moderate scoliosis: Cobb angle measurement of between 25 and 40 degrees
• Severe scoliosis: Cobb angle measurement of 40+ degrees
• Very-severe scoliosis: Cobb angle measurement 80+ degrees

Scoliosis patients need to understand that the best way to treat scoliosis is to be proactive because where a scoliosis is at the time of diagnosis doesn't mean that's where it will stay.

As childhood scoliosis progresses, its main effect of postural deviation tends to become more noticeable, and in adults, the main effect of pain will also increase with progression.

Scoliosis doesn't become a compressive condition until adulthood, which is why scoliosis pain isn't commonly a large part of childhood scoliosis, but it is the main scoliosis symptom that brings adults in for a diagnosis and treatment.

A patient's Cobb angle is also an important factor in whether or not a surgical recommendation is given, and in traditional scoliosis treatment, spinal fusion surgery is commonly recommended to treat severe scoliosis that shows signs of continued progression.

What is Scoliosis Surgery?

Scoliosis surgery is a type of spinal fusion that commonly involves the removal of intervertebral discs that sit between adjacent vertebrae to be fused.

The curve's most-tilted vertebrae are fused together into one solid bone, and this is done so they can't move and become more tilted over time: stopping progression.

Once the bones are fused, commonly rods are attached to the spine with pedicle screws to hold the spine in place.

While holding the spine in place in this manner can indeed stop progression and make the unnatural spinal curve straighter, its methodology goes against the spine's natural movement-based design.

And in fact, what most patients are disappointed with is the loss in spinal flexibility and range of motion they are left with, and this is something that will shape long-term spinal health and function.

What I want patients to understand is that not all cases of scoliosis require surgery, so why not try a less-invasive, costly, and risky treatment option first?

In addition to the potential long-term effects of spinal fusion (spinal rigidity, weakness, and pain), there are risks associated with the procedure itself:

• Excessive blood loss
• Risk of infection
• Adverse reaction to hardware used
• Nerve damage

The truth is that traditional scoliosis treatment commonly funnels patients towards spinal surgery because it doesn't have a strategy for addressing scoliosis while mild, when it's generally the simplest to treat and the chances of success are highest, but if a condition becomes severe, in part because treatment wasn't applied earlier, patients become surgical candidates.

In most cases, when scoliosis is left untreated, or not treated proactively, as a progressive condition, it only becomes more severe and difficult to treat the longer it's left untreated, or isn't addressed proactively.

So how is an unnatural curvature of the spine corrected without surgery?

Non Surgical Scoliosis Treatment

Here at the Scoliosis Reduction Center, my patients benefit from a proactive non surgical treatment approach that's started as close to the time of diagnosis as possible.

I see merely observing conditions for progression as wasting valuable treatment time; after all, as a progressive condition, virtually all cases of scoliosis are going to progress, so why not proactively work towards prevention.

It's far more effective to work towards preventing progression and increasing condition effects than it is to attempt to reverse those effects once they're established.

In children, the most-noticeable symptoms of scoliosis involves postural changes, and this is due to the condition's uneven forces disrupting the body's overall symmetry:

• An uneven eye line
• Head appears uncentered over the torso
• Uneven shoulders
• Uneven hips
• The development of a rib cage arch
• An uneven waistline
• Arms and legs that appear to hang at different lengths

Additional changes to watch for can involve balance, coordination, and gait, and in adults, the most noticeable symptoms of scoliosis include postural changes and pain.

So symptoms one patient is experiencing doesn't always indicate what others will face, but the symptoms an individual is experiencing are likely to get worse alongside progression.

While there are never treatment guarantees, cases of scoliosis that are diagnosed as mild and treated proactively have fewer limits to what can be achieved with treatment.

People with scoliosis need to understand that an unnatural spinal curvature that's structural won't change on its own; it needs treatment that has the goal of, first and foremost, impacting conditions on a structural level, and non surgical scoliosis treatment involves a number of different treatment disciplines, with a focus on chiropractic care.

Chiropractic Treatment for Scoliosis Patients

As a CLEAR-certified scoliosis chiropractor, I know the spine and I know scoliosis.

While general chiropractic care can help with increasing spinal flexibility and pain management, the complex nature of a 3-dimensional scoliotic spinal cure is beyond its scope; a scoliosis-specific chiropractor is needed to treat scoliosis effectively.

Condition-specific chiropractic care for scoliosis can involve a number of techniques and manual adjustments that work towards adjusting the position of the curve's most-tilted vertebrae back into alignment with the rest of the spine.

By adjusting the position of tilted vertebrae, as much of the spine's healthy curves as possible are being restored, and addressing areas of vertebral subluxation with chiropractic care also protects the spine's surroundings.

It is key, however, that patients understand the difference between general chiropractic care and scoliosis-specific chiropractic; the complex nature of the condition necessitates treatment from an expert with specialized training.

Physical Therapy and Scoliosis-Specific Exercises

Once I start to see the type of structural results I can work towards through chiropractic care, I can shift the focus to increasing core strength; it's not just the spine's job to maintain its natural curves and alignment, but also its surrounding muscles that have to support and stabilize it

Again, however, general physical therapy can't help achieve corrective results because it's not specific enough, and the complex nature of the condition necessitates a fully-customized treatment plan.

A scoliosis-specific physical therapist can help patients strengthen their abdominal muscles for optimal spinal support, can address bad posture, stimulate certain areas of the brain for enhanced communication, and improve any muscle imbalances.

An abnormal curvature of the spine doesn't just affect the spine, but also its surrounding nerves, muscles, and the entire body.

When a scoliosis curve develops and progresses, it can pull the spine's surrounding muscles in different directions as they struggle to stabilize and support the unnaturally-curved spine, and this can cause the muscles on one side of the spine to become loose from underuse and muscles on the other side of the spine to become tight and sore from overuse.

Scoliosis-specific corrective exercises can help augment corrective treatment results by increasing spinal flexibility, which makes the spine more responsive to chiropractic care, while increasing core strength means the spine is more supported, and improvements have been made to posture and brain-body communication.

Keeping the spine and its surrounding muscles as strong, loose, and flexible as possible can also help with pain relief, for those who need it (adult scoliosis patients).

Corrective Bracing

Corrective bracing is known to be most effective on growing spines so is a common facet of treatment for adolescent idiopathic scoliosis, the condition's most-prevalent form, diagnosed in adolescents between 10 and 18, and this age group is the most at risk for rapid-phase progression due to the rapid and unpredictable growth spurts of puberty.

Corrective bracing can help augment corrective treatment results by pushing the spine into a corrective position, and here at the Center, I favor the ScoliBrace for its ultra-corrective potential.

Bracing used in traditional treatment is the only form of treatment applied prior to a surgical recommendation, most common for severe cases that have progressed past 40 degrees and show signs of continued progression.

Rehabilitation

The final and ongoing phase of treatment involves patients further stabilizing and healing their spines from home, and this commonly involves custom-prescribed scoliosis-specific exercises and stretches that can be easily performed without the use of equipment.

Continued chiropractic care is also important; remember, as a progressive condition, there is no curing scoliosis, but it can be highly treatable, and continued chiropractic care is somewhat like wearing a retainer after the removal of orthodontic braces; the braces have applied pressure over time to adjust the position of the most-crooked teeth, but some work still has to continue after their removal to sustain those results.

So for sustainable long-term treatment results, rehabilitation is important.

There are a number of benefits associated with non surgical scoliosis treatment so let's focus on the pros of a conservative treatment approach.

What's the Benefit of Non-Surgical Treatment for Scoliosis?

Again, I can never give treatment guarantees, but I what I can say is that when scoliosis is treated proactively, there are fewer limits to what can be achieved, and the benefits of early detection are only available to those who have committed to a proactive treatment approach, and that's conservative chiropractic-centered treatment.

So the first benefit is how a conservative scoliosis treatment provider would respond to a diagnosis of scoliosis: by starting treatment as soon as possible.

Traditional scoliosis treatment would respond to a diagnosis of mild scoliosis with the recommendation to simply watch and wait, but as a progressive condition, we know it's virtually guaranteed to get worse, so this is wasting valuable treatment time while allowing scoliotic curves to progress unimpeded.

And as the trigger for progression is growth and adolescents are the age group most affected by scoliosis, the unpredictable and rapid growth spurts of puberty put these young patients at risk for rapid-phase progression.

So what if an adolescent undergoing traditional treatment is told that as their scoliosis is mild to return for further assessment in three months, and over that three months, that patient has a significant growth spurt that causes their Cobb angle measurement to increase by 5 degrees?

The condition has become more complex to treat as the spine gets increasingly rigid with progression, making it less responsive to chiropractic treatment, and making it difficult for some patients to perform certain therapeutic exercises as part of treatment.

The benefit of non surgical conservative treatment is that the way treatment is applied is in line with the spine's natural movement-based design, so it works to preserve as much of the spine's natural strength, health, and function as possible.

Conservative treatment also doesn't weaken the spine, making it more vulnerable to injury, as spinal fusion does.

Different treatments for scoliosis shape long-term spinal health and function, and while we can't cure scoliosis, we can most certainly treat it effectively, and managing progression while impacting the condition on a structural level is the goal of conservative treatment.

I want to help patients avoid the hardships associated with progression and severe cases; I want to help them avoid the need for invasive spinal fusion surgery in the future because I feel that in many cases, surgical treatment sacrifices spinal strength and function, and many cases of scoliosis don't require surgical treatment.

Conclusion

So can scoliosis be fixed? No, scoliosis can't be permanently fixed because as a progressive condition, scoliosis is not curable, but it can be managed effectively through treatment.

Can scoliosis be corrected with effective treatment? Yes, it can, and while there are never treatment guarantees, the earlier a condition is diagnosed and treatment is started, the more likely treatment success will be.

When an experienced team of medical professionals trained in multiple scoliosis-specific treatment modalities integrate different types of treatment into treatment plans, conditions can be impacted on every level.

The important thing for patients and their families to understand is that how a diagnosis of scoliosis is responded to can have far-reaching effects.

While surgical treatment options still have a place in treating scoliosis, if spinal fusion is unsuccessful, additional surgery is the only recourse, and the risks of scoliosis surgery only increase with age and each subsequent procedure.

There are also different types of scoliosis with different treatment needs; the majority of patients have idiopathic scoliosis, but there are also atypical forms such as neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis, and in atypical types of scoliosis, I know there is an underlying pathology causing patients to develop scoliosis.

The first step to effectively treating any and all severity levels and condition types is determining a condition's underlying cause, when known, and customizing treatment plans around it; this is the difference between addressing symptoms or their underlying cause, the condition itself.

So the best way to fix scoliosis is to ensure patients are being treated by a scoliosis specialist who is trained in multiple scoliosis-specific treatment modalities for the best potential results.

Many patients with scoliosis don't require surgery, especially those that were diagnosed early and responded to proactively, so being educated on the different scoliosis treatment options is key.