Full-time bracing

Why do I need a brace?

A brace reduces the chance of the scoliosis curve getting bigger and needing surgery.

Will the brace work?

There is excellent scientific evidence that full-time braces reduce the risk of people going on to need surgery. The brace doesn’t work for everyone but is more likely to work if it is worn for at least 20 hours every day.

What is the brace made of?

The brace is made of plastic and usually has a foam lining. It is flexible enough to open either at the front or back and fastened usually with Velcro straps.

Your brace is specifically designed to control your spinal curve and should not be worn by anyone else.

It is likely to be a little bit uncomfortable to start with, but you will get used to it.

How does a full-time brace work?

The brace pushes on the curve which makes it smaller whilst you are wearing the brace. It needs to be worn for 20 hours every day including at night. It can be removed for short periods of time during the day especially for doing activities that may be difficult to do in your brace such as sport, dance and physical exercise. Remember to lie down when you put your brace back on.

How can we tell if the brace is working?

X-rays at the hospital are usually taken with you standing and your spinal doctor will measure the size of your curve as an ‘angle’. The bigger the curve, the bigger the angle. A straight spine is zero degrees. 10 degrees is large enough for a curve to be called a ‘scoliosis’. Curves that are 20 to 40 degrees are usually treated with a brace and at 50 degrees, your spinal doctor may discuss the option of surgery.

Getting your full-time brace

A spinal orthotist is a specialist who designs and fits spinal braces.

Visit 1 – brace measurement

The first visit will be where measurements are taken to allow the orthotic team to design and manufacture your brace.

Visit 2 – brace fitting

You will return after a few weeks to have the brace fitted. Small adjustments may be needed to get the best correction of your scoliosis curve or to make the brace more comfortable. The orthotist will mark a line on each Velcro strap to help you know how tight to have the brace.

You will have an X-ray wearing your brace either at the hospital visit when the brace is fitted or a few weeks later.

You will see one of the orthotists usually every 3 to 6 months whilst you are wearing the brace to adjust your brace as you grow.

For your appointments, normal underwear should be worn, and your modesty will always be protected. If you have long hair, please bring a hair bobble or clips to fasten your hair up.

Putting on your full-time brace

1. The orthotist will show you how to put the brace on and take it off correctly. It is essential to wear a seamless protective body sock under the brace to reduce the chance of skin irritation. Two body socks or vests will be provided with your brace. A close-fitting cotton t-shirt may be worn instead if preferred, however, this should ideally be seamless. Open the brace and put it around you positioning the waist section between your ribs and the top of your pelvis.
2. It is essential to tighten your brace when lying down. Lie down on a firm surface and bend your knees slightly towards your chest.
3. Stretch yourself so you are as long as possible.
4. Loosely fasten all the Velcro straps making sure no straps are twisted.
5. Fasten each strap to the mark on the Velcro starting at the lowest strap and working upwards.
6. Your orthotist will mark on the straps how tight they should be and may suggest a slightly looser position to start with. This will allow you to get used to the brace and make it more comfortable.

‘Breaking-in’ your full-time brace

Gradually increase the amount of time you wear to brace each day over 5 to 7 days. Gradually increase the tension in the straps up to the maximum you were shown at the initial fitting visit. Your brace will feel tight at first but will improve over time.

How long will I need to wear a brace for?

They are usually worn for between 1.5 and 3.5 years. Bracing is stopped once you have finish growing so it depends how much growing you have left to do.

As you grow, you will need another brace if it is getting too tight. This will be made in the same way as the previous brace, and you will continue to wear your old brace until it is ready.

Areas of redness

Some minor skin redness is common and should fade after removing the brace and should become less over time. Make sure you are wearing a seamless body sock or seamless close-fitting cotton t-shirt under the brace and there are no wrinkles. If redness or irritation continues, contact your Spinal Orthotic Team.

Wearing your full-time brace

This means the brace should be worn at school and in bed at night.

Do I have to wear the brace on holiday?

If the brace is not worn for a period of time whilst you grow, the curve may get worse, so it is important that you wear your brace even when on holiday.

Caring for your full-time brace

It is important to follow these guidelines on caring for your new brace:

• The body sock or t-shirt you wear under the brace should be changed daily to reduce the risk of skin irritation.
• The inside of your brace should be wiped daily with a damp cloth and the plastic parts of your brace should be cleaned with a mild soap solution. Make sure to wipe off all the soap with a damp cloth and dry to avoid skin irritation.

What do I do if the brace does not seem to fit me anymore or gets damaged?

Please contact your Spinal Orthotic Team.

Advice for schools and teachers

Try to reduce any anxiety your student may have about wearing a spinal brace and potentially feeling different from the other students. Please also be aware of the practical difficulties of wearing a brace:

PE

• Provide a 10 minute early pass before and after PE if needed.
• The brace can be taken off for PE (store it somewhere safe) but some may want to keep it on depending on the activity.
• Some people experience pain which may limit activity.
• Provide somewhere to lie down after PE to put the brace back on.

Toilet

• The brace is not usually removed for going to the toilet.
• If removal is preferred, the Velcro strap noise when taking off the brace may make your student self-conscious. Access to a disabled toilet can help. Provide somewhere to lie down to put the brace back on.

Lessons

Backless stools can be very uncomfortable to sit on when wearing a spinal brace. Please try to provide alternative seating, or be understanding if a young person is uncomfortable.