Scoliosis Bracing
Your spine specialist may order a brace for your child to wear. Several factors are taken into consideration when making this decision such as the age of your child, type and location of curvature and the amount of growth remaining that is expected.
In general, bracing is recommended for scoliosis that measures between 25 and 40 degrees or if a curve progresses 5 degrees and your child is still growing. The goal of bracing is to stop or slow down the worsening of the curve. The best results come from wearing the brace as prescribed, but parents need to be prepared for challenges.
Scoliosis Bracing at CHKD
Not every patient who has scoliosis requires surgery. For some, scoliosis bracing in addition to physical therapy is all that’s needed. Learn more about scoliosis bracing at CHKD and how it helped patient Madyson Merson get back to doing the things she loves.
Types of Braces We Prescribe
Your specialist will decide which type of brace is appropriate for your child.
The Boston Brace is made of plastic and foam. It is one of the most common back braces used to treat AIS. It wraps around the torso and opens in the back. The top of the brace begins under the arms and the bottom is above the hips. It is designed to place the spine in a straighter position. The Boston brace is worn 16 to 23 hours a day and treat scoliosis by using pads to push on the curvature with a 3-point pressure system. The 3-point system, with opposing forces directing pressure on the curves, is one of the best non-surgical methods for correcting AIS.
This brace is made from a custom mold using a scan of your child's spine. This is done with a handheld scanner in an orthotics and prosthetics office. this brace allows for a more customized-fit based on your child's needs, offers a more aggressive 3-point pressure system correction, and includes extra correction to treat scoliosis where there is significant rotation in the spine. It is an improved design based on the original Boston Brace.
AIS can also be treated with night bracing. the Providence nighttime brace also applies a 3-point pressure system but is worn only at night. This type of brace does is made either from custom measurements or a casting technique. This brace does not bend the patient and can offer more overall comfort.
The Charleston brace is a side-bending brace that is worn at night. the brace treats the curve by applying a 3-point pressure system to stretch the spine in an over-corrected position.
The Milwaukee brace is a full-torso brace that extends from above the shoulders to the pelvis. The brace incorporates metal uprights to treat scoliosis curves that are higher in the spine. Two uprights are placed on the back of the brace, and one is placed in the front. The brace keeps the spine in alignment and is worn 23 hours a day.
Tips for Parents When Bracing is Prescribed
- You can expect to get the prescription at the doctor’s appointment. You will then need to make an appointment for your child to be fit for the brace at an orthotics office. At the first appointment, they will either do a cast/mold or scanning device to fit your child for their brace. Your child will be able to pick a color and design for their brace.
- After two to three weeks of wearing their brace, you will go back to the orthopedic doctor for an in-brace x-ray to ensure a proper fit.
- Visits to the orthotist may be frequent while you get the best fit. You’ll have to go back if your child grows taller or wider. Your child may have to get multiple adjustments.
- Your child may complain of the brace being uncomfortable, or experience some difficulty moving around as they are adjusting to their brace.
- Pay attention to your child as they enter growth spurts to ensure the brace is fitting properly. If you have any concerns about the brace fitting properly, contact your orthotist.
- Parents can expect whining, complaining and non-compliance.
- Some children may try to be sneaky. They may put their brace on in the morning to go to school and then take it off before they get to school. They will put their brace on after school to make it appear that they have been wearing it all day.
- Hug your child often to feel if they are wearing their brace.
- Some patients may remove their brace as they sleep. They wake and remove it and then don't remember doing so. If your child does this, make sure to talk to your specialist.
Hints, Tips and Tricks When Living With A Brace
- Wear a seamless tank under the brace. Seams can cause those itchy, irritating indentations in the skin.
- Don't be discouraged by your pant size. You will want to increase all your clothes by 1 or 2 sizes in order to accommodate for your brace
- Avoid applying lotions, oils or perfumes underneath your brace.
- If you are a stomach sleeper, you may need to invest in a body pillow for comfort. Sleeping on your stomach can be uncomfortable while wearing your brace.
- Let your doctor know if you experience tingling or numbness while sitting (for example: in class); your brace may need to be adjusted to fit your legs better.
- It is very important for the brace to be worn tightly. This prevents excess rubbing and irritation.
Refer to Our Scoliosis and Spine Program