Frequently Asked Questions About Scoliosis

— Factually accurate and verified by Dr. Clayton J. Stitzel. Last updated on January 4, 2019.

Scoliosis is a multi-faceted, genetic condition that can be confusing to both parents and children. Many questions arise when you learn that your child has scoliosis, especially if you don't have it yourself. Below are some of the most frequently asked questions we hear at our ScoliSMART Clinics.

General Questions

Questions Specific to the ScoliSMART Approach

What is scoliosis?

Scoliosis is a condition that affects the neuromuscular system, causing the spine to bend in a C-shaped curve or S-shaped curve. About 80 percent of cases are adolescent idiopathic scoliosis (AIS), which means of unknown cause. AIS affects 2-3 percent of children. It's most common in girls age 10 and older, yet boys get AIS, as well. Your child may not have obvious signs or pain if scoliosis is detected in its early stages.

For more information, see our page dedicated to answering "What is Scoliosis?"

If I have scoliosis, will my child get it?

Scoliosis runs in families, so your children have a higher chance of developing scoliosis if you have it. While you cannot outright prevent scoliosis, you can watch for the signs while they are young and during growth spurts. Some signs of early stage scoliosis are:

• One leg longer than the other
• Shoulders hang unevenly
• Eye or hip line is uneven
• Forward head posture
• A rib hump

My child was diagnosed with adolescent idiopathic scoliosis (AIS) – what should I do?

Your doctor's advice may have been to "watch and wait" if your child has a mild curve measuring less than 20 degrees. We hope that the scoliosis was diagnosed in this early stage, because early intervention can stop scoliosis progression and reduce curves, often to less than 10 degrees. Many doctors don't consider a curve measuring less than 10 degrees to be scoliosis.

We recommend you:

• Get a risk assessment test and a neurotransmitter test for your child. The first predicts the probability of progression. The second detects chemical and hormonal imbalances that contribute to progression.
• Talk to us about ScoliSMART™ Small Curve Camp to start Auto Response Training exercises. Learn more about these exercises below where we explain our unique approach to scoliosis treatment.

How has scoliosis been treated historically?

Observation, bracing and surgery are the three most common treatments for scoliosis. Often, doctors will recommend monitoring curves that measure less than 25 degrees, scoliosis braces when curves reach 25 degrees, and surgery if curves progress to 40 degrees or greater. It is not the intention of ScoliSMART™ doctors to condemn the efforts of sincere and caring medical professionals who have dedicated their lives to helping people with scoliosis, but we cannot support any of these historic treatments because they all have poor outcomes.

Observing a mild curve simply allows time for the curve to worsen. The wait and watch period of six months or a year is often stressful on you and your child because you want to be proactive. We do, too. We opt to start non-invasive scoliosis Auto Response Training exercises as soon as possible.

Bracing holds your child's spine straight during the 18-23 hours a day it's worn. This rigid treatment, however, causes muscles to atrophy and joints to be still and sore. Scoliosis braces often cause pain and breathing difficulty in children who were pain-free and breathing perfectly fine before using one. Additionally, bracing doesn't stop scoliosis progression. Often, a patient's scoliosis curve quickly gets drastically worse when the brace treatment ends.

Spinal fusion surgery is the treatment we disagree with most. It's invasive, has severe complications, and causes disability in 40 percent of people within two decades, according to medical studies. It's an especially poor choice for teens whose spines are not yet developed.

What is a Cobb angle?

The Cobb angle is a two-dimensional angle a doctor draws based on an x-ray, MRI or CT scan. The Cobb angle fails to give doctors all the necessary information, however, because it's a two-dimensional measurement of a three-dimensional spine. A Cobb angle doesn't account for spine rotation. Newer methods of evaluating your child's spine structure give us more reliable information. These include methods such as the Scoliometer and both the Nash-Moe and Perdriolle measurements for vertebral rotation.

How do ScoliSMART™ doctors treat scoliosis differently?

ScoliSMART™ doctors do not recommend monitoring mild curves, scoliosis bracing or surgery, primarily because none of these treatment options has great outcomes. We recommend your child start neuromuscular retraining immediately, regardless of the curve measurement. Our proactive treatment is a step-by-step process that creates new, subconscious muscle memories.

We use an innovative process and equipment to unlock the spine, reduce the curve rigidity and retrain the brain to hold the spine straighter automatically. Programs are catered to each child or adult because every curve is different. Our goal is to stop scoliosis advancement and reduce the curvature without pain.

Will my child's scoliosis progress?

The chances your child's scoliosis will progress are much lower when the curve is mild, measuring less than 20 degrees. The probability of progression with mild curves is 22 percent. The chances of progression skyrockets to 68 percent after your child's curve reaches 20 degrees. The chances scoliosis will advance rises to 90 percent once the curve exceeds 30 degrees. For this reason, the ScoliSMART™ doctors emphasize the importance of early intervention when possible.

Why is early stage scoliosis intervention so important?

Starting neuromuscular retraining as early as possible provides the best outcomes. Plus, the probability of scoliosis progression increases exponentially as the curve becomes more severe, as mentioned above. We want to keep your child's curve from reaching 20 degrees — or reduce it to less than 20 degrees — whenever possible.

What activities should scoliosis patients avoid?

One-sided sports, deep backbends and activities that alter the spine's position can trigger scoliosis progression. (They won't cause the condition, however, because it's genetic.) We recommend limiting activities ranging from high-impact running to frequent texting. It's important to let your child be a child, while protecting the spine. See our recommendations of scoliosis dos and don'ts for more information.

How should I sleep if I have scoliosis?

A high-quality firm or medium-firm mattress is ideal if you have scoliosis. We recommend you don't sleep on your stomach, which puts stress on your neck and spine. Using small pillows or rolled towels under your rib cage or shoulders to support your curve while you sleep on your side may be the most comfortable. You may also put a pillow or rolled towel between your knees. For more information, see our article on scoliosis sleeping tips.

Questions Specific to the ScoliSMART Approach

How do ScoliSMART doctors treat scoliosis differently?

We recommend your child start neuromuscular retraining immediately, regardless of curve measurement. Our proactive treatment is a step-by-step process that creates new, subconscious muscle control. We use an innovative process and equipment to unlock the spine, reduce the curve rigidity, and retrain the brain to hold the spine straighter automatically. Programs are catered to each child or adult because every patient is different. Our goal is to stop scoliosis from worsening and reduce the curvature when possible in a non-invasive, pain-free manner.

Are the treatment results permanent immediately after ScoliSMART BootCamp?

No. The short time span allows the doctor to decrease curve stiffness and accurately measure the response to your home training equipment but does not allow for permanent adaptation to occur. A stable curve reduction occurs once the patient's spine has been exposed to the training equipment for a period of approximately 3-6 months following the camp.

Can my child's spinal curvature continue to progress even if they are doing their training faithfully?

Yes. Adolescent idiopathic scoliosis progression is characterized by long periods of being dormant with short periods of rapid progression during growth spurts, followed by long periods of being dormant again. Patients may still experience some curve progression during times of rapid growth; however, the amount of progression may be mitigated and limited as a result of the ongoing training process.

Can my child use a brace while performing ScoliSMART training?

Yes; however, not while the patient is performing the actual training. While many of our patients choose not to use a brace at all, those who do most often use a brace while sleeping. Some patients can also choose to supplement their ScoliSMART program with a rigid daytime brace.

Will my child have to do ScoliSMART training forever?

No. In most cases, they can discontinue their care program once they are done growing.

Will my child have to come back for more "in office" treatment?

Yes, after the initial bootcamp most patients will need to be reevaluated by their ScoliSMART doctor following 3-6 months of home training to properly determine effectiveness and make adjustments to their training equipment. In addition, we recommend patients continue to keep their scheduled orthopedic appointments to ensure proper continuity of care.

What are the risks of doing a ScoliSMART program?

Since ScoliSMART BootCamp and home training do not involve invasive procedures, there is no inherent risks to trying the program. A low percentage of patients with larger curves or a higher risk of progression may continue to get worse while under care and will be referred for surgical consultation in the event their scoliosis remains unstable.