Bracing aims to prevent progression of scoliotic curves during adolescent growth rather than correcting existing curvature. The brace applies pressure to the curved areas whilst allowing space for growth in other regions, creating a corrective force that helps keep the curve from worsening. It doesn’t permanently straighten the spine, but if worn consistently during growth, it can prevent curves from progressing to levels that would require surgery. Once skeletal maturity is reached and growth stops, bracing is no longer needed. The success of bracing depends heavily on consistent wear, typically 16 to 23 hours daily, though specific recommendations vary based on curve characteristics and brace type.

Bracing is most effective during periods of active growth, typically between ages 10 and skeletal maturity, often around 14 to 16 for girls and slightly later for boys. The ideal candidate is a child with a curve between 25 and 45 degrees who still has significant growth remaining. Bracing is less effective once growth is nearly complete. Assessment includes evaluating growth potential using indicators like the Risser sign on X-rays and, for girls, whether menstruation has started. Children with smaller curves or those who have finished growing usually don’t need bracing. Those with curves over 45 to 50 degrees despite bracing may eventually require surgery. Timing is crucial for bracing success.

Modern braces are designed for comfort, though some adjustment is needed initially. You might experience pressure points or mild discomfort when first wearing the brace, similar to breaking in new shoes. These issues usually resolve within a few weeks as you adapt and the brace is adjusted for optimal fit. The brace should feel snug but not painful. Regular follow-ups allow adjustments to ensure proper fit, especially during growth spurts. Wearing a smooth shirt underneath prevents skin irritation. Most young people adapt well and can participate in most activities whilst braced. Any persistent pain or skin problems should be reported so adjustments can be made.

The brace is typically removed for sports and physical education, meaning most athletic activities are possible. Exercise is encouraged as it maintains fitness and strengthens muscles supporting the spine. Swimming is particularly beneficial. Some less strenuous activities might be done with the brace on if removing it would significantly reduce total wearing time. However, contact sports or activities with high fall risk are usually done without the brace. The time spent in sports without the brace is factored into the wearing schedule. Staying active is important for physical and emotional wellbeing during the bracing period, so sports participation is supported with appropriate planning.

Once growth is complete, demonstrated by skeletal maturity on X-rays, bracing is gradually discontinued. Many programmes involve weaning out of the brace over several months rather than stopping abruptly. Follow-up X-rays monitor whether the curve remains stable after bracing ends. If bracing was successful in preventing progression, the curve often remains at a similar magnitude to when bracing started. Some curves may progress slightly after bracing stops, but if they remain under 50 degrees, surgery usually isn’t needed. Continuing exercises that strengthen back and core muscles helps maintain spinal health long-term. Most young people transition smoothly to normal life without restrictions after successful bracing.