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Scoliosis: Brace, Fuse, or Exercise?

Posted Feb 03 2010 10:15am

There is controversy over the use of braces to correct excessive curvature of the spine (scoliosis) in teenagers because research has failed to prove that they work.  “Bracing is regarded as effective by some and as useless by others.” According to Stefano Negrini, MD the scientific director of the ISICO (Italian Scientific Spine Institute) in Milan.

The cause of most adolescent scoliosis is unknown. It affects 3-5 out of every 1,000 children, and is more common and more severe in girls.

  • Idiopathic – Of unknown cause.
  • Functional – From poor posture and body alignment habits.
  • Structural – Caused by disease, or birth defects.


Based on the severity some sort of treatment is required, because if left untreated damage to the spine, heart, and lungs can occur as an adult.  Bracing is less evasive and still allows the option to strengthen the body through exercise and movement to balance and support the spine.  The alternative option of surgery and spine fusion is a permanent and last-resort option to protect the health of internal organs and quality of life.

While studies so far show that none of these can prevent the progression of scoliosis, they may offer some relief of symptoms.

  • Manipulation by a Chiropractor, Kinesiologist, or Osteopathic Doctor
  • Electrical Stimulation
  • Diet & Nutrition
  • Exercise

Over the years,  I’ve had many clients with varying degrees of curvature of the spine participate in Pilates programs.  And while there might not be documented research to the benefits of Pilates exercises for scoliosis…From my experience, I have seen amazing gains in strength, and mobility.  The curves  don’t  go back to normal, but it is possible to learn how to strengthen the body and retrain some of the weaker muscles to better support the spine and achieve more optimal muscle balance.  Plus increased body awareness of good and bad posture habits is vital to learn how to avoid falling into the poor alignment that the scoliosis curve would prefer.  Spend more time using your own muscles to strive for good posture through Pilates and other fitness exercises, and you’re retraining the body for better health.

A brace is an external support for the spine. If the brace is doing the work, our muscles don’t have to work as hard (and in my opinion….may become weaker over time.) But if you don’t have the muscle awareness or strength to properly support the body all day long…bracing may be required to assist.

Spine fusion surgery creates permanent internal support for the spine. (While this might solve one problem, it has the potential to create others) And generally speaking fusion surgery is a last resort option.

Exercise strengthens the core and back muscles so your body can provide it’s own  muscular support for the spine. Pilates  exercises with the focus on core stabilization, and functional mobility of the spine in all directions – flexion, extension, side bending, and rotation, and should be considered as a primary care option to assist in improving health and supporting the spine.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases continues to research and learn more about treatments for scoliosis to determine the best modalities for improved health.  I hope in time, that more documented research into the benefits of Pilates for scoliosis will be conducted.

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