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Changing schools when you wear a brace

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Every year, when the beginning of school comes round, we get asked the same question: “I’m changing school. I’m going to have new classmates and teachers. How should I tell them that I wear a brace?”

Well, the best thing is probably to start by telling the student who sits next to you, and then gradually tell the others. Don’t forget, it’s only a treatment, just like braces to treat teeth or glasses for eye problems.

It can be stressful trying to hide, and there’s absolutely no reason why you should! If your brace is well made it shouldn’t be noticeable under your clothes, although obviously if someone tries to tickle you or give you a hug, then they are going to feel your “shell”.  

Tell your friends about it: some of them might be a bit curious to begin with, others will want to help you with your backpack, and you will probably get teased a bit, but if you treat it as something quite normal then they will soon do the same!

It’s important to think carefully about what to wear for your first days at school. It’s best to choose clothes that make you feel good, and make sure you “wear” a big smile, too. Because even though a new school, like all new experiences, can be a bit scary, it will be exciting and interesting too!

What about those who tease you about your brace? Some classmates will tease you in a nice way, and if that’s the case, there’s no need to get offended. Of course, we all know that there can be some rather stupid people in this world, and wearing a brace is one way of working out who they are. Once you know, you will also know not to take any notice of them.

In fact, wearing a brace is a great way of learning not to care about how others may judge you. It will help you to make sure you only spend time with real friends, those who you know you can always count on! Unfortunately, nothing comes easy in life, and making friends takes time and effort, but you have to be prepared to persevere in order to see the results, just like with your brace!

The people who stick up for you and support you when things are tough are your real friends. As for the rest, take no notice of them. They are just people you happen to know!  

ISYQOL: the international version

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With a pathology such as scoliosis that requires demanding treatment, at Isico we have known for years how fundamental it is to establish a relationship of trust with the patient and to have him adhere to the therapy, ensuring the possibility of a good quality of life in a brace. For this reason, years ago, a questionnaire was developed where our patients could express their assessment of the impact of wearing a brace on their daily lives.
From these questionnaires, the next step was to develop an online model made available to everyone, where, in ten questions, the patient himself evaluates his own well-being with regard to spinal pathologies (kyphosis, scoliosis, or other).
This is how the ISYQOL (Italian Spine Youth Quality of Life) questionnaire was born, which is based on the concerns expressed by patients and has proven to be particularly appropriate in patients with adolescent idiopathic scoliosis (AIS) who have not been treated surgically. 

In recent years, several studies have been published with adaptations and validations of the original Italian version in different languages. 
The latest revision is an international version published recently in the European Journal of Physical and Rehabilitation Medicine, a “Cross-cultural Validation of the Questionnaire: The ISYQOL International”.
The ISYQOL Italian version was translated into six languages using the forward-backwards procedure. The conceptual equivalence of the items’ content was verified, and any inconsistency was resolved by consensus. Finally, patients were asked to complete the ISYQOL before their consultation or treatment session without external help and without being influenced by their parents.
This work aims to assess the ability of ISYQOL to provide an accurate, cross-culturally equivalent measure of the quality of life for young people with idiopathic scoliosis from seven different cultures and languages (i.e. Canadian English, Canadian French, Greek, Italian, Polish, Spanish, and Turkish).
After this last revision, the questionnaire is now available in many languages. In addition to Italian and English, we have Chinese, Polish, Korean, Arabic, Persian, French, Spanish, and Greek versions.

A brace? Nothing to fear!

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Unfortunately, scoliosis has to be treated in adolescence, which is already a very tricky and delicate phase in which youngsters often feel torn between wanting to be independent and wanting to fit in and belong.
We have all been through it and know how difficult this period of growing up can be. It’s not easy being the parent of an adolescent either. Sometimes we struggle to understand our children’s problems as they seem so far removed from our own. We might also struggle because we would like to be able to solve all their problems for them. This particular challenge, though, is one they need to overcome by themselves. What we, as adults, can do is be supportive, helping them to think things through and analyse situations, being careful never to minimise their problems or difficulties. 
For adolescents, it is very important to feel part of a group, and so anything that makes them feel “different” is scary. Years ago, youngsters worried about wearing braces on their teeth for this very reason, whereas nowadays so many have orthodontic treatment that no one bats an eye.   

Friendships are also important for teenagers, who will open up to one another, sharing their problems, feelings, insecurities and worries. True friends are the ones who support their brace-wearing peer (helping them to accept the device as a part of their daily life), and certainly not those who mock or tease another person for a health problem.

Also, as we all know, whenever we have what we consider to be a defect or flaw, we tend to see it as a far bigger problem than it really is. If, for example, we have a pimple on our face, however tiny, we become convinced that it’s the only thing everyone else notices about us!
In the same way, for some patients, a brace peeping out from under a t-shirt is an absolute disaster!
Compared with the braces of the past, today’s ones are made to be almost invisible under a vest or shirt. This is partly thanks to the orthopaedic technician’s skill and expertise and the specialist doctor who chooses the model. 

Over the years, we have seen that our patients can do seemingly impossible things with their brace on. Just take a look at the photos and videos published on our website, www.concorsetto.it, where you can find patients offering tips on how to conceal a brace under clothes, and others who do dance shows, go to the mountains or seaside, or do sport in their brace (even athletics, skiing and gymnastics).
Seeing other brace-wearing youngsters who have accepted the need to treat their condition and managed to deal with the situation in a positive way helps to normalise the whole experience!  Indeed, the key, basically, is to try and focus not on the inconvenience of a brace, but rather on the fact that spinal disorders have to be treated in order to prevent problems from arising in adulthood. It’s far better to pour your energies into fighting your scoliosis, rather than your brace. While you can’t change your brace, you can change your perception of it and how you approach it! In some cases, a patient might find it useful to talk to an expert, such as a psychologist, in order to overcome any difficulties in accepting the treatment.

Recently, one young patient even sent us a photo showing the rock band Måneskin wearing corsets, which are not so different, in the end, from braces! Who knows, this could be the start of a new trend!
The last thing to remember is to take things step by step. Start by telling just a few close friends that you have started wearing a brace. That way, later on, with their help perhaps, you should find it easier to talk about it with others. Also, give yourself time to get used to it, as it is a whole new thing for you. In this way, slowly but surely, you will soon find you are getting on OK with your initially unwelcome new “friend”!

Why the therapeutic team is part of the treatment

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Scoliosis treatment, whether we are talking about exercises alone or also bracing, can be an uphill battle in which adherence to the therapy itself is always fundamental. 

“A famous study conducted in the US and published in 2013 (Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med. 2013 Oct.) confirmed beyond doubt the effectiveness of brace therapy in arresting the evolution of idiopathic scoliosis. And the patient’s adherence to the treatment was the factor that most influenced the result,” underlines physiotherapist Alessandra Negrini.

To ensure that a youngster manages to be collaborative in carrying out this demanding therapy, especially considering that it is often undertaken during early adolescence which is a notoriously tricky time, it is essential that all those interacting with the patient and with their family make sure they are always on the same page, giving clear and consistent messages.

With this in mind, it is easy to see why the therapeutic team, by encouraging patient compliance, plays such an important role in achieving the goals set.

Educating children and parents means explaining the nature of the disease, together with its possible course and potential consequences, setting and explaining realistic therapeutic objectives and rules to follow while performing physical (including home-based) exercises, and ensuring that there is cooperation with the physiotherapist and physician supervising the treatment. Specific physiotherapeutic exercises should be conducted by a trained and certified physiotherapist operating within a therapeutic team that includes a psychologist, orthotist, orthopaedist, and medical rehabilitation specialist.  

The team that takes on the patient’s care needs to manage to lighten the burden of the treatment, and help the patient and their family to cope with the situation. 

Within the multidisciplinary team, the physiotherapist is the patient’s point of reference, the one who motivates and, when necessary, re-motivates them. The physiotherapist is also the linchpin of the team itself.

 “In view of this important role, the physiotherapist should always bear in mind three key rules that I always think of (in Italian) as the 3 As, explains physiotherapist Marta Tavernaro. The first “A” stands for addestrare (coaching), which reminds me of the need to explain to patients what is happening to them, what scoliosis actually means, and how we and they can prevent it from getting worse. The second “A” stands for approccio (approach), which in this case means being enthusiastic about what we are doing and conveying this to the patient; the third “A”, both in Italian and English, stands for “acquire”, in the sense of collecting the information you need to know whether the youngster in your care has been working effectively.”

During the rehabilitation process, the therapist may become aware of specific problems concerning the family and/or the young person that could jeopardise the treatment. The psychologist is the team member ideally placed to manage these difficulties.

In this regard, it is important to remember that this course of treatment is followed in what is already a difficult and delicate life stage, characterised by sudden changes that influence the young person’s developing personality and how they view their role in society: all of this can have important repercussions on the therapy.

“When we are working within a biopsychosocial model of care, we must of course also keep the psychological aspects in mind,” points out ISICO psychologist Dr Irene Ferrario. “In this case, adopting a person-centred approach means not only measuring the individual patient’s Cobb angle, but also taking into account their emotions and feelings at this particular time in their life. When the doctor or therapist senses that there is an underlying problem, they seek the intervention of the psychologist on the team, who, through individual counselling or psychotherapy, will probe and identify the factors responsible for the change.”

An ISICO study published a few years ago (Importance of team to increase compliance in adolescent spinal deformities brace treatment: a cross-sectional study of two different settings) highlighted the role of the therapeutic team. As pointed out by one of the authors, ISICO physiatrist Dr Andrea Zonta, “the concept of compliance has to be understood in a broad sense, and therefore as adherence not so much to the use of the brace or the prescribed programme of exercises, as to the entire therapeutic pathway, which can last years. After all, we will not obtain lasting results if we think we can intensify the exercises for a certain amount of time and then just abandon them”.
In our research, the population was split into two groups according to the setting in which the treatment was performed and the two groups were administered two questionnaires: the SRS-22 [3, 4], and another, specially developed, one (QT) with 25 multiple choice questions about adherence to treatment (sections: brace, exercises, team).In fact, since the population was chosen as having been treated by the same orthotist and physician, the only distinction between the two populations was in the physiotherapeutic and general team approach.

“If the therapeutic team is not working properly, and I refer particularly to the professionals involved, there is a great risk of pain and decreased QoL. The same is true with regard to compliance with bracing” concludes Dr Zonta. “Moreover, this study has shown that the SOSORT management criteria can be important for brace treatment. The results seem to confirm that the management of patients is sometimes neglected, probably because it is an aspect not understood or perceived by the people involved; nevertheless, effective patient management could (through increased compliance) be a main determinant of the final results and/or the patient’s immediate QoL”.

Why we at ISICO “talk in front of the children”: the importance of patient participation

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Although “talking in front of the children” is a deliberate “policy choice” on the part of our organisation, we are sometimes criticised for it in quality assessment questionnaires. Some parents, for various reasons, like to have a separate consultation with us, either before or after seeing the patient, but as doctors and therapists, this request always makes us uncomfortable. Let us explain why.

Scoliosis treatment, whether we are talking about boring exercises, a bulky brace, or even a delicate and risky surgical operation, is always invasive to some degree. Therefore it is crucial to ensure we have the patient’s conscious and willing participation. After all, exercises must be done actively and carefully, a brace must be worn, and kept tightly fastened, for many hours at a time, sometimes even round the clock, and the surgical option is invasive and painful and also has permanent consequences.

How many of us would be willing even to consider undertaking an invasive treatment without first understanding why we need it and what the implications are if we do (or don’t) go ahead with it, and above all without being sufficiently motivated? What’s more, with scoliosis, there is also another consideration.

Whenever scoliosis occurs, the worst stage is always during adolescence. This is the period in our life when our personality is formed and when, as individuals, we distinguish ourselves from our parents, who remain key figures in our lives but from whom, to a greater or lesser degree, we need to break away.

It is when the first parent-child conflicts arise, usually with the parent of the same sex, and sometimes with both. It is the moment we really discover our own body and the other sex, a period more or less marked by hormonal impulses.

Youngsters of this age will usually be very resistant to anything concerning them that is done or decided without their consent or involvement: in this particular case, we are talking about an aspect of their health, about their body (with which they may already have a tricky relationship, and what more personal and private aspect of life can there be than our body?), and about a treatment that always difficult and invasive to some degree.  

A further element in all this is the therapeutic alliance that is formed between the doctor and the patient, often with the mediation of parents, but never without involving the patient. If a doctor struggles to talk to the patient directly, perhaps looking the parents in the eyes and only covertly glancing at the patient, pretending to address the adults present, but really directing the conversation at an adolescent who is pretending not to hear, then the whole patient-doctor relationship, the crucial basis of any therapeutic alliance, will fail. And if this alliance cannot be formed, then nothing can be achieved.

In establishing the therapeutic alliance, it is necessary to set out the sacrifices involved, perhaps trying to sweeten the pill a little to reach the required agreement. And this agreement must be between two people: the doctor and the patient.

I, too, am a parent, and I well understand the importance we parents attach to our children’s wellbeing.
I would love to spare them life’s difficulties, but I know that the key thing, instead, is to prepare them to face them.

I know that the main thing is to ensure they find the right help so that they can face difficulties head-on rather than just endure them. Because what matters in life, even more than the result, is how we deal with things along the way: we all know that you can’t win all of the time, but if you give up before you even start, you will never win at all. Illness, especially one that occurs early on, when a young person is still growing, is undoubtedly a tough test, but, despite themselves, youngsters can find it becomes a formidable tool allowing them to grow with a balanced mindset, able to recognise the importance of external help and to find, deep inside themselves, the resources they need to cope with the treatment they need.

We, parents, are often the first to underestimate just how strong our children can be. We try to protect them, thinking we’re helping them, when our job is not to stand in for them but rather to make them independent, able to take flight by themselves and face any difficulties they may encounter. We need to be willing to let our children and teens amaze us, which means we must stop continually thinking that they are too small to understand (the Little Prince said the same thing!).

Secrets, above all, are to be avoided in this setting, and the patient will always interpret any private meetings between the doctor and the parents as “secrets” being discussed behind their backs.

And what about younger children? In scoliosis treatment, as in other settings, today’s children are tomorrow’s adolescents, and building a relationship with an adolescent should start in childhood. And we can assure you that children are just as attentive as teenagers are, even though their tranquillity and peace of mind will depend on their parents achieving and conveying the same.
Sometimes it is the children who would instead escape from the situation and leave their parents to gather all the information about the treatment they face. Still, such children tend to be already fearful, anxious and distressed, which makes it even more important to reassure them and involve them. Not in an aggressive or overbearing way, of course, but always bearing in mind and respecting their inner pain. And the parents’ role is crucial in all of this.

In short, there can be no going behind our young patients’ backs: to do so is wrong and counterproductive, as it undermines the relationship that must be formed with the person at the centre of the treatment: the patient. Talking openly demands care and sensitivity, and we always remember this and routinely show both to whoever seeks our help. We weigh our words carefully, especially considering the most delicate participant in our discussions: the patient.
Over the years, we have learned that a good patient can overcome the disadvantage of absent parents, whereas no parent, however good they are, can ever make up for the absence of the patient, who is the true and only protagonist of scoliosis treatment.

First night in a brace? Stick with it! 

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For some young scoliosis patients, there is a particular watershed they have to face, one of those moments that separate the ‘before’ from the ‘after’. I am talking about the start of bracing therapy.
It isn’t always easy to get used to a brace, and difficult as it may seem wearing it during the day, that is nothing compared with what it is like trying to wear it at night.
When a patient goes to bed in a brace for the first time, it feels like there’s an unwelcome extra person in the bed with whom they are forced to share their mattress (whose softness and comfort they had never really appreciated, until now!).
The first night will be the hardest and the longest, but providing the patient manages to put up with the brace and resist the temptation to take it off, the second night will be easier, not least because they will be ready to catch up on the previous night’s missed sleep. After that, they will stop noticing the brace.
To begin with it’s quite normal to spend the night tossing and turning, trying to lie on your front, then your back, then on one side and then the other, before starting round again. The first minutes will drag and feel like hours and sleep will seem completely out of reach. 

On top of these initial difficulties, the unluckiest patients, meaning those who start their treatment in the summer, will also have to deal with heat and sweatiness, but these problems are not insurmountable.
Obviously, if the new brace wearer is going to have a sleepless night, it is only fair that the rest of the family endure one too! And if there seems to be absolutely no way to get some rest, it might be an idea to spend some time chatting or playing together to pass the time. If, in the dead of night, the patient still hasn’t managed to fall asleep, the temptation to take off the brace and fling it aside will be great, but they must stick with it, because at a certain point, the position that currently feels impossibly uncomfortable will gradually start to feel more sustainable. And, eventually, sleep will come, finally showing the patient the best position, for them, in which to sleep.

Two Isico patients among the final selection for Miss Italia

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We present two young women who hope to be chosen in the next Miss Italia contest finals as “the fairest of them all”. Lavinia and Cecilia, as well as being beautiful girls who have reached the final of Miss Italia, also have another thing in common: both have had to overcome many hurdles from a very young age, when they were diagnosed with curvature of the spine at our centre and had to embark on a lengthy course of bracing treatment. Looking at their smiling faces today, it is hard to imagine the struggle of those long years spent “braced up” and the determination they had to show in order to get where they are now. 

We spoke to both girls just after they won their place in the final. We were keen to know how Miss Lazio (Lavinia) and Miss Umbria (Cecilia) felt. 

Cecilia, 22, wore a brace for nine years, while Lavinia, 18, is still undergoing treatment that began five years ago when she was diagnosed with a 53° scoliosis curve. This has since been reduced to 35°. 

For both of them, their treatment, from the outset, involved wearing a brace for most of the day: “I had just turned 12 when it all began” Cecilia recalls. “I found it really hard to accept that I would have to spend years encased in plastic. Daily life was a real struggle and I well remember how upset I got every day, because I felt so awkward and stiff inside that kind of case. I remember the tight belts and the sound of the Velcro being pulled open when I took the brace off. I remember the sore patches and how anxious I was that I wouldn’t be loved or accepted in my new “shell” and wouldn’t receive all the attention, affection and hugs I had before. And yet, if it weren’t for my brace and all the self-correction exercises I did, I wouldn’t be the girl I am today”.

As for Lavinia, she turned to us in the hope of being able to avoid surgery for her scoliosis: “Of all the spine centres I consulted, Isico was the only one willing to try bracing treatment, despite the severity of my curve. I have to admit that those were difficult years for me, but I never stopped doing the things I love, like dancing, singing and going out with friends. Thanks to Isico and also to my own determination, I have made a considerable improvement. My curve has been reduced by almost 20°, and even though I don’t have a perfectly straight back, I have learned to love and accept my body the way it is.” 

Both girls firmly believe nothing can stop you from doing what you want and dream of doing. Obviously, you have to show loads of determination and perseverance, the two qualities that have enabled them to win places in the final of Miss Italia and, above all, get through years of treatment, during which they learned to treat their brace as that “friend” you love to hate, who has been by their side throughout their journey and helped them to become stronger people. “There will always be times when you don’t like yourself, with or without your brace, and if you happen to come across someone who doesn’t accept you because of it, you need to remember that it certainly isn’t your fault” Lavinia goes on. “This competition has shown me beyond doubt that my back hasn’t affected my appearance, and that it has actually made me more self-confident!”.

Because, in the end, a brace is also an ally. Both girls stress that “if you are patient, you will get results” and that a limitation, in this case in the form of a tricky condition like scoliosis, can turn out to be an unexpected opportunity: “We must all learn to love ourselves, have the courage to rise to the challenge, and fight prejudice without letting go of our dreams” Cecilia says. “I would like to be a voice encouraging acceptance of our limitations, because in an inclusive world we need to show ourselves the way we are and draw attention to the sacrifices that have made us strong. It is like we are all on a river in full flow and our brace is the boat that can help us make it to the open sea, where new lands and new horizons are just waiting to be explored”.  

This isn’t the first time we have had Miss Italia finalists; it is simply the first time we have had two together. “And it won’t be the last!” says Prof. Stefano Negrini, scientific director of Isico. “I am starting to wonder whether this phenomenon might be linked to the determination that people who face the difficulties in life manage to acquire in part thanks to the help of those around them. The effort you have to put in with a brace is a major investment in your future that gives fantastic results, also in an aesthetic sense. Could it perhaps be that these girls are keen for the world to see how they are not only because of the beauty Mother Nature has given them, but also because it represents the fruit of years of sacrifice and hard work? I’m not sure if we’ll ever get the answer to this question, but I like to think that there is something in this — that we are able to give our patients not just healthy and attractive backs, but also all the strength, pride and determination they need to fight for their goals. All hugely important values in life. So, well done Cecilia and Lavinia. Whatever the result of the competition, you are already winners!”.

How long before having an X-ray should I remove my brace?

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During bracing for scoliosis, doctors want to see X-rays every 6-12 months in order to check how well the treatment is working and also verify the patient’s growth stage in order, over time, to adapt the prescription accordingly. 

This obviously begs the question: “How long before having an X-ray should I remove my brace?”

Let’s see what the scientific literature has to say. 

According to one study, it takes around 2 hours to reach the maximum correction that can be obtained using a brace; after removing, it the correction obtained is gradually lost over around 2 hours, after which the curve/spine stabilizes (https://pubmed.ncbi.nlm.nih.gov/24859575/). 

Another study suggested that subjects who leave their brace off for longer than they would normally do are more prone to this loss of correction (https://pubmed.ncbi.nlm.nih.gov/18810041). 

Because the patients in these studies were not assessed on the basis of repeat X-rays — it would not be ethical to expose patients to so much radiation —, but rather using other (less reliable) examinations, and the patient samples investigated were small, these data are only able to show a trend, which will need to be confirmed by more robust studies.  

So, what happens when you remove your brace? Does the spine remain corrected? And, if it does, for how long? In other words, when you need to have an X-ray, how long beforehand should you remove your brace?

Given the absence of reliable data to rely on, what we find, if we look at what happens worldwide, is that there exists no universally accepted criterion to guide this choice. This means that doctors can decide according to their own beliefs. Accordingly, some doctors ask their patients to remove their brace up to 2 days before having an X-ray, in order to get, even in those who normally wear it full time, a picture that can be considered to reflect the “real” situation, independent of the effect of the brace. Some instead want their patients to be X-rayed immediately after removing it, while others do not give precise instructions.

In our view, it is important to ensure consistency between X-rays taken in the course of bracing treatment, so that they can be compared and the effects properly understood. For this reason, whatever the doctor decides, it is a good idea to apply the same criterion for all X-rays performed during the treatment.

The approach of our doctors at ISICO is to ask patients to do X-rays after they have been out of their brace for the same number of hours they leave it off in real life. So, if a patient is prescribed 20 hours of brace wearing per day and 4 hours of brace-off time, then they will have their X-ray 4 hours after removing their brace.

Why this choice? Because the ISICO doctor wants an X-ray that shows the “worst” scenario, so as to be able to establish how well the spine is holding up during the hours of freedom and, on this basis, whether the brace-off period needs to be shortened.

There are two ways you can achieve optimal maintenance of the correction and, therefore, good results on follow-up X-rays. The first is to adhere scrupulously to the doctor’s prescription every day, rather than some days keeping the brace on for more hours than prescribed, and others for fewer; this constancy allows gradual and targeted strengthening of the muscles that support the spine. The second is to do specific physical exercises designed to increase your ability to practice self-correction of the spine during your everyday activities. 

If you can do this, you will end up with a kind of natural muscular brace that can be activated as necessary during your brace-off hours. This ability to support the spine can be further enhanced by regular sporting activity. 

In short, while there is no clear answer to the question asked at the start, we have here offered some considerations to help you to interpret your specialist’s requests, and also some tips on how to get good results from your treatment.  

Brace: a drawing on cyberbullying

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The brace accompanied Valentina for five long years: due to a scoliotic curve that in the worst period exceeded 60°; a scoliosis form challenging to be contained but faced with great determination thanks also to the support of a wonderful family. From the parents to her sister, Sofia, who wanted to somehow tell about Valentina’s courage, a few months ago participated in a school project that asked for a drawing on cyberbullying.

“We started from reading a story – Sofia writes – the protagonist Camilla wore a corset and suffered from her condition. I understood that I could best represent what Camilla was feeling because my sister Valentina had worn the brace for almost five years. Of course, Valentina was lucky and has never been bullied, indeed, her friends and companions have always been close to her, but I knew that I could best represent the rebirth one feels in overcoming this difficult path. I then asked my sister if I could take one of her old corsets to draw on it. On the one hand, I decided to draw a group of dark-coloured butterflies to represent the sadness and loneliness you feel when you are bullied, while on the other I have drawn colourful flowers and butterflies to describe the sense of rebirth you feel when overcoming a bad situation, like that of being bullied.
Wearing a corset is not something to be ashamed of or to be made fun of, on the contrary, it helped my sister to grow up and overcome the most difficult moments with courage and strength “.

Can scoliosis get worse while you are waiting for a brace?

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It may happen that between the prescription of a brace and its actual application, some time can elapse, may this be due to bureaucratic issues, issues linked to the orthopaedic shop or simply to personal reasons.

Considering that a brace is prescribed precisely to prevent scoliosis from getting any worse, it is legitimate to wonder what happens while you wait for it to be delivered. Could your scoliosis get worse?

Well, there’s really only one way to find out, which is to have another X-ray taken just before starting to wear your brace. At ISICO, our doctors always ask for a new X-ray whenever, for whatever reason, 3-4 months or more elapse between prescribing and fitting a brace. From these X-rays, we have seen that the condition remains substantially stable in some patients, whereas in others scoliosis worsens by a few degrees. 

Patients going through a growth spurt are at risk of their scoliosis worsening in the space of just a few weeks. 

There is another reason why it is a good idea to have an X-ray not long before receiving the brace: by comparing subsequent X-rays with previous ones, it is possible to assess the effectiveness of the treatment. 

Many specialists, for example, ask their patients to have an X-ray with their brace on quite soon after starting to wear it. By comparing this “brace-on” X-ray with the previous one, they are able to see how the device is working and evaluate how well the patient’s spine is responding to the correction.

So, what can be done to reduce the risk of your curve worsening while you are waiting for your brace to arrive? First of all, you can try and speed up, as far as possible, the bureaucratic process. It is also crucially important to start doing, straight away, your specific self-correction exercises, as these are able to slow down the progression of scoliosis.

Since, for some patients, timely intervention can be crucial in managing the condition, the specialist prescribing the brace will carefully explain what has to be done while waiting for it.