Scoliosis Does Not Cause Back Pain I read an article today (September 19, 2013) in the New York Times that encourages that those suffering back pain from scoliosis should buy a back brace. I’ve seen commercials for back braces on television and wondered if they are worth buying. It looks like the answer to that is NO. Dr. Sarno says in Healing Back Pain that scoliosis does not cause back pain. First, I hope you will read the article. Then after reading it, read below it what Dr. Sarno says about scoliosis. NYTimes September 19, 2013 Study Affirms Benefit of Back Braces as Scoliosis Treatment By CATHERINE SAINT LOUIS A new study provides the best evidence yet that wearing a back brace will slow the progression of the most common form of scoliosis in adolescents, helping them avoid painful spine surgery. Physicians have recommended bracing for more than 50 years, but until now, studies of its effectiveness had produced mixed results. The United States Preventive Services Task Force recommended against scoliosis screening in schools partly on the grounds that there was insufficient evidence that bracing and other conservative treatments relieved back pain or improved quality of life in these children. The new randomized study, published on Thursday in The New England Journal of Medicine, should end the longstanding debate, several experts said, and may spur the task force to reconsider its position. The trial is “very convincing,” said Dr. B. Stephens Richards, a pediatric orthopedic surgeon at Texas Scottish Rite Hospital in Dallas. “It scientifically proves that brace treatment works for adolescents with scoliosis who are at risk of curve worsening to the point of needing surgery.” Adolescent girls are more likely than boys to have idiopathic scoliosis, or curvature of the spine from no known cause. Rigid bracing is worn to restore spine alignment by external force. It is a demanding treatment at a vulnerable time of life. “When you have a teenager who is anxious about wearing a brace to school or what their friends will think, it gave us a bit of heartache to try to convince them if we weren’t certain ourselves,” said Dr. Paul D. Sponseller, the director of orthopedic surgery at Johns Hopkins Children’s Center, who was not involved in the study. “In light of this new evidence, we can say we really do have a basis for putting them through bracing.” In the study, researchers analyzed data on 242 patients at 25 sites across the United States and Canada. The children were all aged 10 to 15 and still growing, and they all had a spinal curvature of 20 to 40 degrees. Of those patients, 116 were randomly assigned to observation or bracing for at least 18 hours daily. Because too few families agreed to randomization, the researchers added a group of 126 adolescents who chose for themselves between bracing and observation. Bracing was deemed a failure if spinal curvature progressed to 50 degrees or more, a point at which surgery is often suggested. It was deemed a success if the child achieved skeletal maturity without this degree of curve progression. The trial was stopped early because of the apparent efficacy of bracing. In the analysis that included both groups, the rate of treatment success was 72 percent among children with bracing, compared with 48 percent among those under observation. The benefit increased the longer bracing was worn. More than 90 percent of the children who were successfully treated wore their braces more than 13 hours a day. Dr. Richards, the immediate past president of the Scoliosis Research Society, said the study’s strengths were the inclusion criteria, limited to adolescents most at risk for spinal curve progression, and the use of a high-tech, temperature-sensitive device in the braces to measure compliance objectively. “There were a lot of doctors like me who treat scoliosis as the primary focus of their practice who had doubts about whether bracing was effective,” said Dr. Stuart L. Weinstein, the lead author of the study and a professor of orthopedic surgery at the University of Iowa. “Now the jury is in.” Bracing has been the standard of care since the 1940s. It took so long to perform a rigorous trial of its effectiveness not only because it was “a gargantuan task,” said Joe O’Brien, the president of the National Scoliosis Foundation, but also because parents did not want to “just sit there and wait and watch.” Such a study raised moral challenges, too. “Ethically, you have to accept that some patients will be randomized to not using a brace, and your presumption is they will end up needing surgery,” said Dr. John T. Smith, a professor in the orthopedics department at the University of Utah. When her daughter Maddie was given a scoliosis diagnosis at age 10, Becky Houser, of North Liberty, Iowa, wanted to avoid surgery “at all costs.” So Maddie, a participant in Dr. Weinstein’s study, chose to wear a brace. “We didn’t want to not do anything,” said Mrs. Houser, who manages rental properties. Thirty years ago, she underwent surgery for scoliosis herself, spending three weeks in a hospital and nine months in an upper-body cast. After three years of wearing baggy tops and yoga pants to school to accommodate the brace, Maddie, now 13, was thrilled to learn that her spinal curvature was holding steady at 28 degrees. With no more major growth spurts left, she no longer needs bracing. “We are extremely relieved,” Mrs. Houser said. A common surgical treatment, spinal fusion, entails putting screws and rods in the spine to straighten it. The procedure has greatly improved, but young patients still face risks like infection, bone healing problems and, rarely, paralysis. Despite the apparent success of bracing, the study did not pinpoint which children are most likely to benefit from it. Indeed, the researchers found that outcomes were successful in 41 percent of the intervention group even though they seldom wore the brace. Conversely, Erica Shumaker, a high school freshman in Tipton, Iowa, wore her brace 22 hours a day while participating in the study. Yet her spinal curvature progressed, and she is likely to need surgery. “Her brace isn’t helping as much as they thought it would,” said her father, Rick Shumaker. “But there’s nothing we would do any different.” End of article. This is what Dr. Sarno says in Healing Back Pain about scoliosis: “Scoliosis refers to an abnormal curvature of the spine commonly seen in teenage girls and usually persisting into adult life. Its cause is unknown. It rarely causes pain in teenagers but is often blamed for back pain in adults. I have not yet found this to be the case. “The following case history is typical: The patient was a woman in her thirties who had suffered recurrent attacks of back pain since her teens. Several years before I saw her she had experienced a severe attack at a time when she was taking care of her young children. “Mild scoliosis, to which the pain was attributed, was seen on X-rays. She was told her back pain would gradually worsen as she got older. Despite this dire prediction she recovered from that episode and did fairly well until two months before I saw her, when she had a bad attack. She said it began when she was bending over and ‘felt something snap,’ a common description of on-set. She was further frightened because her trunk was tilted to one side.” Dr. Sarno says that after taking her history he learned that over the years she had experienced a number of episodes of tendonitis in the arms and legs, occasional pain in the neck and shoulders, stomach and colon symptoms, hay fever, and severe headaches. “She was a classic TMS patient,” says Dr. Sarno. The physical examination was normal except for the usual tenderness on palpation of muscles in the neck, shoulders, back, and buttocks. “She had no trouble accepting the diagnosis, took part in my TMS treatment program, and was soon pain free. She later reported that there had been no more pain attacks, that she sometimes had mild pain but knew it was harmless and went about her life without fear. “It is clear that scoliosis was not the source of her pain since nothing in the treatment changed the scoliosis. It is equally clear that her personality predisposed her to a variety of benign physical ailments, including TMS.” Dr. Sarno does not say what the woman’s repressed emotions were, but referring to her personality gives a clue… she probably is a member of the “Perfectionist Club,” trying to be perfect in everything she does and perfect in every relationship she has. Typically, trying to be perfect and please everyone can cause physical and emotional pain. So I don’t think anyone with scoliosis or other symptoms of back pain need to buy a back brace. They just have to figure out what repressed emotion or personality trait is causing them pain. And more good news is what Steve Ozanich, author of The Great Pain Deception, says: “You don't have to know what ‘the’ thing is that is causing your pain, or unpleasant symptoms. Over the past 12 years I've seen people get worse by trying to find the magic healing bullet. But it doesn't usually work. And Dr. Sarno said it was ‘fruitless’ to try to make the unconscious become conscious.” Just chalk your pain up to TMS and let that conviction heal you. Forget about getting a back brace. Treat yourself to something or put the money in the poor box at church.