Prescribing a brace (a “Cheneau” or “Lyon” brace, for example) is like ordering a piece of furniture (a dresser or a kitchen table, say).
You can choose to go to a master furniture maker (for this, read orthopaedic technician) whose products are always made to order, and who never supplies prefabricated goods (a solution that would be entirely pointless for vertebral deformities).
What is more, the most forward-thinking doctors in this field will specify how many pads the brace must have, where these should be located, and how high the brace should be, and so on (rather as though they were specifying how tall they want the dresser and how many drawers it should have).
But even with this input, the furniture maker still has a considerable margin of discretion.
Braces are not all the same
This is why experts in this field have stipulated, at the international level, that only direct collaboration between a physician and an orthotist is valid, because this is the only way of ensuring that you will end up with a product that exactly matches the patient’s needs.
They also maintain that the two should work together regularly and consult each other about every single case to ensure patients receive the very best product. Having said all this, it is clear that braces are not all the same.
We firmly believe that brace tolerability is a key objective, as is minimal visibility.
Patients need to be able to carry on doing physical activity, sleeping comfortably and moving their arms and legs freely, and all these things depend on how the brace is built.
With some braces, even just sitting at school becomes a problem, and this is entirely unacceptable.
We have stopped using specific models of brace precisely because they are visible, bulky and often painful.
Two examples are the Milwaukee and Cheneau 2000, which cannot be modified to avoid creating difficulties in everyday life.
Braces like this can even cause psychological damage, making them even harder to wear. Because of this, they are often worn incorrectly.
The Sforzesco Brace
We at Isico used to use plaster casting, too. But then, in 2004, we succeeded in developing a brace (the Sforzesco brace) that proved to be just as effective as a traditional plaster cast, but with fewer side effects, allowing patients to maintain an excellent quality of life.
These positive results are confirmed in formal studies published in major international scientific journals.
In short, a properly constructed brace:
– should not cause pain, at most only some mild discomfort for the first few days, which should then disappear completely;
– should not interfere with the patient’s sleep, which, after the first few nights, should be peaceful and trouble-free (at the end of the treatment, our patients initially struggle to sleep without their brace on!);
– should be easily concealed under clothing. This is an aspect (sometimes wrongly considered to be of secondary importance) that should always be carefully checked, both by the orthotist who builds the brace and by the physician who performs the final check before giving it to the patient.
With a well-constructed brace your daily life will carry on pretty much as usual. Naturally, you will encounter a few added difficulties, but you should be able to go to school, do sport and enjoy your free time quite normally.
The important thing is to accept the brace, wear it in the prescribed manner, and carry on living a normal life. It is crucial to try and continue doing all the things you did before starting to wear the brace.
It is a demanding therapy, but it doesn’t have to affect your life too much.