For children and adolescents who are prescribed a brace to help correct their idiopathic scoliosis, it can be a long road to straightening their curve. Bracing takes commitment and patience, but the end goal is to correct a patient’s curved spine and avoid surgical treatment.
Dr. Michael Glotzbecker, an orthopedic surgeon in the Spinal Program at Boston Children’s Hospital Orthopedics and Sports Medicine Center, and Deborah Cranford, a nurse at Boston Children’s who works closely with scoliosis patients, provide insights and tips on how parents can help their children better manage their scoliosis treatment.
Are there common misconceptions you hear amongst patients and parents dealing with a scoliosis diagnosis?
Glotzbecker: One of the biggest misconceptions is that scoliosis is associated with back pain, so a lot of people get those two diagnoses confused. Idiopathic scoliosis is typically a painless condition, especially since we’re usually able to get to it early and at the very least begin observation, followed by bracing if necessary.
Most patients with idiopathic scoliosis will never need a brace, and even fewer ever need surgery. But for patients that are prescribed a brace, it’s imperative they follow the protocol as closely as possible. And we’re always here to help patients and their parents if they’re struggling.
What are some challenges parents face after their child is diagnosed with idiopathic scoliosis?
Cranford: If they are prescribed a brace to wear — and especially if they need to wear it at school — it can be hard for a lot of teens to stick to the plan. This is usually happening at a time when their bodies are already changing, and you’re adding this on top of it all. It can be overwhelming for a child or adolescent to deal with this change.
Glotzbecker: I think one of the biggest challenges is finding good educational sources. Boston Children’s has great resources online that are useful for parents — like our patient and family guide to scoliosis. The other good starting point for accurate, helpful information online would be well-known scoliosis or pediatric orthopedic society websites.
What are some other critical actions that a patient and their parents can take when it comes to dealing with scoliosis?
Glotzbecker: Compliance with the bracing protocol is clearly the most important thing you can do. Finding ways to motivate your child to wear the brace will be a little different for every family. But the one thing that I have seen and appreciated is that the parents and kids that really own the brace — they tell their friends and family members, they make it a discussion — do better than those that foster this idea that you have to hide it.
I always find it really enlightening when during an appointment a parent will speak up first and say, “Well that’s going to be really hard for them.” If you start off with that opinion, how can you expect your teenage kid that’s going through it to actually comply?
Cranford: It takes the whole family. Everyone needs to believe in bracing because no kid really wants to do it. Parents have to help support their child as much as possible, and it can be really tough. I find that wearing it to school is the biggest inhibitor for them, as they don’t want other kids to know that they have it.
For kids that are in multiple sports, wearing it to school generally gives them the best option to do all of the activities that they want, while also wearing the brace for the amount of time prescribed. Coordinating with the school nurse can be important, as it gives your child somewhere to go when they need help with the brace at school.
Which patients best adhere to their bracing protocol?
Cranford: It really depends on the patient and family, but it’s typically a little bit easier for our younger patients. If a child has juvenile idiopathic scoliosis, bracing is usually easier for them because — in some cases — the brace is almost a cool thing to have and they don’t feel the need to hide it.
Many athletes have success as well, as they may have better time management skills. They know how to balance their brace-wearing time so that they can participate in activities without wearing a brace. Inherently, I think athletes also have a little more self-confidence — but it definitely depends on the individual.
Do athletes struggle to balance their time between wearing the brace and playing sports?
Cranford: We encourage them to be able to do their sports and activities without any restrictions. We recently had a patient who is a professional dancer — dancing 4 to 6 hours after school — who was struggling to get in her brace-wearing time while also participating in gym class at school. We worked with her family and came to the decision to keep her out of gym for the remainder of the school year. This allows her to dance while also completing her bracing. Ultimately, we really don’t want to inhibit any activities, as it’s good for a child’s well-being and self-confidence.
Learn more about the Spinal Program at Boston Children’s.