What to Expect After a Scoliosis Diagnosis
After a scoliosis diagnosis, it’s natural to have a lot of questions and concerns. At Boston Orthotics & Prosthetics, we treat hundreds of patients for scoliosis every year, and we know that the experience and the outcome are always better when patients and families are well-informed about what the process will involve. With the help of one of our lead scoliosis experts, Kaitlin Rivest, MSPO, CPO, we offer a brief summary of what to expect after you or your loved one has been diagnosed with scoliosis.
The First Appointment
If you or a loved one has been diagnosed with scoliosis and referred to Boston O&P for evaluation and treatment, the first thing your clinician will do is give you an exam, which will include a physical examination, an X-ray evaluation, and a measurement of your spinal curve.
Based on the results of the exam and X-ray as well as other considerations, the specialist will recommend a treatment approach. Patients with curves of less than 20 degrees may be told that no action is necessary, though the curve should be checked periodically to make sure it does not worsen. For curves of more than 20 degrees, bracing may be recommended. The specialist will determine the most appropriate type of brace based on a number of factors.
Boston O&P scoliosis braces are custom made to fit the shape and dimensions of the patient’s body, so before we can fabricate a brace, we need to take measurements. We do that using a specialized type of computer program called CAD/CAM (computer-aided design and computer-aided manufacturing). The surfaces of the patient’s body are scanned using a handheld scanning device, which results in a three-dimensional digital model of the patient’s body, which will be used to create the brace. Using CAD/CAM enables us to create a custom-fitted brace without taking a plaster or fiberglass cast of the patient’s body. Not only does a CAD/CAM scan take less time than casting, it creates a more comfortable, better-fitting brace.
The Initial Fitting
Once the brace is ready (usually about two weeks after the measurement), the patient will come in to meet with the clinician and try on the brace. At this appointment, we will make any minor adjustments to the padding and the brace based on how it fits, and make sure it is as comfortable as possible. As always, we are happy to answer any questions about the brace, and we will also provide important information such as how to put the brace on and take it off, how often to wear it, and how to take care of the skin.
As part of the bracing treatment, patients may need to undergo physical therapy with a psychical therapist and/or do scoliosis-specific exercises on their own. These exercises will not only help improve the outcome of the treatment, it will make the brace more comfortable to wear. The orthotist will be able to give you the specifics on any required exercise program.
Wearing the Brace
Boston O&P recommends an initial three week breaking-in period to help patients get used to wearing the brace. Patients will start by wearing the brace 1-2 hours at a time for a total of 6-8 hours per day, gradually increasing the wear time until the patient is wearing the brace for the prescribed number of hours per day.
The orthopedic doctor who referred you to Boston O&P will want to schedule regular checkups to monitor the progress of the treatment, and may also require a follow-up X-ray 4-6 weeks after the brace fitting. It is important that patients see their orthotist before going to the orthopedic doctor so the orthotist can make sure the brace fits correctly and is working as it should. In addition to checkups with the orthopedic doctor, bracing patients should have follow-up visits with the orthotist every 4-6 months to ensure proper fit and correction.
When the orthopedic doctor determines that the patient should be discharged from bracing, the patient will go to a final discharge appointment.
Frequently Asked Questions About Scoliosis Bracing
Does it hurt to wear a scoliosis brace? In order to treat the spinal curve, the brace exerts steady pressure on parts of your body, so you may experience some discomfort. Our clinicians work very hard to make sure the brace is as comfortable as possible, and in most cases patients are able to wear the brace for the prescribed amount of time with no serious problems. If you are experiencing significant pain or feel that the brace is chafing excessively, make an appointment with your orthotist for an adjustment.
How long will I have to wear a brace? The length of time recommended depends on a number of factors, including the age of the patient, the degree and type of curve, and the growth stage of the patient. Your orthopedic doctor and orthotist can provide specifics for your individual case.
Will I still be able to participate in activities and sports? In most cases, scoliosis patients can continue to participate in sports and physical activity. The brace can be removed for these activities as long as the patient complies with the overall wear schedule.
Will people be able to see that I am wearing the brace? It is actually fairly easy to conceal the brace under clothes. You might need to wear more loosely fitting clothing or clothes made of thicker materials. For more information, we recommend contacting a local branch of Curvy Girls International (see Resources below).
What will happen if I don’t wear the brace for the recommended amount of time? In order to get the best results and prevent the curve from worsening, it is very important to wear the brace for the recommended amount of time. For this reason, many of our braces are equipped with the iButton thermal sensor, which monitors the wearer’s compliance with the recommended wear schedule.
Scoliosis Resources for Parents & Patients
If you need more information about scoliosis and bracing, here are some helpful links:
- Overview of Scoliosis for Patients: https://www.bostonoandp.com/for-patients/scoliosis-and-spine/overview-of-scoliosis-for-patients/
- What to Expect in the Bracing Process [Video]: https://www.bostonoandp.com/for-patients/scoliosis-and-spine/what-to-expect-in-the-bracing-process/
- Scoliosis Brace Comparison Sheet: https://www.bostonoandp.com/scoliosis_braces/
- How to Wear and Care for a Scoliosis Brace: https://www.bostonoandp.com/for-patients/scoliosis-and-spine/how-to-wear-and-care/
- National Scoliosis Foundation: http://www.scoliosis.org/
- Scoliosis Research Society: http://www.srs.org/
- Curvy Girls international: http://www.curvygirlsscoliosis.com/