Bracing for Scoliosis

Written By Nicole Viverito

Bracing is one of the most common non-surgical treatments for scoliosis—especially in growing children and teens. The goal of a brace is not to permanently straighten the spine, but to prevent the curve from getting worse during growth.

There are several types of braces, and the right one depends on the person’s age, curve type, and severity.

1. TLSO Braces (Full-Time Bracing)

TLSO stands for Thoraco-Lumbo-Sacral Orthosis, which means the brace covers the torso from under the arms down to the hips.

Examples:

  • Boston Brace

  • Rigo-Chêneau Brace

Key Features:

  • Worn 16–23 hours per day

  • Custom-molded to the body

  • Usually worn under clothing

  • Designed to apply pressure to specific areas of the spine

Most Common TLSO braces:

  • Boston Brace:

    • More symmetrical design

    • Focuses on holding the curve and preventing progression

  • Rigo-Chêneau Brace:

    • More asymmetrical and 3D-focused

    • Designed to de-rotate and expand the spine using specific pressure and expansion zones

    • Often paired with Schroth physical therapy

2. Nighttime Braces

Examples:

  • Providence Brace

  • Charleston Bending Brace

Key Features:

  • Worn only at night (8–10 hours)

  • Designed to overcorrect the curve while lying down

  • Typically used for specific curve types (often single, flexible curves)

Pros:

  • Easier compliance since it’s only worn during sleep

  • Less impact on daytime activities

Considerations:

  • Not appropriate for all curve patterns

  • Requires careful selection by a specialist

3. Milwaukee Brace (Less Common Today)

Key Features:

  • Extends from the pelvis up to the neck with a ring support

  • Includes a visible metal structure

When It’s Used:

  • Higher curves (upper thoracic spine) that other braces can’t effectively reach

Important Note:

  • This brace is rarely used today, as newer designs are more comfortable and less noticeable

How Bracing Works:

Braces use a combination of:

  • Targeted pressure to guide the spine

  • Relief areas where the body can move into better alignment

  • Postural correction to support a more balanced position

Think of it like guiding growth—helping the spine grow in a better-aligned direction.

What Makes Bracing Successful?

Bracing works best when:

  • The child is still growing

  • The curve is in a moderate range (typically ~20–40 degrees)

  • The brace is worn consistently as prescribed

  • It’s paired with scoliosis-specific exercises (like Schroth)

**Consistency is key—the number of hours worn directly impacts effectiveness.

The Bottom Line

There isn’t a one-size-fits-all brace for scoliosis. The best option depends on the individual curve and lifestyle. Whether it’s a full-time TLSO brace or a nighttime brace, the goal is the same:
to stop the curve from progressing and prolong/avoid the need for surgery.

Working with a provider trained in scoliosis-specific care ensures the brace is properly selected, fitted, and monitored for the best possible outcome.

Nicole Viverito
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