Braces are a nonsurgical treatment option to manage scoliosis. Though scoliosis braces typically treat spine curvature in younger people, adults can also wear them.
Scoliosis affects an estimated
Depending on factors, such as a person’s age and the degree of the curve in their spine, doctors manage scoliosis in one of three ways: observation, surgery, or scoliosis braces.
This article examines scoliosis braces, brace types, how to wear them, and more.
Doctors usually recommend scoliosis braces for children and teens who are still growing and have a spinal curvature greater than 25 degrees.
The main purpose of a brace is to prevent the curve in the spine from worsening as the person grows. Scoliosis braces can also reduce existing curves, although the curve may revert to its previous size once a person discontinues use.
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The review also found that rigid braces were more effective than soft braces.
Scoliosis braces are most effective when the spine is growing, so doctors prescribe them most often for children and adolescents.
A scoliosis brace works by putting pressure on the side of the body where the spinal curve is most pronounced. This prompts the person to stand up straighter to relieve the pressure.
When scoliosis braces are effective, they can often eliminate the need for surgery.
There are several different types of scoliosis braces.
- Cast braces: This type of brace is for infantile idiopathic scoliosis, where people receive a diagnosis between birth and 3 years of age.
- Thoracic-lumbar-sacral orthosis (TLSO): This brace extends from the upper back down to the buttocks.
- Cervical-thoracic-lumbar-sacral orthosis (CTLSO): This braces the spine from the neck down to the buttocks.
Doctors can prescribe braces for full-time or nighttime use. Full-time braces are meant to be worn for 16–23 hours.
| Name | Type | Schedule | Information |
|---|---|---|---|
| Boston brace | TLSO | Full-time | · custom fit · most prescribed · worn under clothing · closes in the back |
| Wilmington brace | TLSO | Full-time | · like a Boston brace, but closes in the front |
| Milwaukee brace | CTLSO | Full-time | · original scoliosis brace · metal structure worn outside the clothing |
| Charleston bending brace | TLSO | Nighttime | · custom fit · provides overcorrection only possible when a person is lying down |
| Providence brace | TLSO | Nighttime | · like the Charleston brace, but uses a different type of correctional force |
Braces for adults vs. teens
Even though the spine has finished growing once a person has reached adulthood, they can still benefit from a scoliosis brace.
One option is to wear a supportive brace part time to reduce back pain.
If an adult has enough flexibility in their spine, they can wear a corrective brace full time, then transition to a supportive part-time brace or no brace.
Each person’s scoliosis brace is correctly fitted by a healthcare specialist called an orthotist.
If the person wearing a brace is growing, the doctor will monitor the brace’s fit and effectiveness every 4–6 months.
Scoliosis braces are more effective the longer a person wears them each day. According to the American Academy of Orthopaedic Surgeons (AAOS), people usually wear daytime braces for 16–23 hours daily.
There are some braces that people wear only while sleeping, but they are not effective for all types of spinal curves.
A doctor can recommend the most beneficial brace type and schedule based on a person’s spinal curve.
A child or adolescent should wear their scoliosis brace until they stop growing. For teens, this is about 2 years, but for younger children, it can be much longer.
Scoliosis braces are most effective if a person wears them as their doctor prescribes.
Many braces have monitors that allow doctors to see the daily usage duration. This tool enables doctors to suggest helpful strategies for people who find it difficult to wear their brace long enough each day.
If a person follows their doctor’s recommended bracing schedule, they may be less likely to need scoliosis surgery in the future.
Scoliosis braces can be uncomfortable in the beginning. Wearing a snug T-shirt underneath the brace can help reduce some discomfort.
A brace shouldn’t cause pain or skin irritation. If it does, this is a sign that it needs adjusting.
Sometimes, children or teens may worry about wearing a new brace to school.
Scoliosis braces are usually easy to conceal with loose-fitting clothing, although it may be easier for a person to talk openly about their brace rather than feel pressured to hide it.
Occasionally, doctors allow a person to remove their brace while participating in activities, such as sports.
It may also be ok to take the occasional short break from wearing a brace, such as for a school dance or a sleepover at a friend’s house.
People under observation with mild scoliosis can benefit from physical therapy (PT).
However, if a doctor has prescribed a scoliosis brace, PT alone is not enough to manage the condition.
PT can supplement the effectiveness of a scoliosis brace. A physical therapist can assess a person’s:
- muscle strength
- posture
- flexibility
They use this information to design an at-home exercise program. This is meant to improve muscle symmetry, increase a person’s awareness of their posture, and stabilize the spine in a more neutral position. This may make wearing the brace easier.
Scoliosis exercise programs can also strengthen a person’s back in preparation for the day they no longer wear their brace.
The cost of a scoliosis brace depends on a person’s insurance coverage.
Without insurance, braces usually range between $5,000-10,000, without considering the cost of doctor’s visits, X-rays, and other necessary procedures.
However, prices for braces may vary depending on:
- size
- style
- materials
- if it has been custom fit
- whether it was custom made
Insurance usually covers braces that doctors deem medically necessary, with a copay of around 20%.
Braces can effectively manage scoliosis by preventing a person’s atypical spinal curvature from worsening. In some people, wearing a scoliosis brace can reduce the size of a curve.
Scoliosis braces have the most impact on people whose spines are still growing. Doctors prescribe scoliosis braces more often to children and teens than to adults.
Braces work better when people wear them more often. In certain situations, wearing a brace only during sleep may be fine. Most of the time, though, a person should wear their scoliosis brace as much as possible.