Scoliosis, a sideways curvature of the spine, is often associated with childhood. However, this condition can also affect adults, presenting unique challenges. For adults, understanding if bracing is a viable treatment option for managing their scoliosis is a common concern. This article explores the role of braces in adult scoliosis, highlighting their aims and practical considerations.
Adult Scoliosis Explained
Adult scoliosis involves an abnormal sideways curvature of the spine, often with rotation. This condition can manifest as a progression of adolescent idiopathic scoliosis (AIS) from youth, or as “de novo” degenerative scoliosis, which develops in adulthood. Degenerative scoliosis typically arises from age-related wear and tear on spinal components like intervertebral discs and ligaments.
Disc degeneration, osteoporosis, or trauma can contribute to degenerative scoliosis, often appearing after age 50. Unlike childhood scoliosis, where progression is rapid during growth spurts, adult scoliosis can still progress, though usually at a slower rate. Main concerns for adults include persistent back pain, balance issues, and potential nerve compression, leading to discomfort in the back, buttocks, or legs.
Brace Options for Adults
Several types of braces are available for adults with scoliosis. Rigid braces, such as custom-molded thoracolumbosacral orthoses (TLSOs), are commonly used. These plastic braces fit snugly around the torso, applying pressure to support the spine.
Newer corrective braces are designed to address the three-dimensional nature of adult scoliosis. Dynamic bracing systems, which use more flexible materials, are also an option, though their effectiveness can vary depending on the curve’s rigidity. The choice of brace often depends on the individual’s specific curve, symptoms, and lifestyle.
Aims of Adult Bracing
For adults, the objectives of bracing differ from those for growing adolescents. While adolescent bracing primarily aims to prevent curve progression, adult bracing typically focuses on managing symptoms and improving functional aspects.
A primary goal of adult bracing is pain reduction, as the brace can alleviate pressure on spinal nerves and muscles by providing external support. Bracing can lead to a reduction in back and leg pain for many adults with scoliosis.
Braces improve posture and spinal alignment, which can enhance comfort and daily mobility. By supporting the spine, a brace can help restore balance and minimize visible postural imbalances. Bracing can also contribute to stabilizing the spinal curve, potentially slowing progression, particularly with degenerative scoliosis.
While significant curve correction is not the main intent, corrective braces, especially when combined with a scoliosis-specific exercise program, may offer modest curve reductions and help stabilize the spine. Bracing is a non-invasive approach to managing the condition, with minimal risks compared to surgical interventions.
Practical Aspects of Adult Bracing
Wearing a scoliosis brace as an adult involves several practical considerations. Patient compliance is important, as consistent wear is usually necessary to achieve desired outcomes. Adult braces are often worn for several hours a day to counter gravitational effects on the spine.
Comfort is a significant factor, and potential issues like skin irritation can arise, necessitating proper fitting and adjustments. The brace’s impact on daily activities and clothing should also be considered. While bracing can be beneficial, it may not be suitable for all adults, especially those with very severe or rigid curves, or significant pain. Consulting a healthcare provider is essential to determine the most appropriate brace type and wearing schedule.
Other Treatment Approaches
Bracing is often part of a broader strategy for managing adult scoliosis, which includes both non-surgical and surgical options. Non-surgical treatments involve physical therapy with scoliosis-specific exercises to strengthen core muscles and improve posture. Pain management techniques, such as pain relievers, injections, and complementary therapies, are also commonly employed to alleviate discomfort.
Lifestyle modifications, including maintaining a healthy weight and good posture, can further support spinal health. For severe cases, or when non-surgical methods fail to adequately manage symptoms, surgical intervention may be considered. Spinal fusion is a common surgical procedure where vertebrae are joined to stabilize, strengthen, and straighten the spine. Other surgical options include decompression to relieve nerve pressure or osteotomy to realign bones.