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Navigating Scoliosis Treatment: From Braces to Surgery and Beyond

Introduction

When you think of scoliosis, what comes to mind? Perhaps a childhood diagnosis or a visibly curved spine. Scoliosis, however, encompasses more than a spinal curvature; it can significantly impact daily life in ways that are often overlooked.

Scoliosis is a medical condition characterized by an abnormal lateral curvature of the spine, often forming an “S” or “C” shape. While the spine typically appears straight when viewed from behind, individuals with scoliosis exhibit a sideways curve that can vary in severity. This condition is most commonly diagnosed in children and adolescents, particularly during growth spurts, but it can affect individuals at any age, including adults.

The impact of scoliosis on daily life ranges from minimal to significant, depending on the degree of curvature and individual circumstances. Those with little curvature may have mild or no pain, while more severe curvatures can lead to chronic back pain, reduced mobility, and visible postural changes such as uneven shoulders or hips. In some instances, severe scoliosis can also affect lung and heart function due to the distortion of the chest cavity.

In children and adolescents, it may lead to noticeable physical changes, while adults might experience chronic pain and functional limitations. Recognizing scoliosis as a progressive condition underscores the importance of early diagnosis and proactive management.

Understanding Scoliosis Progression

The severity of scoliosis is measured using something called the Cobb angle. This number shows how much the spine curves, based on an X-ray. A higher Cobb angle means a more noticeable curve, which helps doctors decide the best treatment approach — whether it’s watching the curve over time, using a brace, or considering surgery.

For many children and teens with moderate scoliosis (typically curves between 25–45 degrees), bracing is the first treatment considered—especially if the spine is still growing.

How Braces Work

Braces don’t reverse scoliosis, but they can prevent the curve from getting worse. By applying consistent external pressure, they guide the spine’s growth and help delay or avoid surgery. There are several brace designs tailored to individual needs, including:

  • TLSO (Thoraco-Lumbo-Sacral Orthosis) – one of the most common.
  • Boston brace – widely used and customizable.
  • Rigo-Cheneau brace – designed for three-dimensional correction.
  • Providence/nighttime brace – worn only at night for certain curve types.

Bracing typically requires daily wear for up to 18–23 hours, depending on the treatment plan. While some physical activities may be restricted, many kids continue sports and daily routines. Bracing usually ends once skeletal growth stops. Studies show that bracing can be effective in slowing or halting curve progression in many cases. However, it does have limitations—it requires consistent use and doesn’t work equally for everyone.

Surgical Options for Scoliosis

Surgery is generally recommended when the curve is greater than 50 degrees, if there’s rapid progression, or if bracing has failed to stop worsening the curve. Common surgical procedures include the following:

  • Spinal Fusion: This is the most common scoliosis surgery. It involves fusing two or more vertebrae together using rods, screws, and bone grafts to stabilize the spine and prevent further curvature. Recovery can take several months but typically results in significant improvement.
  • Growing Rods & Vertebral Body Tethering (VBT): These are used for younger patients whose spines are still growing. Growing rods are periodically lengthened to keep up with the child’s growth, while VBT uses a flexible cord to guide the spine’s growth without fusion.
  • Minimally Invasive and Fusionless Procedures: Emerging options are being developed, offering smaller incisions, faster recovery, and the possibility of preserving more spinal flexibility.

While surgery often leads to lasting improvement in spinal alignment and quality of life, it carries risks like infection, hardware issues, and nerve damage. A thorough discussion with your surgeon is critical to understanding your specific risks and expected outcomes.

Beyond Braces and Surgery: Additional and Supportive Treatments

Scoliosis care doesn’t end with braces or surgery — many patients find relief and support through complementary treatments such as physical therapy to improve posture and reduce pain, pain management strategies like medications or bracing (especially for adults), and lifestyle adjustments including low-impact exercise, stretching, or mindful movement like yoga or Pilates. Some also explore alternative therapies like chiropractic care or acupuncture, which may offer symptom relief when used responsibly alongside medical treatment, though evidence for their effectiveness is limited.

Living with Scoliosis: What Patients Should Know

Scoliosis is a lifelong condition, but with regular check-ups, a strong support system, and care for both body and mind, many people—especially teens—can stay active, build confidence, and enjoy a full and rewarding life.

Conclusion

There is no one-size-fits-all treatment for scoliosis. Every spine is different—and so is every patient. It is key to have individualized care that takes into account your needs, goals, and stage of life. From bracing to surgery and supportive therapies, understanding available treatment can empower you to evaluate options and choose the best one for you. If you or a loved one has been diagnosed with scoliosis, don’t wait. Early evaluation leads to better outcomes.

To learn more or find care; schedule an appointment online or call 608.234.7436.

 

Sit at a Desk? 5 Tips to Prevent Neck & Back Pain at Work, School or Home

Spending long hours at a desk can strain your body and lead to orthopedic issues if your workspace isn’t set up correctly. Studies have shown that poor posture at work is linked to a significant increase in the likelihood of experiencing musculoskeletal disorders.  

For example, research indicates that individuals who maintain poor posture while working are 40% more likely to visit a doctor for musculoskeletal pain compared to those who practice good posture. This highlights the importance of ergonomic practices in reducing the risk of work-related injuries and improving overall health. 

To stay comfortable and reduce the risk of injury, follow these five essential tips:

Invest in an Ergonomic Chair and Footrest

A high-quality ergonomic chair is crucial for maintaining orthopedic health. Choose a chair that provides adequate lumbar support and allows for proper alignment of your spine. Ensure that your chair is adjustable so you can set it to the right height, allowing your feet to rest flat on the floor and your knees to be at a 90-degree angle.  

Additionally, consider using a footrest to further enhance your comfort and support, particularly if your chair’s height cannot be perfectly adjusted for your leg length. A footrest helps keep your feet supported and your posture aligned, reducing strain on your lower back and legs.

Keyboard and Monitor Adjustments

Proper placement of your keyboard and monitor is key to preventing strain. Position your monitor so that the top of the screen is at or slightly below eye level, which helps maintain a neutral neck position. The monitor should be about an arm’s length away to reduce eye strain. For your keyboard, use a stand to keep it at a comfortable height where your wrists remain in a neutral position while typing.  

Incorporate a wrist rest to provide extra support and cushioning. Additionally, follow the 20-20-20 rule: every 20 minutes, look away from your screen and focus on something at least 20 feet away for at least 20 seconds to reduce eye fatigue.

Consider Wrist Support

Wrist support is crucial for reducing strain and preventing repetitive stress injuries such as carpal tunnel syndrome. When typing, ensure that your wrists are in a neutral position to avoid unnecessary pressure on your joints. Investing in a keyboard wrist rest pad can provide the cushioning and support needed to keep your wrists aligned properly, reducing the risk of discomfort and long-term injury.

Maintain Good Posture and Lumbar Support

Practicing good posture is essential for preventing orthopedic issues. Sit back in your chair with your back straight and shoulders relaxed, using the chair’s backrest for support. For added comfort and support, consider using a lumbar support pillow to better align your lower back.

Go for a Walk and Stretch at Your Desk

Use your breaks to take a short walk, whether around the office or outside, to improve circulation and reduce stiffness. Additionally, incorporate desk stretches like seated spinal twists and hamstring stretches to alleviate muscle tension without leaving your workspace. Regular breaks to stand, stretch, and move can help prevent stiffness and discomfort from prolonged sitting, keeping your muscles flexible and reducing tension throughout the day. 

By integrating these five tips into your daily routine, you can enhance your comfort and protect your orthopedic health while working at your desk. Investing in an ergonomic chair, making proper keyboard and monitor adjustments, incorporating regular movement and stretching, maintaining good posture, and staying hydrated are all crucial for creating a healthier and more comfortable workspace.   

Additionally, stay hydrated by drinking plenty of water, as proper hydration supports muscle function and overall well-being. Don’t forget that getting adequate rest each night is also essential for overall well-being and managing orthopedic issues. 

Observing National Spine Health Awareness Month – Your Backbone for a Healthy Life

National Spine Health Awareness Month

National Spine Health Awareness Month

The month of October makes most people think of pumpkin spice lattes, vibrant leaves, and Halloween costumes. But here at Southeast Orthopedic Specialists, we have something else we keep an eye out for, too, because it’s also the time of year known as National Spine Health Awareness Month. That’s right, a full month dedicated to those 33 amazing bones that literally “have your back” every day.

Why Spine Health Matters

Your spine is the unsung hero of your body since it supports your weight and allows you to bend and twist. It also protects the spinal cord – the super information highway of your nervous system.  it plays such a central role in our daily lives; we often take spine health for granted until something goes wrong.

Did you know that back pain is the leading single cause of disability globally? In the United States, approximately 65 million adults reported a recent episode of back pain. That’s larger than the population of California and Texas combined! Most astonishingly, about 16 million adults experience back pain that is persistent or chronic, limiting every-day activity.

These figures detail why National Spine Health Awareness Month is so crucial. This is the time to educate ourselves about spine health and what measures we can take to look after our backs.

Know Your Spine

Your spine is built for strength and durability, comprising 33 vertebrae, which are divided into five regions. These include:

  1. Cervical- Neck- 7 vertebrae
  2. Thoracic- Upper Back- 12 vertebrae
  3. Lumbar (lower back): 5 vertebrae
  4. Sacral: 5 fused vertebrae
  5. Coccygeal: 4 fused vertebrae (tailbone)

Between each vertebra are shock-absorbing discs that allow for flexibility and movement. This complex structure works in tandem to keep you up straight and moving throughout your day.

Common Spine Conditions and Their Impact

At Southeast Orthopedic Specialists, we see it all when it comes to spine conditions. Some of the most common include:

  1. Herniated Discs: This includes the condition when the soft inner material of the disc bulges out through some crack in the tougher exterior. This can irritate nearby nerves and may cause severe pain, numbness, or weakness in an arm or leg.
  2. Spinal Stenosis: Narrowing in the spaces inside your spine can put pressure on the nerves that travel through the spine. This commonly occurs in the lower back and the neck.
  3. Scoliosis: A sideways curve in the direction of the spine, usually occurring during childhood; very severe cases can be disabling. However, most people only have mild varieties and often manage.
  4. Osteoarthritis: With increasing age, cartilage that cushions bones in the spine may break down and result in pain and stiffness.
  5. Sciatica: Pain radiating along the path of your sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg.

These conditions have a huge impact on the quality of life. In fact, a study from the Global Burden of Disease reported that low back pain is the leading cause of disability. But there is good news- many conditions of the spine can be prevented or well managed with good care and early intervention.

Celebrating Your Spine: Tips for Spine Health

This National Spine Health Awareness Month, take some time to appreciate what your spine has been able to do for you. The following are a few tips for maintaining a healthy back:

  1. Stay Active: Regular exercise, especially those that are low impact such as walking, swimming, and yoga, can strengthen the muscles that support the spine.
  2. Maintain Good Posture: Good posture at work, such as sitting or lifting heavy objects, prevents unnecessary strain on the spine.
  3. Perform regular stretching: It reduces the risk of injury while improving your range of motion.
  4. Eat healthy: Engage in a diet loaded with calcium and vitamin D because they support your bones, including your spine.
  5. Get enough sleep: Your spine needs to rest, too. Make sure you get enough sleep on a supportive mattress.
  6. Manage Stress: A high degree of stress tends to create muscle tension, particularly in the neck and back. Practice deep breathing or meditation.
  7. Stop Smoking: Smoking restricts blood flow to the spine, accelerating disk deterioration.
  8. Keep Hydrated: Adequate intake of water maintains the soft tissue elasticity along your spine.

Southeast Orthopedic Specialists Commitment to Spine Health

At Southeast Orthopedic Specialists, we believe in taking care of our patients for optimal spine health. Our team of experienced orthopedic specialists offers a comprehensive range of treatments, from conservative management to the most up-to-date surgical techniques if indicated.

Patient-centered practice: We believe in working hand in glove with the individual to come up with a treatment plan unique for each. Our focus is not just to treat symptoms but also to get to the root cause of spine issues and equip our patients with the knowledge and tools they need to ensure long-term spine health.

Remember, your spine has been supporting you day in and day out, and now is your chance to return the favor. Here at Southeast Orthopedic Specialists, our place is to act as a backbone in helping you achieve and maintain optimal spine health.

Even though National Spine Health Awareness Month only happens in October, spine health should really be all year round. If you take good care of your spine today, you’re investing in a healthier, more active future. Here’s to standing tall and living well!

References

Institute for Health Metrics and Evaluation (IHME). (n.d.). Global Burden of Disease (GBD) research. Retrieved October 1, 2024, from https://www.healthdata.org/research-analysis/gbd

 

                                                                        (Photo Credit – Adobe)

Causes & Treatment Options for Sciatica

Pain that starts in the lower back and radiates down the back of the leg is what is commonly referred to as sciatica. The pain follows the path of the sciatic nerve down the leg which means that typically, only one side of the body is affected. The sensation that those with sciatica experience varies from one person to the next. While some people feel a sharp, shooting pain, others describe a dull pain. The pain that you experience from sciatica is caused by irritation, inflammation, pinching or compression of a nerve in the lower back.

Sciatica is a common complaint among Americans and according to Harvard Medical School, about 40% of people in the U.S have reported having sciatica sometime in their life. Sciatica can be caused by a plethora of spinal conditions, some of the most common are listed below:

  • A Herniated Disc. This is the most common cause of sciatica and occurs when the discs that are found between the vertebrae undergo trauma or damage and the gel-like center of the disc begins to herniate through the outer wall. The herniation causes irritation and inflammation of the sciatic nerve.
  • Degenerative Disc Disease. This is a condition where the discs found begin to thin and weaken over time which results in reduced space between the vertebrae. When the space is reduced, the sciatic nerve can become impinged.
  • Spinal Stenosis. This occurs when the spaces that surround the spinal cords begin to narrow. This abnormal narrowing can pinch the sciatic nerve roots as they leave the spine resulting in sciatica.
  • A spinal condition that affects the lumbar vertebrae, spondylolisthesis is a disease that causes a lower vertebra to slip forward over the vertebrae directly beneath it. The change in vertebral positioning can cause impingement or irritation of the sciatic nerve.
  • Facet Joint Arthritis. Lumbar osteoarthritis is degenerative arthritis in the low back that causes pain, stiffness and inflammation in the facet joints of the vertebrae. There are two facet joints on the back of each vertebra that connect the bones of the spine. Wear and tear on facet joints on the lower spine cause the cartilage between the joints to break down and causes inflammation and sciatica.

Ultimately, when you have sciatica the goal is to decrease your discomfort and increase your mobility by reducing pressure on the sciatic nerve. In most cases, time and treatment are successful in resolving sciatica pain. According to Mayo Clinic, about 90 to 95% of the time, sciatica cases will be resolved with time and non-surgical treatments. However, if your symptoms persist despite all efforts, surgery might be considered. Oftentimes, surgery is considered for those whose leg pain or weakness is persistent after methods of non-surgical options are unsuccessful. Your physician will ultimately tell you the best solution for your specific needs.

  • Physical Therapy. Physical Therapy can be an excellent option to treat sciatica because it involves stretching that improves your flexibility and strengthens the muscles of your core and lower back. In addition to going to see a Physical Therapist, staying active can also ease your sciatica symptoms.
  • Corticosteroid Injections. This treatment option delivers medication directly to the sciatic nerve via an injection. Corticosteroid injections are often a temporary solution that can provide weeks or months of pain relief.
  • This is a common minimally invasive surgical procedure when sciatica is caused by a large disc herniation. In a microdiscectomy, the surgeon removes the small part of disc material that is compressing the sciatic nerve.

If you find yourself experiencing sciatica symptoms, it is important to stay as active as possible and try to introduce some conservative methods of pain relief. Sometimes, conservative options don’t give you immediate relief, especially if your pain is caused by an irritation of the sciatic nerve. This is when it is best to allow your physician to offer you more aggressive methods of pain relief for your sciatica.

Non-Surgical Treatment Options for a Herniated Disc

The spine consists of 26 bones called vertebrae and between them are cushion-like pads called “intervertebral discs”. The discs serve as shock absorbers for the vertebrae and help provide stability to the spine. When one of these intervertebral discs loses its normal shape or consistency and begins to bulge into the spinal canal, it is referred to as a bulging disc. Over time, the gel-like material that is found inside of the disc can rupture and come in contact with the spinal canal or spinal nerves and cause pain and weakness. This is what is commonly known as a herniated disc.

The two most common ways that a disc can become herniated is the natural degeneration of the disc or through trauma. Sometimes, a herniated disc goes unnoticed as it can cause few to no symptoms. Other times, patients will not have symptoms in their neck or lower back but rather in their shoulders, hands, legs or feet, which will lead them to seek treatment related to the extremities. Finding yourself with a herniated disc does not mean you have to have a surgical procedure. For those with a herniated disc in the neck or lower back, there are several non-surgical options available.

Medication

When it comes to relieving mild to moderate pain, several different medications can help. There are also a variety of medications that a physician can prescribe to you that are stronger such as muscle relaxants or steroids. Remember, over-the-counter medications only mask the pain from your herniated discs, so it is important to consult with your physician to fully relieve your discomfort. You should also read the medication label and speak with a pharmacist to determine if it is safe to take anti-inflammatories.

Injections

If there is little to no improvement from oral medications, a physician might recommend cortisone injections as an alternative solution. A Corticosteroid injection can reduce inflammation around an irritated nerve, but it will not reduce the actual size of the herniated disc. The injected medications may include steroids, local anesthetics or saline. The goal of an injection is to numb the irritated nerves which will ultimately relieve the pain symptoms. Injections go straight to the area of injury to deliver the pain-reducing medication to your spine.

Physical Therapy

Physical therapy may be able to combat some of the painful symptoms associated with a herniated disc. With this injury, a Physical Therapist will utilize exercises that attempt to relieve pressure on the compressed nerves. Another target exercise is core stabilization which in turn helps with spine stabilization. Other practices such as stretching and manual work also might be used to benefit your flexibility. When working with a physician on your herniated disc, your physical therapist will work in conjunction with them to give you the most successful recovery.

When you have a herniated disc, you will want to control your pain management to the best of your ability. If you are experiencing back pain or discomfort, Dr. Ron A. Patel at Southeast Orthopedic Specialists is dedicated to finding the right solution for you.  Schedule your appointment online today!

Lumbar Discectomy vs. Fusion: Which Surgery is Right for Me?

Lumbar Discectomy vs. Fusion: Which Surgery is Right for Me?

By Frederick M. Moore, MD

If you’re suffering from leg or lower back pain caused by a lumbar herniated disc, you’re probably on the hunt for ways to address your discomfort and get back to living a comfortable, pain-free life. After you’ve exhausted your nonsurgical options, it may be the right time to consider spine surgery if the painful symptoms of a herniated disc are still present—but which surgical procedure is right for you?

We’ll break down lumbar discectomy and lumbar fusion to help you learn more about the different procedures and what they treat.

What is a lumbar discectomy?

Lumbar discectomy is a surgical procedure to relieve painful symptoms caused by a herniated disc in the spine, such as leg pain (sciatica), foot drop, muscle weakness, numbness or tingling in the legs, and decreased mobility. During a discectomy, a spine surgeon removes any free disc fragments that are putting pressure on your spinal nerves. This may be performed via a traditional midline incision, or with newer techniques that allow a smaller incision, which achieves decompression implementing fiberoptic technology.

There are different types of discectomy surgery, which can either be aggressive or limited with regard to removal of disc material depending on your spinal anatomy, the size of the hole(s) in your lumbar disc, and your overall health. During an aggressive discectomy, all free disc fragments—as well as any additional material located inside the disc—are removed. Limited discectomy takes a more conservative approach by removing free disc fragments without probing the inner core of the disc (nucleus pulposus) for additional material to remove.

What is a lumbar spinal fusion?

Lumbar spinal fusion is a surgical procedure that treats pain resulting from abnormal movement of the vertebrae, whether due to spinal deformities such as scoliosis, spinal weakness and instability, or a herniated disc.

During a lumbar fusion procedure, bones are permanently “fused” or essentially joined together to reduce motion in painful areas of the spine. In some cases, the entire disc is removed and replaced with bone-like material between the vertebrae, which ultimately takes the place of the natural disc that functioned as a stabilizer and shock absorber.

How do lumbar discectomy and spinal fusion differ?

While a lumbar spinal fusion can stabilize the spine and reduce pain from a herniated disc, lumbar discectomy is the most common surgical approach because it’s less invasive than a fusion, preserves movement, has a shorter recovery period, and is associated with fewer complications.

In fact, lumbar spinal fusion is rarely the first surgical intervention a patient will get for a lumbar disc herniation. It is typically performed further down the degenerative cascade, often after a patient has already had one or more discectomy procedures. Appropriately selected lumbar discectomy patients are more satisfiedwith their results, and see fewer complicationsthan spinal fusion patients.

Despite the success of the discectomy procedure, there is a significant reherniation risk for approximately 30% of patients, often resulting in repeat surgery. Recently, newer technology (Barricaid) has significantly reduced the risk of reherniation for this group of lumbar discectomy patients.

Which surgical procedure is right for me?

The best way to determine whether you’re a candidate for lumbar herniated disc surgery—not to mention which procedure is the best fit—is to consult with a spine surgeon for a diagnosis and treatment recommendation. During your appointment, your physician may recommend a magnetic resonance imaging (MRI) scan to identify the root cause of the pain you are experiencing if you haven’t already been diagnosed with a lumbar herniated disc.

When determining the best option for you, your surgeon will consider the size and location of your herniation, the severity and duration of your symptoms, and the result of any previous treatments. If you are considering surgical intervention, the Barricaid implant can reduce your chances of needing a second discectomy surgery—and potentially a fusion—down the road if you have large holes (6 mm or larger) in your disc.

Take Diego, for example. Diego is a dedicated athlete with a lifelong passion for running and mountain climbing. After Diego suffered from multiple injuries that resulted in a lumbar herniated disc, several surgeons recommended a spinal fusion.

Diego explored his alternatives and chose a limited discectomy with Barricaid, an innovative technology that would allow him to return to the active lifestyle he loves with a lower risk of additional surgeries and disability.

If you’re suffering from a lumbar herniated disc and considering surgery, Barricaid may improve and enhance your outcome. Consult with our team at Southeast Orthopedic Specialists to see if you are a candidate for one of these ground-breaking procedures.

Spinal Fusion Surgery for Chronic Back Pain

Most adults suffer from back pain. Don’t let your back pain keep you from working or doing the things you enjoy. Visit a spine care doctor. Tests can determine the cause of your pain. Your doctor will discuss a plan of treatment. Conservative means can be tried, but if you can’t get relief from your chronic pain, your doctor may recommend spinal fusion surgery. From diagnosis to recovery, you can get excellent spine care in Jacksonville, FL. (more…)

A Brief Introduction on Comprehensive Spinal Care

It’s no wonder that we often use the term backbone to describe something that is of central importance. Your own backbone, or spine to be more precise, is central to the function of your body. The spine is made up of the spinal cord, cerebral spinal fluid, and the bones that protect them. These bones are made up of individual vertebra with spinal discs positioned between them. Your spine is what allows you to move and twist and is key to your mobility. Anyone who has experienced serious back pain, problems with spinal discs, or any other spine problems can tell you that when the spine is not functioning properly, mobility can be severely limited. You may have difficulty walking, turning your head, sitting, bending over, or picking things up. (more…)

Common Myths about Sports Related Spine Injuries

Spine injuries among athletes are more common than you know, especially in sports like mixed martial arts, wresting, football, and other extreme sports. At your local spine care clinic in Jacksonville, FL, you’ll see many people getting treatment for spinal injuries. As important as it is to learn as much as possible about spine injuries, it’s also important to dispel myths, especially if you participate in a sport that’s prone to these injuries. Learn more about these 4 spine injury myths. (more…)

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