Often, braces will be suggested as part of traditional treatment. Between observation for the mildest cases, and surgery for the most severe, there are many different therapeutic approaches geared towards helping manage scoliosis symptoms and progression. Less Than 10 Degrees. My alternative treatment option is a chiropractic-centered functional approach. A curve of at least 25 degrees is typically considered moderate scoliosis. My approach is a functional one, meaning the goal is to improve and facilitate the spine’s function, rather than holding it in a straighter alignment at the cost of mobility. The traditional approach relies heavily on the use of X-rays to monitor a curve’s progression, but I find there’s a shortcoming to relying so heavily on X-rays as it provides only a 2-D measurement of a 3-D condition. Once a doctor or surgeon has a patient’s condition fully classified by age, condition severity, location of the curve, and cause, an appropriate treatment path can be decided upon; that treatment path can fork in two different directions with very different outcomes: traditional vs. functional. Babies and toddlers may not need treatment as the curve might improve over time. Taken from a variety of angles, I use X-rays to view what’s happening with the spine in terms of twist, tilt, and other important factors. What Degree of Scoliosis Requires Treatment? Depending on the particular patient and the specific degree of curvature, this form of scoliosis may be treated successfully with non-surgical methods like bracing, physical therapy, and pain medications. Determining what degree of scoliosis requires treatment is a complex issue. The traditional approach that funnels patients towards intensive spinal-fusion surgery is firmly entrenched in the condition’s treatment history, and I think a part of that is because it plays on the hopes of patients and their caregivers that things will improve on their own or that surgery will cure scoliosis. In general, the larger the curve’s Cobb angle, the more likely it will progress. If this curvature is not more than 25 degrees, your doctor may suggest exercise therapy. The traditional treatment approach is a passive one. Curves between 10 and 24 degrees are mild scoliosis and likely just need to be monitored. This includes physical therapy, as well as Caesar therapy and mensendieck. See Scoliosis Treatment. Idiopathic scoliosis appears to be primarily a neuro-hormonal condition that is driven by genetic predisposition and metabolic factors. To properly cure scoliosis, the treatment must match the source of the problem. A moderate curve is between 25 degrees and 40 degrees. It can be seen at any age, but it is most common in those over about 10 years of age. If a condition is left to progress unimpeded, the curvature is only that much harder to reduce down the road; however, there is certainly no harm in acting early and staying ahead of the curve. Our approach involves ingenuity and dynamic thinking. Back braces are best suited for treating moderate scoliosis because they can not reverse spinal curvature, they only prevent the condition from worsening too severely by holding the spine firmly in place. Curves may be as mild as 10 degrees, or as severe as 100 degrees or more. May 24 2017. The advantages of the techniques : No transplant required. Health care providers measure scoliosis curves in degrees: A mild curve is less than 20 degrees. Most patients recover from surgery with curves that have been straightened to less than 25°. We rely on small specifically-targeted X-ray machines to assess the spine’s biomechanical integrity and produce reliable and precise measurements. On one hand, there’s the traditional approach that most often doesn’t start treatment until a curvature has reached or progressed past 25 degrees; on the other, there’s my chiropractic-centered functional approach that initiates treatment as close to the time of diagnosis as possible. In the vast majority of cases, scoliosis doesn’t require treatment at all. Scoliosis surgery is becoming all too common in Asia. When paired with a scoliometer, a Forward Bend Test is a reliable means of finding indicators of the condition and the need for a scoliosis X-ray. In addition, the main goal is to stop further lateral curving of the vertebral column. The next range of 10 to 15 degrees does not normally require treatment other than monitoring by an Orthopaedic doctor until the patient has gone through puberty. The goal of treatment for your child is to reach the end of their growth with a curve of less than 50 degrees. Our team, under the leadership of Dr. Tony Nalda, is focused on treating your scoliosis in the most patient-centered, effective manner possible. There is no curing scoliosis, but there are different approaches to managing and controlling its progression. I would turn the clocks back to that initial diagnosis, in the doctor’s or specialist’s office, and I would start the treatment clock that very day. While we can’t manage or control our patients’ growth, we can certainly monitor it and counteract the resulting progression. In the United States, severe scoliosis is defined as a curvature with a Cobb angle measurement of 40-plus degrees in adolescents and 50-plus in adults. Here are a few treatment options for scoliosis. Realistically, there is no known cure for scoliosis, only ways to manage it and prevent its progression. These experts treat diseases of the bones and muscles. More significant cases may be treated nonsurgically, using braces, or with spine fusion surgery. Scoliosis, the medical term for curvature of the spine, affects millions of people, an estimated 2 to 3 percent of the population. Based on the traditional approach, a surgeon in the States often suggests surgery when progression is rapid or a patient’s Cobb angle measurement is 40-plus degrees. Scoliosis classification is given by measuring the side-to-side spinal curvature, referred to as the Cobb angle. The 3 most common treatment options that our scoliosis specialists recommend are observation, bracing and surgery. Scoliosis with a primary diagnosis (nonidiopathic) must be recognized by the physician to identify the causes, which may require intervention. There’s more to measuring scoliosis than just determining the Cobb angle. Once we achieve a reduction, we know what works and we augment that work with at-home exercises and stretches for the patient. Below is an up-to-date summary of facts about scoliosis. Every 4 to 6 months, the doctor will take another X-ray of the spine to see if the scoliosis is progressing or not. Whether or not surgery is recommended depends upon the condition’s severity, age of patient, treatment approach, and the surgical threshold of the country in which the surgery will take place. The States has the lowest surgical threshold with surgeons most often recommending spinal-fusion surgery for severe cases with curvatures of 40-plus degrees or where progression is rapid. The goal is always to decrease pain and improve function. A visual test such as the Forward Bend Test, also known as the Adam’s Test, will likely be performed. Once we assess those initial X-rays, we take into account how much the adolescent patient has grown, how much their spine has grown, and how much they are likely still to grow. Asymmetries of the shoulders, hips, and waistline. In adults, the degree of the spinal curve may or may not determine treatment. Out treatment plans prioritize strengthening the spine through natural means, rather than holding it with a brace or rod. There is also the issue of how wearing a traditional brace for 13+ hours a day will affect the mindset, happiness, and confidence level of the average adolescent facing scoliosis. The treatment for pediatric scoliosis depends on several factors: The type of scoliosis. What Degree of Scoliosis Requires Surgery? Contact Us Today! The following are general guidelines for treatment. Your family history of scoliosis. Curves may be as mild as 10 degrees, or as severe as 100 degrees or more. In order for a patient to receive an official scoliosis diagnosis, a visual assessment will be done and an X-ray will be taken. Most subtle curvature signs will start to appear with a 10- to 15-degree curve. Fortunately, regardless of whether you have an idiopathic, functional, or neuromuscular scoliosis, it can be cured or eased up with the help of various types of physical therapy treatments. While there are several variations of the surgery, most use hardware such as hooks, bolts, and screws that are attached to the spine so long rods can be anchored on each side of the spine to hold it in a corrective position. 25- to 39-degree curve. A History of Scoliosis: Non-Surgical Diagnosis & Treatment . A moderate curve is between 25 degrees and 40 degrees. We actually encourage our patients to keep doing the physical activities they love. Living with a fused spine can have a heavy emotional weight. Scoliosis surgery should be the last options for curves over 45-degrees when conservative treatment fails. Back braces are best suited for treating moderate scoliosis because they can not reverse spinal curvature, they only prevent the condition from worsening too severely by holding the spine firmly in place. These variables are also beneficial in preparing the patient for what to expect in terms of the scoliosis-related symptoms they are most likely to experience. A patient’s Cobb angle is measured by first locating the most tilted vertebra at the apex of the curve. School screening for scoliosis is controversial and is falling out of favour. A curvature of 10 degrees is regarded as a minimum angulation to define scoliosis. Treatments may be surgical or nonsurgical, and they also vary depending on the type of scoliosis a person has, and the age at which they develop it. The traditional treatment approach would start when a curve reaches or progresses past 25 degrees. Muscle weakness 2. Final Curve Size: 7 degrees Scoliosis Reduced By: 68% Age at Start of Treatment: 12 years old Risser at Start of Treatment: Risser 1 Observation Period: 18 months . Usually, a doctor who only measures a Cobb angle will recommend no treatment — just observation — for a curve measuring less than 24 degrees, hoping it won't get any worse. Scoliosis treatment. Degrees of scoliosis ranging between 20 and 50 are considered moderate scoliosis, and can usually be treated with a back brace. They see lots of teens with scoliosis and can decide if you need treatment. Knowing the condition severity, age, curvature location, and cause of a patient’s condition helps determine the best possible course of treatment. Custom 3-D bracing has its place, but we make sure that it doesn’t come at the expense of the patient’s mindset or quality of life. Scoliosis is defined as spinal curvature greater than 10 degrees. Each treatment has its own advantages and disadvantages, which is why it is best to talk to your doctor before going for any treatment option. Treatment options for idiopathic scoliosis could include: Observation. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. The danger of watching and waiting, especially in cases of adolescent scoliosis, is that a huge growth spurt can occur between X-rays, resulting in rapid curvature progression and further funneling patients towards surgery. The differences in occurrence and severity between genders increases with age. A Scoliosis diagnosis is given when an abnormal curvature is measured at 10+ degrees and includes rotation, which is what makes scoliosis a 3-dimensional condition. She was diagnosed with scoliosis after her brother required spinal surgery for his own severe curvature. The traditional treatment path is frequently traveled, and it is the path most likely to involve passive observation and end with a recommendation for spinal-fusion surgery. If there is an inch of growth, I monitor how that growth affects progression and adjust the treatment plan accordingly. With an adult, however, it is very likely that pain will be a symptom. This is because there are two main approaches to treating the condition and they differ widely. While most doctors would be able to spot an abnormal spinal curvature, when it comes to being able to fully interpret a scoliosis X-ray, seeing a specialist is highly beneficial. If I could turn back time for these patients, I would. While it often expresses itself in areas other than the back such as the hips, knees, and feet, for adult patients, scoliosis-related pain is commonly expressed. Surgery can be performed for smaller curves if the appearance of the curvature is bothersome to the patient or if symptoms are associated with the scoliosis in the adult patient. In general, a curve is considered significant if it is greater than 25 to 30 degrees. The type of brace and amount of time it should be warn … Kyphosis is characterized by an abnormally rounded upper back (more than 50 degrees of curvature). The traditional approach would dictate that intensive treatment starts after a 25-degree curvature and most often ends with spinal-fusion surgery; my chiropractic-centered treatment would say any degree of scoliosis, once it is diagnosed, is best managed with immediate treatment. Large lateral curve. If you or a loved one are facing the possibility of spinal-fusion surgery to treat scoliosis, I urge you to first explore other options such as my scoliosis-specific chiropractic approach. In most cases, it is a painless condition. If your child has this condition, your family doctor may recommend the wait-and-see approach. Welcome to Scoliosis Reduction Center. Through scoliosis-specific chiropractic care and exercises, custom 3-D bracing, and therapy, my team and I offer our patients the benefits of a variety of treatment approaches. To return to the original question of what degree of scoliosis requires treatment, by now you know that the answer will change depending on the approach you’ve chosen. This angle is the maximum distance between a straight spine and a curvature. What degree curve do you decide to do a brace? We want our treatment to facilitate a healthy lifestyle and shape it around how well it allows our patients to maintain the physical activities they love. Treatment for scoliosis depends on your age, how severe the curve is, and whether it's likely to get worse with time. While there is no known cure for scoliosis, there are known treatment options. Then intersecting perpendicular lines are erected from the two parallel lines from the curve’s apex and bottom. Today, many modern clinics offer the latest scoliosis treatment methods. Mild cases may not require any treatment. Less Than 10 Degrees. Most cases of scoliosis are mild and don’t need treatment. Curves between 10 and 24 degrees are mild scoliosis and likely just need to be monitored. Once a spine has been fused, it is less able to absorb force, limiting certain activities that are safe post-surgery. Of course, this is not exact as the condition develops across a wide spectrum with treatment decisions that work for one case not working for another, not to mention other important variables such as age. Scoliosis takes many forms. Patients with congenital scoliosis must be evaluated for cardiac and renal abnormalities. This is true for both teen and adult patients. Abnormal reflexes Scoliosis Surgery. Severe migraines as a young teen introduced Dr. Nalda to chiropractic care. In the United States, severe scoliosis is defined as a curvature with a Cobb angle measurement of 40-plus degrees in adolescents and 50-plus in adults. After experiencing life changing results, he set his sights on helping others who face debilitating illness through providing more natural approaches. This is not scoliosis. Adolescent scoliosis is the largest group of diagnosed scoliosis patients. What degree curve do you decide to do a brace? The above methods are very traumatic and require a long rehabilitation period. Just as laws vary from state to state and country to country, healthcare-industry protocols and guidelines also vary. It involves a lot of, “Let’s wait and see what happens.” To that, I would like to remind people that there’s no harm in working towards a reduction immediately as no one is going to simply outgrow an abnormal spinal curvature. A scoliosis diagnosis ranges from mild to severe. We include each and every patient and caregiver in customizing a treatment plan that will align most effectively with that patient’s quality of life. The main reason for the rapid rise in surgical interventions is possibly due to improper conservative care. This is a tight brace that is worn over the upper body that holds the spine in a straighter alignment with the goal of preventing the curve’s progression. A person will be getting an X-ray for another reason, and the doctor notices a curvature. The number of remaining growth years your child has until skeletal maturity. A person with scoliosis has a sideways curve to their spine. I combine X-ray results with a number of other standing and seated measurements taken from multiple angles and positions to ensure I am getting full 3-D measurements of the condition. Mild curves, like those found in 90% of scoliosis cases, typically don’t require treatment. In this instance, the patient’s age is one of the main factors that determine how painful the condition is likely to be, and age is also an important factor when it comes to deciding whether surgery is an option or not. Surgical treatment is reserved for curves which are generally greater than 50 degrees for adolescent patients and adults. Age is generally the first stage of condition classification as it helps paint an overall picture of the patient. While no one can look at a patient’s scoliosis and know exactly how their condition is going to progress, age can help us predict how likely it is that a patient will experience progression and how rapid that progression is likely to be. To return to the original question of what degree of scoliosis requires treatment, by now you know that the answer will change depending on the approach you’ve chosen. 15 degrees is a fairly mild spinal curvature, but treatment may still be required to manage your symptoms and prevent your scoliosis from progressing to a more problematic stage. It’s at this point that I highly recommend patients ensure they’re working with a scoliosis specialist. Classifying a patient’s scoliosis is as much for the patient’s benefit as it is for the health-care professionals. A look at how our understanding of scoliosis treatment has developed over time. Most often, it is recommended that X-rays are taken every three-to-six months to watch and wait to see if the spinal curvature is progressing and at what rate. The doctor will initially take a detailed medical history and may ask questions about recent growth. Scoliosis. The Scoliosis Reduction Center uses X-rays on a daily basis to diagnose, assess, and measure our patients’ scoliosis. If a curve has reached 20 degrees and the child or adolescent is still continuing to grow, bracing might be considered. In this article, we will be focusing on the various degrees of scoliosis and the treatment options for each respective degree. A curvature of 10 degrees is regarded as a minimum angulation to define scoliosis. Patients with congenital scoliosis must be evaluated for cardiac and renal abnormalities. If your child has moderate or severe scoliosis, it may seem like it's too late to correct the scoliosis curve without drastic measures like surgery or bracing. As I mentioned earlier, the condition’s most common form is AIS, meaning adolescents between the age of 10 and 18 make up the largest age group diagnosed with the condition; this is an age group characterized by rapid and unpredictable growth spurts. Severe scoliosis: Cobb angle measurement of 40-plus degrees for adolescents and 50-plus for adults. The remaining 20 percent with known causes are classed as congenital, neuromuscular, degenerative, or traumatic. As older adults, these people may have a slightly higher incidence of back pain than the general population, as shown by Hong et al. The goal is always to decrease pain and improve function. The ultimate goal is to achieve a reduction and slow or stop the condition’s progression, and I take a functional approach that encourages staying active and mentally healthy throughout treatment. While no one can tell just how much a patient’s scoliosis will progress, visual assessments and X-rays can give us the information we need to make our predictions as accurate as possible. Spinal curvatures under 40 degrees, in pre-pubescent children, may be treated with a brace to slow the progression of scoliosis. 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