Treatment Options for Scoliosis: What You Need to Know

What you need to know about scoliosis is the sooner treatment is started, the better. As a progressive condition triggered by growth, when treatment is started can be a key factor in treatment success; continue reading to find out why.

Treatment options for scoliosis include a traditional surgical response and a modern conservative non-surgical treatment response. What you need to know is that many patients don't need surgery, especially in cases diagnosed early and treated proactively.

Scoliosis causes the spine to bend unnaturally to the side and twist, making it a complex 3-dimensional condition.

Scoliosis: A Complex Condition

Scoliosis is often deemed a complex condition to treat, and this is for a number of reasons.

As a 3-dimensional structural spinal condition, treatment has to impact the condition on every level, primarily addressing the condition's underlying structural nature.

Scoliosis is also a progressive condition, meaning its nature is to get worse over time, and as progression is triggered by growth, childhood scoliosis always needs to be taken seriously, and treatment is about how best to manage an ongoing condition.

Scoliosis also ranges widely in severity from mild scoliosis to moderate scoliosis, severe and very severe scoliosis, and the more severe the condition, the more noticeable its effects are going to be.

There are also different types of scoliosis, with unique characteristics and treatment needs. The most common type of scoliosis is idiopathic scoliosis, and this type accounts for approximately 80 percent of known cases, and the remaining 20 percent are associated with known causes: neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis.

Curve progression has to be managed, and while there are never treatment guarantees, an unnatural spinal curve can be highly treatable, particularly with early detection and intervention, and the benefits of early detection need to be understood.

The Benefits of Early Detection

Early detection means diagnosing conditions early in their progressive line, while they are still mild; mild curves are simpler to treat.

Condition severity is determined by a measurement known as Cobb angle, and the higher a patient's Cobb angle, the further out of alignment the spine is, and the more severe the condition.

If a spine's natural and healthy curves are in place, its vertebrae (bones) are stacked on top of one another in a straight and neutral alignment, but if one or more vertebrae become unnaturally tilted and shift out of alignment with the rest of the spine, the biomechanics of the entire spine are disrupted.

In order to diagnose scoliosis, risk factors (age, gender, and a family history) are considered, and a physical examination involving an adams forward bend test and a scoliosis X-ray are performed.

Treatment Efficacy

If scoliosis is diagnosed while still mild, this is the best time to start treatment because the curve is the smallest it will be and is likely to be at its most responsive.

As progression occurs, the size of the unnatural spinal curve increases, causing spinal rigidity and making the spine less responsive to treatment.

Avoiding increasing spinal rigidity is one of the benefits of starting treatment immediately following a diagnosis.

Early detection is also beneficial in terms of condition effects; the more progression occurs, the more overt its effects are, and the harder they are to reverse and/or improve.

Minimizing Condition Effects

Particularly when it comes to the effects of childhood scoliosis, it's more effective to proactively work towards preventing progression and increasing effects than it is to attempt to reverse them once they've become established over time.

The main effect of childhood scoliosis involves postural changes such as uneven shoulders, uneven shoulder blades, uneven hips, development of a rib cage arch, and arms and legs appearing to hang at different lengths.

Changes to balance, coordination, and gait also occur as progression occurs, and these types of changes become more noticeable the longer conditions are left untreated.

In adults, postural changes are common, but the most noticeable symptom that brings adults in for a diagnosis and treatment is pain; scoliosis pain is caused by compression, and the condition doesn't become compressive until skeletal maturity has been reached.

So treatment for adult scoliosis patients has to include pain management, while in children, the focus is more about counteracting growth and related rapid progression.

So how is scoliosis treated with surgery, and without surgery?

Scoliosis Surgery as a Treatment Option

Traditional scoliosis treatment has been around for hundreds of years, but that doesn't mean it's the best or only treatment option available, and that's what patients need to fully understand; not all cases of scoliosis require surgical intervention.

Traditional treatment tends to funnel patients towards surgery because it doesn't have a strategy for addressing scoliosis while mild, so commonly recommends mild scoliosis patients merely observe, watching and waiting for signs of progression.

But as a progressive condition that's triggered by growth, what happens if a significant growth spurt triggers significant progression? What happens is curve progression can continue unimpeded, and when/if a patient crosses the surgical threshold with severe and very severe scoliosis curves, surgery can be recommended.

Scoliosis surgery is a type of spinal fusion that involves fusing two or more vertebrae that are unnaturally tilted into one solid bone so they can't shift further out of alignment with the rest of the spine, and metal rods are attached to the spine to maintain its alignment; hardware attached is permanent and a fused spine is fused for life.

If the procedure fails for any reason, the only recourse is more surgery, and there are both short- and long-term risks to consider.

Risks associated with the procedure itself can include:

• Excessive blood loss
• Infection
• Adverse reaction to hardware used
• Nerve damage

Long-term risks associated with living with a fused spine can include:

• A spine that's more rigid, less flexible, and has a reduced range of motion
• Increased pain at the fusion site
• A spine that's weaker and more vulnerable to injury
• Psychological effects of living with a fused spine
• Disappointing cosmetic results (surgery can't reverse all postural changes associated with scoliosis)
• Hardware malfunction over time means more surgery

All types of spinal surgery are invasive, and spinal fusion is no exception; conservative non-surgical treatment offers a less-invasive treatment alternative.

Conservative Non-Surgical Treatment Options

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

Conservative treatment has the goal of preventing progression, increasing effects, and the need for future surgery, so while surgical treatment is delayed until a certain amount of progression has occurred, non-surgical treatment is started immediately in the hopes of impacting conditions while they are still mild and highly responsive.

What I want patients to understand about non-surgical treatment is that it's less invasive and better for the spine, but the longer scoliosis is left untreated, the less effective non-surgical treatment becomes.

Integration and Innovation

Conservative treatment is integrative so combines the power of multiple scoliosis-specific treatment disciplines; this allows for the complete customization of treatment plans.Chiropractic care is applied to work towards adjusting the position of the most-tilted vertebrae back into alignment with the rest of the spine: impacting the condition on a structural level.

But structural changes need to be supported by strong and balanced muscles, so physical therapy and scoliosis-specific exercise becomes a key facet of treatment that can improve the spine's support and stability.

To treat scoliosis in children, bracing can be particularly effective as growing spines are more malleable, and a corrective scoliosis brace can push the spine straight and complement other types of treatment.

As an ongoing condition, patients need to understand that continued effort will be needed to further heal and stabilize the spine, and this can involve custom-prescribed home exercises and continued chiropractic care.

A scoliotic spine that's treated successfully with conservative treatment is one that will have as much of its natural strength and function preserved as possible.

Conclusion

What you need to know about scoliosis treatment options is that a diagnosis doesn't automatically mean future spinal surgery.

While spinal fusion can help straighten a bend and rotating spine, it can come with increased back pain at the fusion site, a spine that's less flexible, and at a higher risk of injury.

Conservative non-surgical treatment for scoliosis is proactive, corrective, and doesn't come with the same potential risks, side effects, and complications that characterize a surgical response.

When treated proactively, progression triggered as a child grows can be counteracted by structural improvement within the spine, and optimal support from the spine's strong and balanced surrounding muscles.

Most patients with scoliosis who are diagnosed early can avoid surgical treatment, and the best way to minimize the condition's effects and provide permanent pain relief for adults is to treat conditions proactively.

While scoliosis surgery focuses solely on the spine, we know that the effects of scoliosis aren't just limited to the spine, but also the spine's surroundings, and the entire body; conservative treatment, however, focuses on improving all the condition's effects, including postural changes.

As the effects of scoliosis can be so widespread throughout the body, addressing scoliosis can mean making improvements to patients' overall health, and following treatments that are customized and proactive can mean a spine that's more flexible, is stronger, and has as much of its healthy curves as possible restored.