Listen to the Episode Below or Visit http://www.drjustintrosclair.com/bookonline to Access it on Your Phone
- Dr. Justin Trosclair hosts a solo episode focused on scoliosis.
- The discussion caters to both healthcare professionals and patients.
- Topics covered include scoliosis basics, screening methods, and treatment options.
Understanding Scoliosis More About ScoliBrace & ScoliBalance Click the Link
- Scoliosis involves abnormal spinal curvature, which can occur in different areas of the spine.
- Children experience scoliosis as they grow, with the condition typically worsening during growth spurts.
- In adults, scoliosis often results from spinal degeneration, causing a collapse in the spine.
- X-rays reveal scoliosis, particularly by detecting spinal rotation.
- Non-rotated curves may be postural issues, treatable with massage and adjustments.
- Pain is a common symptom in real scoliosis cases.
Scoliosis in Children
- Scoliosis is most prevalent in girls aged 10-12 and boys aged 11-13.
- Rare cases occur in younger children.
- Left or right curves may warrant additional testing for underlying issues.
- Idiopathic scoliosis is the most common form without a known cause.
- Early intervention is encouraged to prevent curve progression.
Treatment Options More About ScoliBrace & ScoliBalance
- For curves less than 10 degrees, manual therapy, exercise, and adjustments may suffice.
- Curves between 10 and 25 degrees may require bracing.
- Severe curves (over 25 degrees) in thoracic or 20 degrees in lumbar regions often necessitate bracing.
- Extreme curves (over 60 or 50 degrees) may require surgical consultation.
Identifying Scoliosis Signs
- Signs include uneven shoulders, hip elevation, and visible humps when bending forward.
- Prevalence: 2-3% of children aged 10-15, increasing during rapid growth.
- Family history increases risk.
- Age-related scoliosis affects 30% of individuals over 60.
Benefits of ScoliBrace
- Braces can improve posture, balance, and reduce the risk of falling, especially in older populations.
- Altered spinal bone shapes contribute to scoliosis, but bracing can help correct it.
- read more about scolibrace
- De novo scoliosis is the term for age-related, degenerative-based scoliosis in older individuals.
Importance of Early Detection
- Early and accurate detection of scoliosis can significantly impact treatment outcomes.
- Early detection can prevent the need for surgery and offer improvements in appearance, posture, pain, and balance.
- The Scoliosis Research Society recommends early detection and nonsurgical management.
School Screening Programs More About ScoliBrace & ScoliBalance Click the Link
- Many schools lack a consistent formal screening program for scoliosis.
- Informal screenings may involve bending forward with clothes on, making it difficult to detect scoliosis.
- Summertime, when people wear bathing suits, can be a better time to notice irregularities.
- A step-by-step assessment includes checking for uneven shoulders, protruding shoulder blades, spinal curves, hip differences, and creases in the lower back.
- A detailed assessment is easier without a shirt.
- An app called “app.scoliscreen.com” can aid in self-assessment and referral to healthcare professionals.
The Importance of Early Intervention
- Detecting scoliosis early is crucial to prevent severe progression.
- Strong family history may prompt intervention even for curves less than 10 degrees.
- Massage, adjustments, and postural exercises are recommended for minor curves, while bracing becomes necessary for larger ones.
Bracing for Scoliosis More About ScoliBrace & ScoliBalance Click the Link
- Bracing recommendations vary depending on the degree of the curve.
- Children may need to wear braces for most of the day, while adults can wear them part-time.
- Wearing a scolibrace for longer hours can yield better results.
Case Studies and Results
- Case studies demonstrate the effectiveness of braces in reducing scoliosis curves.
- The appropriate brace is essential for optimal results.
- Besides bracing, treatments include scoli balance exercises tailored to the type of curve.
- The scoli roll is a device that helps stretch ligaments and tendons.
- Specific muscle work, chiropractic adjustments, and kinesiology taping can also aid in scoliosis management.
Sports and Scoliosis
- Sports are encouraged for scoliosis patients except for competitive ballet and swimming training.
- Extensive swimming and dance training may not be suitable for scoliosis.
- The prevalence of scoliosis varies with age, with a higher incidence among older populations.
- Low back pain is a common reason for adults to seek treatment.
- Pain, cosmetic concerns, balance issues, and the desire to avoid surgery are reasons for seeking scoliosis treatment as an adult.
Adult Bracing with Scolibrace More About ScoliBrace & ScoliBalance Click the Link
- Bracing is considered an alternative to surgery for adults with scoliosis and severe pain.
- The focus is on pain relief and supporting the body differently rather than extreme curve reduction.
- Bracing for adults typically involves fewer hours per day than for children.
Bracing and Muscle Strength
- Braces provide some flexibility, allowing for movement and exercises without causing a loss of muscle strength.
- Endurance tests improve as you wear the brace longer, ensuring muscle strength is maintained.
- learn more about scolibalance
Scoli Meter and Screening
- The Scoli Meter app can be used to measure spinal deformity.
- Screening for scoliosis is important, especially for children and adolescents.
- Specific screening recommendations include females at ages 10 and 12 and males at ages 13 and 14.
Adults Seeking Treatment
- Adults may seek treatment for scoliosis due to cosmetic concerns, pain, or previous unsuccessful treatment.
- Treating scoliosis at a younger age can yield better results as curves tend to progress over time.
- Gravity and aging can cause scoliosis curves to worsen at an average rate of one and a half degrees per year.
Types of Curves More About ScoliBrace & ScoliBalance Click the Link
- Thoracic curves are typically right-sided.
- Pain is less common in teenagers, so it should be investigated if present.
- MRI may be necessary to understand the cause of night pain.
Scoliosis in Young Children
- Scoliosis in children younger than seven should be addressed early to prevent complications.
- Mortality rates increase for young children with scoliosis.
Effectiveness of Spinal Manipulation
- Spinal manipulation (chiropractic adjustments) is not effective for stabilizing or correcting scoliosis.
- It may provide pain relief but doesn’t significantly impact the curve itself.
- A study showed that wearing a brace for at least 13 hours a day had a 90 percent success rate in avoiding surgery.
- Bracing is more effective than observation without treatment.
- If no improvement is seen after a month of brace wear, reassessment is necessary.
Different Brace Types More About ScoliBrace & ScoliBalance Click the Link
- Traditional Boston braces may not be as effective, especially for large and stiff curves.
- The TLSO Boston brace can be challenging to put on, and it changes the biomechanics of the spine.
Custom 3D Braces
- Custom 3D braces, like the Scully brace, are designed to reverse the curve and offer better results.
- Wearing these braces during growth spurts helps improve the curve over time.
Before and After Assessments
- Before-and-after photos and posture assessments are used to track progress.
- Many individuals seek treatment for cosmetic reasons and want to look better in swimsuits.
Reasons to Seek Treatment
- There is no wrong reason to seek scoliosis treatment, whether for pain relief, cosmetic concerns, or prevention of curve progression.
- Conservative treatments can be effective in avoiding surgery.
Hope and Empowerment More About ScoliBrace & ScoliBalance Click the Link
- The podcast encourages reaching out for questions and concerns about scoliosis.
- Empowering patients with hope and information to make informed decisions is a primary goal.
TRANSCRIPT[00:00:00] Welcome to a doctor’s perspective podcast. This is Dr. Justin Trost Claire. Today’s episode is going to be a little unique. I’m going to do a solo episode. I’m going to talk all about scoliosis. I’m going to cover pretty much two different presentations one’s geared towards professional doctor audience and the other is more for patients And those who want more information about scoliosis. So I’m going to go pretty deep in some areas about what is scoliosis. How can you screen for it at your house? There’s a simple app for that, as well as just five or six different things you can look at. So we’ll cover that. We’ll cover the different treatment options. The major one being the scoli brace, its effectiveness and compare it to the regular kind you would get. The scoli roll, the device you lay on, and then of course, as a chiropractor, targeting certain muscles with massage and adjustments, whether it’s manual snap, crackle, pop style, or with the instruments where you just lay there and there’s no popping.[00:01:00] We also have a unique kinesiology taping method that we can use as well, and we’ll go through all of that later as far as What’s available in this clinic, we see a lot of different types of people from kids to adults, the elderly, and they come from all over.
So some people can come in once a week. Other people, they don’t have that option because they just live too far away. They’re just here for a brace. One of the ways patients find us by referrals from other chiropractors, physical therapists, and surgeons. And pretty much those referrals, you come in, fit you for a brace, and we do follow ups with that, but I don’t actually treat you on an ongoing basis like your local doctor would. So let us jump in. Of course, scoliosis. It’s a curve. It can be in the thoracics, which is where your ribs are, your low back, which is the lumbar, and typically you either have one, two, or potentially a three curves. Okay, once you have it, it typically will get worse and it gets worse as you grow. It’s like that growth spurt kicks in [00:02:00] and then just physics doesn’t allow it to go straighter. Typically, it just kind of gets worse. That’s when you’re a kid. When you’re an adult, Typically, it’s, if you didn’t have scoliosis as a kid, then it’s some kind of degeneration in the spine and it can really kind of collapse on itself. More About ScoliBrace & ScoliBalance Click the Link
Not fully, but definitely gets worse from like a six month to even a year period time. One of the things we’re looking for as far as an x ray, you can see the curve, but we’re looking for rotation. So in the middle of an x ray, there’s a little V shaped white spot and that’s the, spinous process that you feel. If you’re touching your back, well, if that thing is rotated, that’s how we know you actually have a real scoliosis.
If you have a curve and those things are still straight, that means it’s a postural thing. And that’s when massage adjustments will take care of it. It’s kind of like a muscle spasm type of situation. So that’s not a real scoliosis. So those are curves that we can definitely go, wow, it’s 10 degrees. Now it’s zero and typically there’s pain involved. So. come in a handful of times, your pain goes away. If you were to re x ray, [00:03:00] that spasms gone. So the curve is, is improved as well. So let’s start with just kids. Okay. So who gets scoliosis the most girls between the years of 10 and 12. And boys between 11 and 13 years old. You can get it as a young kid, like four and five, but those are pretty rare. Also boys get it less often than girls. And so if you’re a boy who has it, we’re definitely looking for any other red flags that may occur if you have a left curve versus a right curve in the thoracics, again, where your rib cage is.
Then again, we’re looking for more red flags like potentially a cyst in the spine or something going on with like C1 brainstem area. And if we have any reason to suspect anything, then we’ll probably order an MRI. And find out if there’s anything in there, that would be the cause of the scoliosis. But most of the time it’s called idiopathic. Means we don’t know why you get it. One of our favorite sayings is, Large curves were once [00:04:00] small, so treat early. To me, a wait and see approach is not great. Wait and see what? If the curve gets worse? Of course! It was 5 degrees. In 6 months, it might be 10. Wait a year, they grow. oh, now you have a 20 degree curve. It happens. So what are we waiting and seeing? so my thought is, I’m not saying you gotta get a brace first thing, but start getting some treatment and make some work. Get some work done. And get some work done. Especially with the scoli balance and the exercises that you give the 3D overcorrective Postural specific scoliosis exercises. That’s a big thing that you can do when the curve is really small, but let me get back to it Just to jump in real quick if it’s less than 10 typically manual therapy exercise Adjustments we can do that curves 10 to 25 10 to 25 degrees. This is when you’re going to be looking at a brace if you’re trying to be aggressive and actually take care of this while the spine is still flexible enough to, make some big changes. And of course the exercises and everything [00:05:00] else. If it’s over 25 degrees up to 60 in the thoracic curve or 20 degrees up to 50 degrees in the lumbar curves, bracing is pretty much anybody’s going to recommend that whether you’re going to see a chiropractor, you’re at the hospital. That’s when it’s super clinically necessary to wear it. And then I think over that over 60 or over 50 it’s more of a surgical consult every now and then you’ll have someone who’s really doesn’t want to have surgery. And so they have to sign like a consent form saying that I understand the risk and there’s no guarantees that any brace will take care of it enough to where you won’t have problems in the future.
So that one, you know, definitely we’re, we’re sending you out, having a consult and making sure you’re making the right choice. Nobody really wants a rod on their back, but sometimes it’s inevitable if you catch it way too late. Some of the things you can look for when you’re seeing if your kid or yourself has scoliosis is, you know, the shoulders are uneven, one hip’s higher, you bend over and there’s a hump on the back on one side or the [00:06:00] other. I’ll go a little more detail, but that’s just generically what you’re kind of looking at if you see yourself in the mirror. Basic stuff. 2 3 percent of children aged 10 15 years have scoliosis. When it’s 11 14 years of age, the prevalence will increase because they grow rapidly. Yes, it can run in the family. So, if a sister has it, maybe check out the other assemblies as well. And, believe it or not, the population over 60, 30 percent of those will have age related scoliosis.
So, they may not have had it as a kid, but they get it from Being old and their spine kind of getting arthritis and degeneration and they kind of lean over to the side or they hunched over Well, we know if you’re hunched over and leaned over you have a more prevalence of having pain It could be back pain pain in the front of the leg Overall balance issues so you may find like grandpa might be stumbling and maybe falling but you put them in a brace, straightens them up, gets their center of gravity better, less chances of falling.
It’s a good thing. so when we’re talking about the curve of the spine, yes, it’s curved and yes, it’s twisted, [00:07:00] but also that’s because the spinal bone, the vertebra has actually changed shape. Later we’ll talk about it, but if it doesn’t quite grow. At the same speed, it can change. And then we’ll just gravity and physics and the way the body works.
They’ll just keep that weird shape. And then the body has to compensate for it. And then it’s a cascading effect. So that’s why it gets worse. But if you can put something in place to take the curve away and change it, then you can actually see some improvements. And if you like big words, de novo scoliosis is actually the name of the degenerative based scoliosis in the older population. We do know that early and accurate detection leads to the most appropriate treatments. It could be a difference between a patient needing surgery and not. And even for adults, if we find out there’s a scoliosis, there’s things that we can do to help with the appearance, posture, pain, or balance. All of these are reasons why people seek out treatment. So it’s not always pain. It could just be appearance. The Scoliosis Research Society, [00:08:00] so sort, they do say early detection and nonsurgical management is the best way to go, all right? Most schools do not have a consistent formal screening program. Some people can remember a nurse or somebody lines you all up and you bend over. And then they check your spine. Now, a lot of times it was even with a shirt on and really you want to have a shirt off to even see these things. That’s why summertime is kind of nice because you see people in bathing suits and, oh, yeah, something doesn’t look quite right.
And that’s when you notice it. So now let’s do an assessment. The first thing you want to do is have them stand with their feet about shoulder width apart and let the arms dangle to the side. And just don’t look at them. Like I said, without a shirt, it’s easier to see these things. You’re looking to see if one shoulder is higher than the other.
You’re looking at the shoulder blades to see if one pops out more than the other. You might actually see. A curve in their back to begin with, or one hip is higher than the other, or you might see that one seems [00:09:00] like it’s pushed forward on one side. Sometimes it’s shadows and just the way the body is shaped, you see that.
And in the stomach area, in the low back, you might see like this crease on one side that you don’t see on the other. Then you want the feet together, knee straight, palms together in front of them, and then they bend over. And here, we’re looking at either side of the spine, you may find that there’s like a hump.
So it’s higher than the other side. You can see that in the thoracics where the ribs are, or you might see that if you bend over a little bit further in the low back and the lumbar. That’s a very classic sign. In fact, there’s an app we’ll talk about later. If it goes past six degrees, definitely indicated that there’s something going on. Probably need to get you. Some films may have scoliosis. So that app is called app. scoliscreen. com. A P P dot S C O L I S C R E E N dot com. It’s free. It’s got eight simple questions. And you can use it anytime. And it’ll run you [00:10:00] through what I just told you with a visual picture of what you’re looking for. And you just answer yes or no. And at the end of it, it spits out a score.
And if it says, medium risk, high risk, then it advises you to go find somebody. And then they have a webpage where you can… Find a doctor near you in case you hear this podcast and you’re not in the three or four state radius of Louisiana at the time of this recording Again, large curves are once small. Unfortunately, some people don’t even notice it Maybe they’re 15 years old. They see something going on. They get a film. It’s like, oh my goodness My daughter’s at 35 degrees. Well, how come nobody noticed it and it happens and sometimes They don’t have much going on They have a big growth spurt and that curve just gets really bad really fast six months to a year So that’s why it’s important if you see it early. You have to at least have films from time to time to see how it’s looking If you have a strong family history of scoliosis It might be important even at a 10 degree to get on a brace so you can capture it early So it doesn’t have a chance to get bad. [00:11:00] Okay, but in general, like we said, if it’s less than 10 degrees, we’re looking at massage adjustments and the postural exercises to help straighten that out.
And we can see how you’re doing over a span of time. But once it’s higher, we’re looking at braces. When you’re an adult, you don’t have to wear it part time as a kid. Yeah. You got to wear it like 23 hours a day. You can get about three hours of break. If you play sports. Some research says 13 to 16 hours, but then there’s more of it that comes out. It’s like, Hey, the more you wear it, the better results you get.
So that’s really, that’s our recommendation. We have some case studies where you’re 13 years old. You have a 33 degree curve after 22 months of wearing the brace. It goes down to a six degree curve out of the brace. One of them is a three year old, it’s 40 degrees in a traditional brace. They only got a 33 degree curve. So from a 40 to a 33, but when you put them in a scoli brace after 24 months, it’s only a 14 degree curve. So that’s a 26 degree [00:12:00] improvement when you have the appropriate brace and that’s, what’s really important. So that’s the basic lecture, okay? Let’s come up, give me a little grace here while I work through this, next lecture. And we’ll go into more details about what makes this brace unique versus another one. I know this talk kind of sounds like, well, you’re just trying to sell braces. Well, it’s more of like, it’s what the treatment you actually need, but we’ll go through the other things. So for instance, say it’s a scoli balance, the postural corrective exercises. If you have a right curve. In the thoracics or a double curve in the primary bigger curve is in the lumbar. Well, there can be different exercises for you. And so you’re doing these sitting and we’ll have you put you in these special positions. And you have to do those, you know, 10 times a day. If you’re trying to get aggressive, you might do it more. And then as the get better at it and as you get better at it, we start doing more activities with it. Like, you know, raising an arm or if you play guitar, you play guitar in this special position. Doing it in a standing position, not just a [00:13:00] sitting position. you know, the scoli roll, that is a device that you lay on and it forces your curve into the opposite direction. And so it’s all about tendon and ligament creep. So after about 10 to 15 minutes of laying on this thing, those structures, the ligaments, the tendons are actually able to release and stretch. So the more flexible the curve, the more likely when you do the exercises. You’ll see some positive changes where the degrees get better, especially if you have wearing a brace and you’re doing these things.
Well, now you’re actually flexible. So the brace can actually put you into the position that you need to be in a bit easier and you’ll see better results that way. And like I said, there are special muscles. And I said, there are certain mess. And like I said, there are certain muscles that we find that get tighter.
And more contracted in scoliosis that we just want to address. If you can address those again, flexibility, the pelvis can get more level, you can see more flexibility and you accept the treatment a bit better. Of course, as a chiropractor, personally with scoliosis, I like to use these instruments so we can [00:14:00] actually target one side versus the other and the patients don’t have to worry about being.
You know, jumped on or I don’t want to be cracked or whatever. So you don’t have to worry about all of that. And you can be extra specific with these instruments. So that’s my preference there. Just so you know, if someone’s coming in just for pain relief, especially as an adult whose curve is pretty stable, maybe not so big, maybe in their 30s or 40s or 50s, something like that. We can also do a specialized kinesiology taping. We put that on there. It just supports you in a certain way. So you make some postural corrections. And usually. Between three and eight visits, they’re really seeing a big difference. It might go longer, might go less, just kind of depends on the person and how they’re responding and their activities, their lifestyle, what they do for work, you know, there’s a lot of factors that go into it, but that’s a pretty standard plan, for that.
And like I said, it works right. It works quite well. It works quite well, but again, that’s once a week. So someone who’s coming in from four hours away, of course, that’s not really going to work for them. So we have to think of other ways to help these people. But if you’re [00:15:00] local. It’s definitely an added benefit and we know if it doesn’t quite work, there’s always more that we can do. Now, before I move on, a lot of questions we get are about sports. We encourage sports. I encourage sports with scoliosis. The only two things you don’t want to do is competitive level training for ballet and swimming. Can you swim? Yes. Could you swim every day? Sure. But what we don’t want is two to three hours of swimming four or five days a week, something to do with the buoyancy and the gravity just doesn’t work well with scoliosis. We used to think scoliosis and swimming was okay, but it turns out not so much dance. It’s the same way. If you’re going to be doing two or three hours of that. The amount of flexibility and the positions they put themselves in is just not great. Can they do some? Sure. They can take a class, learn a bunch of different ways, but again, just competitively, it’s kind of a no no. All right, so [00:16:00] this little presentation, all right, this presentation is more geared towards the doctors. I’m trying not to repeat a bunch of things, but we’ll sprinkle in some new information as well as some old. All right. Thank you. Early accurate detection is the difference between a fused or non fused spine. Again, when we’re looking at x rays, we’re looking for spinal rotation, not just bending. Here’s the prevalences in children, young children, less than less in young children, less than five years of age, it’s less than five. It’s less than 0.5% teenagers up to 18, it’s only two to 4%. When you’re over 49% gets scoliosis, 30% over 60, and if you’re over 90, you can book it.
50% will have that de novo scoliosis. It’s not uncommon within six months to a year, if someone had a 26 degree curve to get down, to get up to a 45 degree curve. when they’re over that 60 plus age. Low back pain. Low [00:17:00] back pain is the most common reason why they would, an adult would seek care. Of course, it’ll be in the back. It’ll be the side that has the biggest curve. We call it the convex side. That’s the way it curves. That’s how we classify those curves. It could be on the convex side, which is the way we classify curves. And there’s always one area that’s like the most. pushed over. We call that the apex. And so a lot of our treatment is based around where that apex is. And you can have pain in the front of the leg for children. It might have some mild pain.
And of course, when they’re putting on this brace, it can be somewhat uncomfortable to start with. So reasons to be treated, you can pain, cosmetic deformity, balance control. And if you’re looking at. Having a surgery as an adult, it’s mostly for pain relief, and you’ll find that a lot of the surgeons are not excited to do these surgeries because of the risks versus the reward. Research is showing that bracing for an adult is an interesting treatment option because [00:18:00] it’s an alternative to surgery, especially for those who don’t qualify but still have a lot of pain and don’t want to take narcotics. So what are they supposed to do? But like they said, the nice thing is they’re looking at five or six hours of wear. Versus 20 plus, especially for an adult. Are we trying to an older adult that is, are we trying to go from a 45 degree to a 35 degree curve? Not necessarily. We will see those things, but it’s about supporting the body in a different way so that they actually can have the pain relief. And surprisingly with the brace, some people say, Oh, you’re going to lose your muscle strength.
Thank you. Well, that’s true if you’re doing like a back brace because you hurt yourself, but these There’s some play in the brace so you can move and you’re doing the exercises So they actually have a couple of tests endurance tests that you can do and those will get better as you wear the brace longer So that’s really exciting that you’re not gonna lose muscle strength while wearing it Again, when you bend over and use a scoli meter, they do have a scoli meter app that you can download as [00:19:00] well Just type in scolimeter, and if you see that it’s 5 to 7 degrees of deformity, so the degrees is 5 to 7, then more follow up is necessary. This should be screened twice for females at age 10 and at age 12, and in males 13 and 14 they should be screened. Because when you have that rib hub on one side, you’re pretty much going to have a pretty big curve that we have to deal with. In the lumbar spine, you’re looking at more four degrees and more is the problem. Just so you know, I would say a big reason why 20 and 30 year olds come in is because of cosmetics to start with. They might’ve had a curve that they wore brace for as a kid. They took it off and they find that they still look different or they’re having a little bit of pain, either one. And so now they’re here. Hoping what can we do so you can try the standard treatments and then if it’s still not working and they’re willing, you know, then you can put them in a brace and you can still see some changes, some big changes at that age because there should still be flexible and movable.
And, you know, if you can get a 30 degree curve down to a [00:20:00] 20 degree at a younger age, well, we know it’s going to progress about a degree and a half a year. So when you’re older, it’s gonna be a problem. Right? So, 20s and 30s, if you stay in shape, don’t gain a lot of weight, stay active, you know, they might have somewhat of a stable curve for a long time, but after a while, gravity, old age kicks in, middle age, all that, and it will progress, like I said, between, usually average one and a half degrees a year.
So at some point, you know, things are going to happen. So if you can get a smaller now, you’ll be better off in the future. Again, typically the curves in the thoracic Our right sided, so if you have a left curve, we have to be more careful about that. Pain is not so much common in teenagers, so if they have that, we want to rule that out. Night pain, and for a lot of things, is a red flag that you want to rule out. Why is that happening? It’s less common in boys, like we said. And so, one of the ways to follow up is doing an MRI in that area to see what’s kind of going on. When you’re very young, like less than seven years old, and you’re diagnosed with scoliosis,[00:21:00] It wants to be addressed because they do have a mortality rate increase, but not so much if you’re an adolescent. So that’s teenage years, it’s fine, but it’s really low. You want to take more caution, that way you don’t have any respiratory or heart cardiovascular issues from that. So spinal manipulation, aka the chiropractic adjustment, is not effective to stabilize or correct scoliosis. Yes, it increases the joint. Yes, that turns off pain, increases blood flow and overall has great positive effects. But as far as helping the curve itself, it’s not going to do much. They had a study, at least 13 hours a day of brace wear, you had a 90 percent chance of avoiding surgery. 90 percent chance. And then they noticed the longer you wear it, the actual better results you get as far as getting the curve under control. So that’s awesome. They did a study. Of 242 people, roughly half were braced, half were not, and the trial was stopped early because there was a 72 percent [00:22:00] efficacy or good results with the brace compared to not. Now, a lot of times these things happen when you’re discussing, say, medications for heart disease. They would plan to do a five year study, but after like a year and a half or two years, those who get the medicine versus those who don’t have. So much better results and they’re not having heart attacks and all this stuff. So the, Hey, it’s unethical to continue this trial. We already see the results. So that’s, that’s what we’re talking about when they say the brace is working to help reduce the curve. Well, let me just say this, the traditional brace, this is how I look at it.
They open from the back. So they’re hard to get in. Ours open from the front. It’s also a three point pressure brace. So I look at that as you got these two, two by fours, they’re holding you in place and while you grow, you’re just kind of bumping into it and there’s a little pad to kind of help push you. Those braces aren’t necessarily built for correction. They’re just built to prevent it from kind of getting worse or getting to the worse enough to where you have to have surgery. So if they can avoid surgery, even if your curve gets worse, that’s a success. That’s also why they don’t really have good results [00:23:00] with. Making the curves better. And so there’s a lot of doctors out there that are like, ah, the bracing doesn’t work. And so it’s the kind of the brace that you use the brace that we’re talking about, the Scully brace, it’s a three D custom built brace is engineering CAD technology, combine that with the x rays and it’s built just for you.
And so it’s going to look much like the exercises we teach you. If you’re supposed to shift to the ride and give a little twist. And when shoulder ends up being higher, the opposite shoulder ends up being higher, well, the brace is going to be in pretty much that same kind of position. And so instead of quote two by force holding you in place, this brace is going to put you in the opposite position of the curve. So while you’re growing, it’s being pushed. Into a straighter position. So that’s why it’s so important to wear your brace for a long time and catch it early. So while you get those growth spurts, cause we don’t know when you’re going to grow, if we could, I had a magic ball. We can say, okay, you only need to wear it for this week.
And then that week, and then these shifts at school and we’ll cover all the times when you grow the most and you’ll be good to [00:24:00] go, but that’s not the way life is. So you just have to wear it all the time to catch it. So that every time you have a growth spurt. You’re being pushed into the reverse image of your curve.
And that’s why we see such good results and curves actually improving. So you really don’t even need surgery, but you’re also got a better curve. All right. So that’s one of the major differences. Also these TLSO Boston braces. These are what these are called. I was talking about the bad ones. They’re quote, they’re not as effective in large and stiff curves for sure. Cosmetic improvements are moderate. So that’s something. But compliance can be difficult because it’s difficult to put on because it opens in the back and it actually has static stabilization. So it’s almost like a fracture the way it they put it on you and just hold you in place and you actually lose your Lumbar lordosis, so your low back is supposed to have a curve you end up losing that that changes the biomechanics the way the muscles work Strings related. So there’s a lot of you know inconsistencies that we wouldn’t want When wearing this kind of brace and it’s the most common because that’s what’s kind of prescribed at the hospitals and at this point [00:25:00] I’m only person in a couple of states that actually does this brace. There’s a lot of people that do it In the United States, but for some reason in the South, not so much. Maybe because of the effort that it takes to treat scoliosis, they’re pretty complicated. They’re time intensive, so maybe there’s something to do with it as well. For some of these braces, when you look at them, like if there’s a right shoulder high and you put on the brace and you look at it and you’re like, they don’t look any different. That right shoulder’s still high, there’s a little pressure, like what exactly is this supposed to be doing? where, you know, scolibrase, it’s going to actually push you the opposite direction. so in a year, someone might go from 44 degrees to 29 degrees. 71 percent of the patients saw any, 71 percent of the patients saw an improvement in their curve. And this was a study done where people were refusing surgery even though they had a 45 degree curve or higher. Which again, That’s a big curve and definitely a surgical consult is necessary. So those are the people, they got a 71 percent improvement down to 35. Those are the ones that [00:26:00] found an improvement anywhere from 30 to 40 degrees. So that’s really good results. The quality of the evidence needs to improve, but there is more papers coming out showing that. Bracing is better than observing and doing nothing. So if a brace, after a month of wearing it, you get x rayed while you’re in the brace, if we’re not seeing an improvement, then, what’s the brace doing? You need that asymmetrical, over corrective, position. We’re seeing things, 33 degrees, down to 11, after a couple years of use. Now the nice thing again is, adults don’t have to wear it all the time. You might wear it for like a year, whereas kids kind of have to wear it until they’re finished growing. When their growth plates have closed, that’s when he’s like, okay, now you can wean off of it. So it just takes time for kids, but adults, it’s, it’s a quicker procedure. We do take, what did you say? We do take like before and after pictures of, of the spine and the way you look. We do take before and after photos of your posture. So over time, you actually see that the shoulders. Or more level and you’re not leaned over to one side like the [00:27:00] before and it looks better so for a lot of Younger people especially the ladies.
They love that so that they look good in a swimsuit There’s no wrong reason to get treated is what I’m trying to say whether it’s for pain cosmetic or You don’t want it to get worse end up having to have surgery These are all good reasons to use it Well, look, I think that’s it If you have any questions, you can always contact the office, Justin Trosclair, Scoliosis Center of Louisiana. We’re in Lafayette. Like I said, it’s not uncommon for people to drive down, fly in and stay at a hotel for a night and we get everything done in one day. We ship it off to get made and then it comes back between two to four weeks, depending on the production. But when you wear it, of course. That first month is going to be uncomfortable.
You’re putting your body in a position that it’s not used to. Flexibility has to increase with all the therapies together. And, I mean, it is, it’s a brace. It can be a little bit hot, of course. As well as, It’s going to be [00:28:00] pushing in one here, pushing somewhere else. And there’s ways to make it a little bit more comfortable in the, say, the armpit or when you’re sitting or if your hip is poking out, it’s one of those things we can modify the brace, trim things away, flare things out.
We want to make it to where it’s comfortable enough to where you can actually wear it and you sleeping in it, which is something you have to get used to, but people do it all the time. Really love the exercises because it gives you an active part. And it’s something that you can do at your desk. It’s something that you can do when you’re standing, you know, just elongating, not even doing all the translations and rotations, but just practicing how to make your spine stronger.
You see huge benefits from it. It’s kind of fun to see people who are like, ah, that’s not doing much and then they do and they’re like, whoo They’re sweating. They’re like, oh man, I didn’t expect it to be this challenging and it’s like, yeah You got a bit more familiar with your body because some positions you’re just not you’ve never done So you have to learn how to do them and then do them correctly and then progress into like harder and harder Stances even laying on that [00:29:00] the role after a while One, it gets boring and so we also incorporate a couple of things to make it a less boring, but also more effective.
Cause like when you move your leg, you move your arm, it fires off a lot of these muscles. And so it’s kind of training while you’re in that position as well. It doesn’t take a lot of trips, which is cool. And then yes, every three months or so you’re going to get x rays to make sure we’re progressing and see how much less the curve is. And of course, if it’s not working out well, you know, address that as well. But for most of the time, Like that study said, 71 percent you’re going to see major results. And the biggest thing is saving you from having to do surgery. If we can stop that, that’s usually a really good thing. Because you can always have surgery later. You know, if you’re 16 and you’ve got the curve under control, but you’re 35 and you’re really having a lot of pain and just progressed for some reason, well, you can either try conservative again, or… I think that’s the takeaway. Big curves or one small, they could have been managed better at a smaller [00:30:00] amount, but if you’re willing to wear a brace or if you’re willing to do the exercises, you have hope. Hope for pain relief. Hope to get the spine, hope to get the spine straighter from the scoliosis and kyphosis for that matter.
I know we didn’t talk about that much, but versus a side to side of a forward hump, Shuren’s disease. Kyphosis, we have braces specially designed to pull your chest back and get that, that relief. Those have different numbers, 60 and 80 degrees. That’s whenever you’re like, okay, we can’t really probably put you in a brace on that.
You need to have a consult again, but under that, you know, forties and fifties, thirties, Schumann’s disease, that hunched over look, you can get them in the brace. It pulls that chest back. You get a lot of pain relief. And that’s the biggest concern when you have that, is pain. So it’s very helpful for that. Reach out. DrJustinTrostclair. com For now the number is 337 453 5199 Hope this was educational. But also [00:31:00] a glimpse of hope that there’s something that you can do, you can avoid surgery. Results are there for those who want them. Reach out with any questions you might have very active on social media on the website. They have all those links. You can DM me there if you need to as well. Try to be very flexible in our hours as well as giving people the information that they need to make the decision for them. I want to empower you.
I want to give you hope and hope you have a great day. You listen to a doctor perspective special solo episode all about scoliosis and kyphosis management.