Scoliosis Braces:
Are They Outdated & Ineffective

Dr. Clayton J Stitzel
Factually accurate & verified by
Last updated on
November 5, 2021

Full-time scoliosis braces often cause more problems than they solve. Pain that didn't exist before, breathing problems, weakened muscles, and even psychological scarring. Most shockingly, back braces for scoliosis aren't proven to prevent scoliosis surgery, either.

Full-time scoliosis bracing is an outdated treatment that needs to be limited to a very narrow range of scoliosis cases:

Scoliosis brace treatment has existed for more than 450 years. Yet its success is still controversial. Much of the research conducted on back braces for scoliosis reveals mixed and contradictory results. Also, studies are demonstrating the negative physical, emotional, and psychological effects scoliosis bracing has on children and teens. It has become clear that a better way for treating scoliosis needs to be developed based on the latest science and technology. Get our free recommendations on how to avoid scoliosis bracing sent directly to your email.

“Scoliosis Braces Are No Longer The Only Option for Scoliosis Treatment.”

Clayton J. Stitzel DC

New research shows that genetic testing and nutrient therapies can positively impact the scoliosis condition. Once specific genetic patterns are found, appropriate nutrient therapies can halt curve progression. 

So... why does it continue to be the most recommended treatment for scoliosis? 

Bracing is recommended for children in early-stage growth with a scoliotic curve between 25 and 40 degrees. The "hope" is that bracing will delay or halt curve progression, since the condition is progressive. One major problem with braces, including hard plastic braces, metal braces, and even softer dynamic braces, is they cause muscles to weaken. When you don't use your muscles, they atrophy. For example, when your arm is in a cast, the muscles inside the cast become small and weak. This is what happens when your child wears a brace for the recommended 18-23 hours a day. 

It also explains why the curve worsens once the brace is taken off. In a brace, your child's spine becomes stiff. Joints don't get necessary movement and they often develop more degenerative issues. Bracing also puts stress on the ribs and causes a rib hump. Doctors almost always recommend removing the brace when they see this negative change using 3D x-rays, yet the damage may have already occurred.

Scoliosis bracing constricts breathing and bone growth

Another serious issue with bracing is that bones cannot grow properly without intermittent pressure. The theory behind bracing is that it will open the inside of the curve (the concavity) by removing pressure, and encourage growth on the concave side of the curve (the convexity). But you need intermittent pressure on bones to stimulate growth, and the concavity needs to grow. You cannot "guide" bone growth by squeezing the ribs and bending them while the wearer sleeps or sits. 

Even if bracing was successful, studies suggest that children only wear them 10 percent of the recommended time. They say bracing hurts, is embarrassing and handicaps their lives. Full-day bracing doesn't prevent surgery, so they aren't inclined to follow the protocol. 

Braces like the most common thoracolumbar-sacral-orthosis (TLSO) brace squeeze the chest wall and abdomen. A Norwegian study of the TLSO found it decreases breathing capacity. Breathing impacts hormone regulation, muscle and fat composition, and cognitive performance. One study showed that children who wore a hard brace had a 30% decrease in vital capacity (VC).  Also, a 45% decrease in expiratory reserve volume (the air you can push out after a normal exhale). These decreases in pulmonary function are identical to those found in long-term smokers! Respiratory distress causes headaches, anxiety, sleep disturbances, nightmares, and cognitive dysfunction (memory, perception, and problem-solving). The risks associated with scoliosis braces are demonstrable. 

More effective options for treating your child’s scoliosis condition are available. Nutrient therapy, combined with scoliosis-specific core strengthening exercises can halt curve progression. 

Don’t know where to start?  Take our FREE “ScoliQuiz.”  (No x-ray required)

Why are we still using full-time scoliosis bracing?

Doctors and chiropractors still prescribe scoliosis braces because they continue to view the condition as only a spine problem. Rather than a neuro-hormonal condition resulting from a genetic predisposition. The condition is the result of an incorrect “posture memory” development during growth spurts. In children, the brain doesn't recognize that the spine is out of alignment.  Thus it doesn't trigger a response to fix the curvature.  The natural alarm bells don't sound in the posture memory, so the brain doesn't realize there is a problem to fix. 

Scoliosis exercise treatment needs to create a new message that helps the brain recognize something is going wrong! The brain will then "reflexively respond" to correct spinal alignment on its own. Exercises need to stimulate this reflexive reaction.  Only specialized scoliosis exercises can do this. 

This is why using braces by itself to guide bone growth doesn't make sense. Neither does "waiting and watching" for a curve that measures less than 25 degrees. Unfortunately, this is the common management approach in the early stages of the condition.

Alternatives to scoliosis bracing

At ScoliSMART Clinics, we teach your child an exercise training routine that creates new muscle memory to hold the spine straighter. Our Early Stage Intervention and ScoliSMART BootCamp programs halt scoliosis progression, reduce curvature, and improve your child's breathing. We also decrease each child's curve rigidity to help reduce scoliosis curvatures even more! 

Every case is unique. Larger curves need more extensive treatment, especially in children whose spines are still growing. Curves that measure over 30 degrees have a 68 percent chance of progressing in adulthood, as well. Our innovative equipment and "reflexive response" training helps reduce spinal twisting. This is when the spine twists from the top to the bottom, kinking in the middle like a rubber band. Patients need to stop this coil down effect to improve the chances of stabilizing or reducing the curvature.

fusion scoliosis surgery

The ScoliSMART Activity Suit alternative to scoliosis bracing

The activity suit and exercises work with the natural torque pattern of the body to create new posture memory. The new posture memory helps the spine unwind, stabilizes asymmetrical muscles, and reduces curvature without pressure or pain. The ScoliSMART Activity Suit in combination with the Scoliosis "BootCamp" program works well for patients under the age of 18. But it is also available to adult patients looking for back support for scoliosis to help relieve back pain.

Genetic, Neurotransmitter, and Hormone Testing

ScoliSMART Labs has pioneered scoliosis genetic testing, as well as clinical testing (neurotransmitter, hormone, and bone metabolism). It is part of a new way of treating the whole scoliosis condition, as well as the spinal curve. 

Genetic variant testing can identify the exact "blips" in the patient's genetic record. These lead to the hormone and neurotransmitter imbalances. The result is the inability to coordinate spinal alignment during periods of rapid adolescent growth. Identification of these variants is critical to finding the most "at risk" patients for severe curve progression. It also allows for very specific nutritional interventions to provide the critical nutrients patients need to "stay ahead of the curve." 

Neurotransmitters are the chemicals your brain uses to talk with the rest of your body. We test neurotransmitters for imbalances that contribute to the development or progression of idiopathic scoliosis. Imbalances can be corrected with supplements and dietary changes. Normal neurotransmitter levels help your child; Abnormal neurotransmitter or hormone levels can also create abnormal bone growth patterns. These biochemical abnormalities need treatment for an optimal response to any scoliosis therapy. Whether it is exercising, bracing, and/or even surgery.

Opportunities for combined treatment

Many children are at a high risk for curve progression based upon:

  • their age,
  • skeletal maturity,
  • and curve measurement at diagnosis.

In these cases, it may be beneficial to combine ScoliSMART treatment with conventional nighttime bracing. A nighttime brace, such as a Providence brace, does not cover the torso like a typical TLSO brace. This allows for better breathing and comfort. It also takes advantage of the guided growth principle known as the Hueter-Volkmann principle. This brace is only used during sleep. So there is less concern for torso muscle atrophy due to the fact that the child is not using it while upright during the day, fighting gravity. 

This combined approach can be helpful in juvenile idiopathic scoliosis or progressive adolescent idiopathic scoliosis. It allows your child to avoid wearing the brace to school, athletic practices, or events.  Yet, it still provides some guided spine growth during sleep. Patients who have used this combined approach tell us the Providence brace is more comfortable than the TLSO brace. It also gives parents peace of mind knowing that they are using every non-surgical therapy. 

Caution must be used when electing to use nighttime bracing only. Some studies suggest that nighttime bracing by itself does not produce a different outcome than only "watching and waiting."

Progression factors

Progression factors attempt to predict how progressive a child’s curve might be.  Determining how aggressive treatment should be at that time. These progression factors include your child’s age, stage of growth, and current curve size. This helps ScoliSMART doctors develop the most appropriate treatment plan for your child.  Thus minimizing unnecessary treatment and avoiding under-treatment.

5 of the Most Common Questions Parents and Patients Have About Scoliosis Bracing

What are the different types of braces for scoliosis?

There are many different types of back braces for scoliosis. Some patients and parents would say there are "too many" to choose from.  Each has different attributes that may seem more beneficial or desirable in some way. One source of confusion for many is the tradition of naming the brace after the city where it came from. This is how we get brace names like "Boston Brace," "Wilmington Brace," and "Charleston Bending Brace." Only recently have newer scoliosis back braces taken on more "marketing style" names like "SpineCor Brace" (short for Spine Corporation) and "ScoliBrace."

What is the best brace for scoliosis?

Scientific research has determined there is no "best back brace for scoliosis." Using a spinal brace for scoliosis should only be part of a patient's total scoliosis treatment strategy and effort. It should be only for scoliosis in children who are at high risk for a moderate curve getting worse.  (very early stage growth (Risser sign 0-2) with curves greater than 25 degrees). The Boston Brace and Wilmington Brace are two of the most recommended braces for scoliosis.  But that doesn't necessarily make them "the best." Regardless of which brace is recommended, it must achieve:

  • at least a 50% in-brace improvement without making the spinal rotation worse,
  • and the patient will need to wear the brace for the prescribed amount of time.

How much does a scoliosis brace cost?

The actual "out of pocket" cost of a brace will vary a lot and depend on many factors. Insurance coverage and deductibles are policy-specific, but there are many other "hidden" costs to getting a brace.  For example, many orthopedic doctor visits and potential physical therapy. Some "soft" brace options like the "SpineCor Brace" are not covered by insurance and often cost upwards of $5,000.

Can braces correct scoliosis?

No, the sole purpose of a brace is to keep the curve from getting worse. Scoliosis bracing back support devices like the Boston Brace and Wilmington Brace are "intended" to work under the "theory" of guided growth. When a patient begins to develop a spine curve, their spine becomes unevenly loaded, putting a little bit more pressure on the inside of the curve vs. the outside of the curve. This unequal pressure may cause the vertebrae to grow in a slight wedge shape, contributing to some further curve progression. The published research data on wearing a brace, hours per day, and combination with physical therapy is very inconsistent and unclear.

How long do you have to wear a brace for scoliosis?

Assuming the brace achieves at least a 50% in-brace correction without making the spinal rotation worse. And the child is still in early stage growth with a curve of 25 to 40 degrees. Most orthopedic doctors recommend at least 18 hours of daily wear to help, and many doctors insist on 20 hours of wear to help it from getting worse. The number of hours needed to help seems to be an unanswered question and scientifically unclear. 

Most doctors recommend patients wear a brace from early stage growth (age 9-12) until skeletal maturity (age 15-16 in females).

Proactive Scoliosis Treatment

Children with mild or moderate scoliosis benefit most from ScoliSMART exercises. This is because their bones are not yet deformed by months or years of compensating for abnormal twisting and bending of the spine. We use proactive treatment solutions such as genetic testing, nutrient therapies, and the ScoliSMART Activity Suit. Remember, all kids who have large spinal curves started out with small curves first! 

If a scoliosis brace was suggested for your child, you deserve a second opinion. Our programs can replace bracing and surgery, or be combined with standard nighttime bracing treatment — and allow your kid to still be a kid.

Don’t know where to start?  Take our FREE “ScoliQuiz.”  (No x-ray required)

ScoliSMART Clinics is committed to treating the WHOLE scoliosis condition, not only the curve. Genetic & clinical testing with targeted nutrient therapies, expert in-office treatment programs, and the world’s only ScoliSMART Activity Suit provides patients of all ages with the most comprehensive, most effective, and least invasive treatment options available worldwide.

Need more information about the ScoliSMART Approach?

Pioneers of Scoliosis BootCamp

World's Only Scoliosis Activity Suit

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Meet the ScoliSMART Doctors

Click the images below to get more information about the ScoliSMART Doctors.

Dr. Clayton J Stitzel

Dr. Clayton J. Stitzel

504 W. Orange Street
Lititz, PA 17543
Dr. Mark Morningstar

Dr. Mark Morningstar

8293 Office Park Drive
Grand Blanc, MI 48439
Dr. Brian T Dovorany

Dr. Brian T. Dovorany

26940 Aliso Viejo Parkway, Suite 105
Aliso Viejo, CA 92656
Dr. Aatif Siddiqui

Dr. Aatif Siddiqui

34 w 119th st
New York, New York 10026