The Original Bending Brace from Carolina | Frequently Asked Questions
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Frequently Asked Questions

What are the Benefits of the Original Bending Brace?

Unlike most braces used to treat scoliosis, the Original Bending Brace offers a major advantage. Patients wear this nocturnal (nighttime) orthosis only eight to ten hours at night; they therefore may participate in normal daytime activities, including sports. Many physicians and orthotists report that nighttime-only wear makes the brace especially acceptable to patients and parents. They also have observed frequently that children and adolescents enjoy major psychological benefits when they can participate fully in daytime activities, unrestricted by a bulky brace.

How Does the Original Bending Brace Work?

The Original Bending Brace introduces bending forces at certain specific locations on the patient’s spine. Since bone grows in response to stresses placed on it, these forces over time alter growth rates of the vertebrae. The image of a crooked young tree pulled and pushed by poles and wires as it grows may help explain the concept. After years of such “bracing,” the tree begins to grow straight on its own. Likewise, the orthotist designs this brace to create a mirror image of the spinal curve(s) of the person with scoliosis. The brace may, for example, work to “unbend” a patient’s left lumbar curve by creating a right lumbar curve. Spinal flexibility helps determine the degree of success achieved by the Original Bending Brace in unbending the curve(s).

Why Bracing?

For decades, scoliosis has been managed with braces, also known as “orthoses,” usually worn throughout a child’s or adolescent’s growth period until they reach skeletal maturity. They then begin a gradual weaning process. Traditional scoliosis treatment, which requires wearing a brace 23 hours daily, has proven very successful. The Original Bending Brace, a more recent development in scoliosis management, provides another alternative for successful treatment in some patients.

Why is the Original Bending Brace Worn Only at Night?

Studies indicate that children and adolescents grow in response to the levels of Human Growth Hormone (HGH) in their bodies. The same studies indicate that HGH levels peak at night. Most growing happens therefore at night, during sleep. The Original Bending Brace works on principle that if the spine can be bent to change how it grows at the time of day when most growing occurs, the direction of the spinal curve can be successfully changed as well.

How Long Must the Original Bending Brace be Worn?

It’s critical to wear the Original Bending Brace eight to ten hours each night, seven nights a week, until the patient’s skeleton reaches maturity. A doctor can determine from x-rays when an adolescent is approaching skeletal maturity.

What determines if the Original Bending Brace Has Worked?

Bracing is considered successful when the doctor determines that the curve at skeletal maturity has not progressed beyond the degree to which bracing began. Or, there has been a slight increase in degrees and/or surgery has been avoided.

Will Scoliosis Curves Worsen Without the Brace?

There are five categories of curves and curve combinations. Each category has its own risk for progression. Since much remains today that we don’t understand about idiopathic scoliosis, we do know that some curves will progress in spite of brace treatment. With proper treatment, however, bracing frequently halts curve progression. Sometimes, in mild cases of scoliosis, a doctor may determine that a minor curve has not progressed enough to justify prescribing an orthosis.

Will the Original Bending Brace Prevent My Curve from Getting Worse?

Medical studies conducted in recent decades show that the Original Bending Brace to be highly effective in managing certain kinds of scoliosis. In many curves, especially single curves under 35 degree either in the thorax (chest) or lumbar areas (between the pelvis and ribs), the rate of progression with this braces has been as low as that of any of the 23-hour bracing systems. In severe cases, however, 23-hours of brace wear may be indicated either by another brace protocol or a combination of day brace wear and the Original Bending Brace at night. Research on the brace continues today.

What Takes Place During Visits to the Orthotist and Doctor?

On the first visit, the orthotist gives a complete explanation about how the Original Bending Brace works and how it is tailored to the patient’s spinal curve(s). Also, the orthotist should encourage the patient and family to pose questions. Next he/she evaluates the patient’s x-rays and will take a series of measurements on the patient.

About two weeks later, the patient returns for a fitting of the Original Bending Brace, a procedure that takes approximately one hour. The orthotist will then trim and adjust the brace to ensure the best possible function and comfort. A snug fit is the most effective. The orthotist also will draw lines on the straps of the brace to help the patient remember to wear it tightly. Shortly afterwards, the patient will receive the brace along with instructions on its use and wear.

Upon receiving the brace, the patient next visits the doctor for an x-ray of his/her spine in the brace. The x-ray should display a dramatic decrease in the curve(s) indicating that the brace works properly. Once the doctor approves x-ray results, the patient may start wearing the brace that night.

Thirty days later, and every three of four months thereafter, the patient will return to the orthotist for further evaluation. About every four months, it is necessary to see the doctor, who will evaluate the status of the scoliosis. For convenience, these visits may be scheduled on the same day.

Will the Original Bending Brace be Difficult to Put On at First?

The Original Bending Brace should not be worn too tight at first. It is best to allow a ten-day adjustment period, wearing the brace loose for the first few days and gradually tightening the straps each night. By the time patients reach the lines drawn by the orthotist on the straps, they usually feel reasonably comfortable in just a short time.

What is the Best Way to Apply My Original Bending Brace?

Once a patient becomes familiar with the brace, it’s not too difficult to follow these steps:

  1. Apply the brace either lying down or standing up. Most wearers prefer to lie down, but it is equally acceptable to apply it while standing.
  2. Lie Down to fasten the straps. Make them a little snug, but don’t tighten them yet.
  3. Wiggle around inside the orthosis to be sure that it fills in the right place. Then begin to bend your body in those places where you feel the brace pushing. For example, if it is pushing on the left side of your waist, move your waist to the right as if you are trying to move away from the pressure on your left. If the top of the Original Bending Brace seems as if it’s trying to bend you to the right, then bend your upper body to the right. Moving your body in the direction that the braces pushes, makes you more comfortable and the brace more effective.
  4. Tighten the straps, starting always from the bottom up. Tighten the bottom strap a little, the middle strap a little and then the upper strap a little. Then, return to the bottom strap and start all over again, and again, and again until you have tightened the straps to the lines drawn by the orthotist. It is very important to tighten the straps gradually and slowly. It may take as long as 30 minutes each night to arrive at the lines drawn on the strap. The goal is to tighten the Original Bending Brace to a point of maximum effectiveness, comfortably.

Is there an Adjustment or Break-in Period for the Original Bending Brace?

Yes. You have ten days to reach the lines drawn on the straps. Take your time and wear the brace loosely at first to accustom yourself to sleeping all night while wearing it. After a few nights, begin to tighten the brace a little. Each night afterwards, continue to tighten the straps a little more then you did the night before.

Remember, the goal is to stretch the muscles and tendons of your spine slowly, gradually and comfortably. Recall how tight and uncomfortable the brace felt when you first went to the doctor’s office for an x-ray in the brace? After the adjustment period, it will no longer feel that way if you follow the instructions.

How Does the Patient Sleep in the Original Bending Brace?

A tight-fitting shirt worn underneath the Original Bending Brace, especially a long sleeveless cotton t-shirt that fits snug and has no seams, makes a good choice. A shirt bought a little too small provides a snug fit. Garments that wrinkle of have thick seams may irritate the skin.

A firm mattress that is turned often is best for sleeping. A soft mattress may be firmed inexpensively with a full-size piece of 3″ x 8″ plywood placed between the mattress and box spring. Sleeping on the back or stomach is the most comfortable position. It is usual to awaken in the morning a little damp with perspiration. For refreshing effect, patients who don’t normally shower in the morning may wipe their bodies with rubbing alcohol to remove skin oils and perspiration. The same cloth and rubbing alcohol can be used to clean the inside of the brace.

What is the Minimum Time to Wear the Original Bending Brace at Night?

The Original Bending Brace is expected to be worn during the hours of sleep; optimal results are based on a minimum of eight hours, seven nights weekly. If the patient sleeps longer, it is anticipated the brace would be worn longer, understanding that optimum results happen when worn a minimum of eight hours. If the patient occasionally attends a sleepover, the brace may be left at home for that one night only.

Sometimes, patients start to feel inpatient or negative about having to wear the Original Bending Brace seven nights a week. An effective way to place this feeling in better perspective is to consider the much greater inconvenience if they had wear a 23-hour brace instead.

Does the Patient Have Any Other Responsibilities Between Visits to the Orthotist and Doctor?

If at any time the patient experiences problems with the brace, such as pain, rapid growth or an inability to wear it as directed, it is critical to call the orthotist immediately. It also is important to keep track of measurements, height and weight. Should they change; the orthotist will determine if a brace adjustments is necessary. Rate of growth also determines if and when it is necessary to replace your Original Bending Brace. Most children and adolescents wear their braces for a year or longer before outgrowing it.

Only one opportunity arises in a lifetime to arrest the progress of scoliosis. This is the time when a young person is growing. That’s why regular visits to the orthotist, who can make necessary adjustments in a timely manner, is extremely important.

Patients who follow instructions on wearing the Original Bending Brace have every reason to relax. They are doing the very best possible to control their scoliosis so that they will reach skeletal maturity with minimal progression on their curves.