If you read my first post this month, June 10, 2016, you read a little about managing scoliosis including chiropractic management. This post is an expansion on that previous post, specifically chiropractic management of scoliosis. Somethings here might surprise you, so be prepared.
Treatment of scoliosis is most effective when diagnosed as early as possible. As I mentioned in my previous post, screening tools are important to identify those with a potential scoliosis but only a thorough evaluation with radiographs (x-ray) is diagnostic. The number of children who develop some form of scoliosis is small, only 2-4% but it is important we screen as many children as possible because early diagnosis leads to better long term results. The earlier a scoliosis is diagnosed means a greater number of treatment options are open, later when the curve is large, surgical intervention may be the only option.
The most common treatment chiropractors are understood to perform is the spinal adjustment but we do many more things than that. With a scoliosis case there are some studies that show improvement in a scoliosis curve by utilizing spinal adjusting alone. The study I referenced was one case study where medical interventions, including bracing, had failed the patient. One case does not provide definitive proof that spinal manipulation alone can reduce a curve but it does give us an understanding that spinal adjusting may help to reduce a curve in some patients. Honestly, based on what I understand in the literature, if you have a child that has a moderate to large scoliosis and you are seeing a chiropractor who is only doing adjustments you need to see someone else. This case study I referenced shows improvement by only 16 degrees, we should be able to do better.
We, as chiropractors, can do better when we do more than adjust the spine alone. The addition of spinal exercises and traction in and out of the office can lead to much greater improvements in the spine, even in severe cases. While not representative of what we can do in our clinic this study shows the potential for a chiropractic management of scoliosis when that includes spinal adjustments, exercise, and traction. When applied properly this type of care has the greatest likelihood of reducing a curve and preventing progression than chiropractic adjustments or exercise alone. I would argue it is possibly superior to physical therapy as well.
In some cases bracing might be appropriate. It is not fun to think about putting your child in a rigid brace for 20+ hours a day but it might be the best option. What you might not know is that chiropractors, like us, are diving into bracing. A chiropractor who has researched and worked with scoliosis cases for this career recently developed the scolibrace. This is a unique brace that stretches the patient beyond neutral towards their mirror image opposite posture. In the future I would like to offer this as part of our scoliosis treatment, at present I would have to send a scoliosis patient out to a clinic to fit the brace and I would mange the rest of the treatment. With the combination of spinal adjustments, exercise, traction, and a brace I believe this has the potential to be the best option for children who do don’t qualify for surgical intervention. The evidence on scoliosis care indicates bracing is an extremely valuable treatment that should not be discounted.
One final note, I never count out surgical intervention as a potential necessity. I am not a big fan of surgery but I understand my limitations and place the health and well being of the patient above my ego. In some cases the curve is too large or progressing too fast which means surgery should be considered if not outright necessary. I have worked to develop relationships with surgeons in my area whose opinions I trust and feel comfortable sending patients to when this is necessary. Any chiropractor you see to help manage scoliosis should understand their limitations and be in a similar position. With an early diagnosis and the right management, hopefully this might never be something you need to consider.
While you might have not considered it, chiropractic management of scoliosis can be very effective especially when done with the right chiropractor. This is someone who incorporates more than just spinal adjusting in care and never counts out bracing or surgical intervention as an option in come cases. If you are curious to learn more, feel free to contact me via email, direct message on Facebook, or give the office a call. I would be happy to discuss what type of care is best to treat scoliosis.