Scoliosis is an abnormal sideways curvature of the spine that is typically noticed during the growth spurt of puberty. Treatment can require wearing a brace or even surgery. Because it can happen right when most teens are worried about their appearance, the thought of wearing a brace every day can create a lot of stress and questions. This blog post will answer some of the most common questions about scoliosis bracing to help reassure your child.
How does scoliosis bracing work?
The primary purpose of wearing a scoliosis brace is to prevent your spine from becoming more curved as you grow. As the spine curves, the vertebrae sometimes also twist toward one side of the body. Your brace will be molded to hold your spine in a straighter, unrotated position. It does this by putting pressure on the outer edge of your curve. This will cause you to stand up straighter as you pull away from this pressure.
What degree of scoliosis requires a brace?
Bracing is generally used to prevent your scoliosis from getting worse when you have:
- A curve that is moderate in size (20 to 40 degrees) AND
- A small curve that is progressive (has increased by more than 5 degrees) OR
- A curve that is over 30 degrees when first diagnosed AND
- A lot of growing has yet to happen
Your doctor may consider other factors in recommending a brace, such as if you have additional medical conditions or have family members with scoliosis.
What kind of brace will I need and why?
Your doctor will work with an orthotist, a professional who specializes in fitting and making braces, to recommend the best type of brace for you. The kind of brace you need depends on several factors like:
- Where the curve is located on your spine
- How flexible your curve is
- The number of curves you have
- The position and rotation of some of the vertebrae in your spine
- Any other medical conditions you may have
Your doctor and orthotist will also take into account your activities and lifestyle when suggesting braces. You and your parents can then decide which brace you prefer among the choices given. The brace only works if you wear it as directed, so it’s important you’re a part of the decision-making process.
How long will I have to wear my brace?
The most important time for scoliosis bracing is during periods of rapid growth. This is when you have an opportunity to have a positive effect on your scoliosis. After taking your growth pattern into account, your doctor will create a personalized schedule of how many hours you need to wear your brace each day. It will be based on the degree of your curve and your stage of growth. Generally, people with moderate scoliosis wear their brace between 12 and 20 hours a day. Those who wear their brace for the recommended number of hours a day are less likely to need surgery. Nighttime bracing is used in some patients for mild curves or when full-time bracing is not possible.
What’s the difference between nighttime and full-time scoliosis braces?
Nighttime bracing systems are meant to only be worn just before bed and while sleeping. Full-time braces are typically worn more hours during the day than at night, and are designed to be worn in an upright position.
How will scoliosis bracing affect my daily life?
It will probably take time to get used to wearing your brace, but it should become more comfortable after you’ve worn it for a couple of weeks. Most braces can be worn under normal clothing. It will be up to you to decide if you want to tell other people you are wearing it. However, many people find their brace easier to deal with when they can talk with their friends about what it’s like to wear a scoliosis brace.
What if I grow out of my scoliosis brace?
Because you’re growing, it’s common for kids to grow out of their braces. If this happens, your doctor may recommend you get fitted for a new brace.
What kind of clothes can I wear?
Clothes to wear under your brace: The clothing you wear under a scoliosis brace is nearly as important as what you wear over it. Look for these types of shirts:
- Tight-fitting, seamless shirts to prevent chafing
- T-shirts that cover the armpit (if your brace comes up to your armpit area)
- Shirts made of breathable material (braces can be warm)
Clothes to wear over your brace: Today’s fashion trends make it easier than ever to find outfits that are in style and make your brace disappear.
- Leggings with long shirts or tunics (leggings are comfortable to wear with a brace, and tunics tend to be loose and flowy, which hides most braces)
- Dresses and skirts with elastic waists (long skirts and stretchy dresses cover braces and keep you cool)
- Vests (pairing a vest with a tank can keep you cool in the summer, and their loose design disguises places where your brace might show if you wore a tank alone)
- Off-the-shoulder tops or dresses with uneven hemlines (uneven hems are in style, and they help disguise any body unevenness caused by scoliosis)
- Accessories (statement jewelry and infinity scarves are great for disguising uneven shoulders and drawing attention up toward your face)
- Layers (never out of style, a top paired with a sweater, jacket, blazer, etc., is a surefire way to keep your brace hidden and make a fashion statement)
For guys with scoliosis: Some guys prefer to wear elastic-waisted pants (gym shorts, sweatpants or warmup pants) with their brace. You can also wear T-shirts, long-sleeved shirts and hooded sweatshirts.
If you go shopping, remember to wear your brace so you can try it out with your new clothes before you buy.
What’s the best way to put on a brace?
Proper brace application initially takes two people, the wearer and a helper. This will keep the brace from being twisted when you put it on. Steps for putting your brace on include:
- Stand with your helper behind you holding the brace in their left hand.
- Your helper should put the brace in front of you with the opening at the back.
- Your helper then reaches around you with an arm on each side and spreads the brace wide enough so that you can step into it.
- Make sure all the straps are outside the plastic girdle.
- Make sure the brace is not twisted and is facing straight ahead. (The opening of the brace should be in the middle of your back so that the bumps on the spine and the crease between the buttocks are halfway between each edge.)
- Bend your hips and knees about 45 degrees. The brace will only fit properly if this is done.
- With your hands on the “hips” of the brace, push the brace toward your feet so the pads on the inside of the brace fit above your hip bones
- Pull the extra cloth of the undershirt out at the brace opening. Make sure there are no wrinkles in the undershirt because the wrinkles can cause sores on your skin.
- Your helper should then thread the straps through the loops and fasten the Velcro.
- To tighten the brace, apply pressure to the side of the brace opposite the loop and refasten the Velcro. If you’re unable to secure the brace this way, you may lie on a firm surface.
- If you’re using the ”side-lying method,” secure the brace loosely, lie on the floor, bend your knees, and have your helper lean on the side of the brace — squeezing the brace to the lines — while pulling the straps.
- When the brace is on as tightly as possible, fasten the Velcro.
How do I care for my brace?
Do not put any part of the brace into water. Wash the brace daily with a washcloth and mild soap. Rinse with a washcloth and clear water, and then wipe it dry.
How do I prevent skin problems?
To protect your skin from your brace, you should always wear something snug that absorbs sweat. Even small wrinkles in the wrong place under a brace can cause a skin problem, so be sure to take the time to smooth your shirt out and apply your brace correctly. You’ll sweat a little under your brace and, during warm weather, may need to change your shirt a couple of times a day.
Can I still exercise?
Keeping your body moving is important. While you should talk to your doctor or orthotists about which types of exercises you can do, these activities should be OK:
- Swimming (noncompetitive). Avoid the butterfly stroke (freestyle, backstroke or breaststroke are preferred). You can also go scuba diving and diving.
- Cycling (not off-road cycling).
- Walking, hiking and sprinting (avoid long-distance running and jogging).
- Aerobics, such as dance, color guard, yoga and flexibility training.
- Table sports: table tennis/pingpong, foosball.
- Croquet, badminton and shuffleboard.
- Gliding-type activities such as cross-country skiing, as well as using ellipticals and similar exercise machines that do not involve repetitive shocks.
- Short-term, high-intensity exercise (burst training) is preferable to endurance training.
How can I maximize the benefits of my scoliosis bracing?
To give your brace the greatest chance of successfully stopping the progression of your spinal curve, it's important that you:
- Wear your brace each day for the full amount of time your doctor recommends.
- Take good care of your skin daily.
- Wear a well-fitting, wrinkle-free shirt under your brace at all times.
- Put on the brace exactly as instructed by your doctor.
- Perform any daily exercises recommended by your doctor.
What’s the best way to sleep with a brace on?
When you go to sleep, try to lie on the side that’s curved outward.
What if I don’t stick to the plan perfectly?
Nobody expects you to be perfect. If you deviate from your plan, simply try to get back on schedule. Talk with your doctor if you’re having a hard time sticking to your plan.
Gillette Children’s. Your scoliosis resource.
At Gillette Children’s, our physical therapy department is specially trained to work with children who have scoliosis. In fact, we even have our own brace shop. You can read more about our scoliosis treatment here.