13 May 2019
When patients are undergoing treatment for scoliosis, they often ask our scoliosis specialists questions about which lifestyle changes they can make to help alleviate symptoms, make the most out of bracing or to reduce the likelihood of their spinal curve progressing. Those with severe scoliosis curves may experience difficulty sleeping due to aches, pain and inflammation.
Below are some of the most common questions about chairs, furniture, sitting positions and mattresses, asked by patients undergoing treatment, with LOC’s Schroth-Certified physiotherapist Deborah Turnbull to answer them.
There are many mattresses and pillows out there that use the terms ‘orthopaedic’ and ‘postural’ that purport medical benefits for back pain and scoliosis sufferers. Our advice would be, don’t be conned by the term ‘orthopaedic’ as, in relation to mattress products, this simply means ‘to support the joints, muscles or body’. The term ‘postural’ simply means ‘position of the body’.
This is a commonly asked question, though the answer really depends on what your issues are. Although a bad mattress won’t worsen your curve, it may aggravate symptoms of scoliosis, and the right mattress can help alleviate discomfort. Most of the time, a few simple modifications and adjustments can help as mattresses tend to lose their upper layers of support over time.
If you have scoliosis and do not suffer greatly from pain and are relatively mobile then the general advice I would recommend when buying a new mattress is buy as many pocket springs as affordable, go for medium to hard firmness for support and a layer of memory foam for comfort. If you upgrade the firmness of your mattress, you may need to upgrade your pillow at the same time or you could end up with a painful neck.
While a soft, cushiony mattress may seem appealing, a medium to firm mattress will keep your spine supported. Scoliosis is a curvature of the spine and conservative treatment (i.e. bracing and physiotherapy) broadly aims to return it to a straighter position. A firm, supportive mattress and pillow that supports your spine into a flat position is best. Memory foam is helpful for increasing comfort, as a medium to hard mattresses can feel unbearable to some, but an entire memory foam mattress will deprive your spine of support.
With adults, it’s often more important how we sit and the daily activities we do that keep the spine extensors and bones loaded and strong. If you suffer from chronic back pain (chronic meaning it’s lasted for over six weeks) then you may need to try out different types of mattresses to see what helps your symptoms and what you can tolerate. Most mattress companies offer a risk-free trial period of around 90 days, so this could be worth exploring. If you have mobility issues, again, your needs will likely require a more complex assessment with a specialist.
For scoliosis sufferers, a new mattress with as many pocket springs as affordable is a good place to start.
We don’t recommend a specific product to patients at present, just the guidance above.
Another common question - though you would need to be assessed by a physiotherapist to be sure advice is suited to you. Scoliosis treatment at the London Orthotic Consultancy is entirely bespoke; the Gensingen brace is tailored to each curve as well as the breathing and Schroth-based physiotherapy exercises. Sleep positioning will likewise be specific to the type and severity of scoliosis.
Another popular question. The simple answer, again, is it depends on what your issues are. There are many seating products that claim to reduce back pain although the majority are extremely costly as they’re made with expensive material and manufacturing costs.
My general advice, for those without mobility issues or complex medical needs is:
If you’re tall – small, short-legged chairs will automatically cause you to slouch. If possible, go for a chair with a seat that reaches your knee height level or higher.
If you’re short – you’re more likely to struggle to reach your feet to the floor and will therefore perch and slouch at the edge of a chair. The deeper the chair the more likely this will happen so try to find one with a shallow seat.
Take regular breaks and consider postural advice from a physiotherapist to help offload certain postural muscles.
Our specialist Scoliosis clinic in our headquarters clinic in Kingston, though we also offer a Schroth Best Practice physiotherapy clinic at The Portland Hospital in central London. You can make an appointment at any of our scoliosis clinics by calling 020 8974 9989.
My results are amazing and unexpected, and I am glad that I received the brace through LOC. I am still wearing the brace 18 months later and my back feels even straighter. Thanks to LOC I realised that I wanted to help people with similar if not the same condition as me, so I am now going to Salford University in September to study Orthotics and Prosthetics so I will hopefully be able to help others with Scoliosis as much as LOC has helped me.
If you say something is going to be easy it will be easy and if you say something will be hard it will be hard. So, I'm just going to say that wearing my brace is easy. And as it turns out, it really is.
Sally and Debs have helped remove the stress from our situation. They have given us hope based on their extensive knowledge and expertise.
I had my brace fitted and I was also given a personalised exercise programme to help with my 3D rotation. Not only was I wearing this new brace but I still had my pectus brace on and the amazing orthotists managed to combine the two so they worked together. I really struggled with this at first; however, I kept going and now I’m really glad I did. My scoliosis overcorrected by 10 degrees and I was able to reduce my scoliosis brace wear to 16 hours a day within 6 weeks.
Don’t wait. It’s about the children because they are more likely to be confident in their late teens if you act quickly and support them. We have been lucky because we understand the condition well. That’s one of the main things, to be honest. It was hard work, but it pays off in the end.
I finally found that I had arrived at the right place and something was actually being done.
My pain levels are hugely improved, my ribs were tender and now they are not. My brace was made individually for me. It’s not one size fits all and, if it is not completely perfect, LOC alters it on the spot. I was so surprised that I could wear the brace under my clothes, I did not need to go and buy anything, I just wear loose tops.
The brace is very light. Obviously, the first couple of days we were told it was going to be uncomfortable for her, I bought so many pillows! But although the first night was not very comfortable, the second night she got used to it and then she was wearing it all day long and I thought ‘that’s brilliant!’ She was only taking it off for two or three hours to go out with friends or do the exercises, but she didn’t have any problems really.
Debs and Sally are fantastic. I mean, they’ve become like family now. They are extraordinary people and do such good work with these kids, both of them, it’s fantastic. The whole experience has been very good. They make you feel welcome from the beginning, and you can ask as many questions as you want, and they answer everything. If you have a problem they give you their personal mobile so you can just call them if you have a problem and they’ll solve it straight away. I’m very pleased with the treatment, the people, with everything.
She’s wearing the brace all the time now and she’s doing very well. She’s very good at school too, the brace doesn’t get in the way of anything. It fits underneath her school uniform and you can’t see it. Sometimes I even have to ask her when she’s sitting down if she’s wearing it because I can’t see it! She says ‘of course mummy’ and I say ‘let me try!’ I have to knock through the clothes and only then can I hear she’s wearing the brace!
Obviously, the results speak for themselves. I would definitely credit LOC, but if I were to give any advice [to parents in a similar position] it would be to contact Debs and Sally. Ricarda likes it there, she loves the people like Debs and Sally and felt really comfortable, everything was really relaxed and nice. She worked really hard during training with Debs who kept saying that Ricarda was such a workhorse!
The operation used to treat severe scoliosis curves is typically spinal fusion surgery; a major procedure that involves moving muscles and realigning the skeleton into place. The curved, deformed vertebrae are fused together into a single bone, putting metal screws and rods into the spine to help straighten it. Surgery typically lasts between 4 and 8 hours depending on the severity of the curve. Bone graft is then taken from other parts of the body and used to cover the implants.
Following the operation, it is necessary to spend around a week in intensive care before returning home and the first few days are often uncomfortable. Most adolescents can expect to return to school from 2-4 weeks following surgery, but pain medication may be required up to 6 weeks following. A full recovery from the procedure can take up to a year, as it can take that long for the spine to heal fully.
Spinal fusion surgery causes the fused portion of the back to become permanently stiff, as a result, returning to sports that require large amounts of flexibility (ballet, yoga, gymnastics, dance) or contact (rugby, football, karate, hockey) may take longer.
Risks of spinal fusion surgery are like that of any other major procedure and include infection, blood clots and anaesthesia complications. The added risks include permanent nerve damage to the spine and paralysis.