When 15-year-old Gabriella Garcia was diagnosed with scoliosis four years ago, she was afraid it would mean the end of her burgeoning dance career. Thanks to Ron Marinaro, DC, founder and director of the Chiropractic Treatment Center in Studio City, Calif., Garcia was able to leave her traditional hard brace behind.

“When I wore the hard brace, I cried a lot,” Garcia says. “I had a lot of pain because the brace was forcing my spine straight while making the muscles around my spine weak.” Since moving to the soft brace, she has regained confidence and again participates on her high school dance and track teams. Garcia says, “I am no longer in pain.”

Now a freshman at Calif.-based Quartz Hill High School, Garcia says, “It’s pretty much like being a normal kid again.” Her spine now has a 26-degree curve when she takes off the soft brace, representing a 13-degree improvement in less than two years.

Before Garcia was diagnosed with idiopathic scoliosis of the lower lumbar, a 36-degree, C-shaped curve in her lower back, she spent two years living with unexplained symptoms and increasing pain. First, she occasionally felt dizzy, which her mother, Mary Garcia, attributed to dehydration or under-eating. Then, she started walking crooked and began experiencing shooting back pain that often sent her home from school in tears. 

With scoliosis, depending on the degree of the curve, the spine may also twist around, forming a corkscrew-like shape that pulls the rib cage, hips and shoulders out of line. Severe scoliosis can also cause damage to internal organs, which is one of the reasons doctors often recommend corrective surgery when the curvature progresses beyond 40 degrees.

Correction and Prevention: When There Is No Cure

Marinaro, from a family of chiropractors, always thought he would find a cure for scoliosis. While not a cure, he did find a Canadian-made “Spine-Core” soft brace, a combination of four wide straps that wrap around the body, holding and supporting the spine and gradually, gently moving it into a straighter position while still allowing freedom of movement.

Marinaro says, “Most children don’t feel pain in the spine until they are adults.” The greater the degree of curves, there is more chance of respiratory and digestive problems. He adds, “Also, some of the larger curves are visible with the naked eye [causing posture problems] and contribute to self-esteem and emotional issues.”

When a child is diagnosed with a smaller curvature, physicians monitor it and once a curve has reached about 25 degrees, a hard brace is usually used. For more severe curves, surgery is the course of treatment most orthopedics would suggest.

According to Charles H. Rivard, MD, out of 365 patients who used the soft brace and corresponding physical therapy exercises, 96 percent improved. His 2004 study, “A non-rigid brace for the treatment of idiopathic scoliosis: post-treatment results,” published in the European Spine Journal, found the treatment effective for pediatric patients with idiopathic scoliosis. The key to treatment is core-strengthening exercises, which the soft brace allows because it is flexible.

The study reports at the two-year follow-up there was an overall correction of greater than 5 degrees for 55 percent patients. In addition, 38 percent of patients stabilized and 7 percent worsened by more than 5 degrees. According to Rivard, “this initial cohort of patients demonstrated a general trend of initial decrease in spinal curvature in brace, followed by a correction and/or stabilization at the end of treatment, which was maintained through one and two years follow-up.”

Quality of Life

A hard brace limits movement and affects the quality of life for many pediatric patients. The brace is like a shell over the child’s torso, prohibiting flexibility and creating muscle atrophy and weakness. Marinaro says when placed in a hard brace, children are “unable to participate in athletic activities at school and in their personal lives.”

Because of its conspicuous nature, children are often self-conscious about the brace and compliance is low. While the soft brace is not a cure, Marinaro says it is a welcome alternative for pediatric patients trying to regain a normal lifestyle. 

Because the soft brace is flexible, it allows patients to remain active, which strengthens the muscles and increases quality of life for pediatric patients. It is also easy to hide under clothes, resulting in a higher compliance rate.

Soft braces allow for more freedom of movement, dramatically increasing the quality of life for pediatric patients. When Gabriella was put in the hard brace two years ago, they told her she could not exercise anymore.

Marinaro says, “The soft brace can be adjusted to the growth of the child, whether they gain or lose weight or grow in height.” Also, if the curve increases or decreases it can be adjusted without changing the whole brace. With the hard brace, when the patient grows, she must be refitted and purchase a new brace.

According to Marinaro, “This was devastating to her because she wanted to be a professional dancer.” When Garcia got the soft brace, she wore it regularly and “was very happy to hear that she must exercise to help support the treatment,” Marinaro says.

Now, the soft brace allows Garcia to do core strengthening exercises, under Marinaro’s direction, to help strengthen the muscles surrounding her spine. Garcia says, “I used to worry about having surgery and what kind of life I would have with rods in my spine. I would wonder if it would affect me having children in the future and also if it would prevent me from certain careers. I no longer think about that and know the doors are open for everything now.”

In addition to reducing her concerns, using the soft brace allows Garcia to live the life of a normal teenager. She says, “I get to wear all my cute clothes and you can’t even tell I am wearing a brace. I am able to share my experience and often show off my brace. My friends think it’s cool!”

Garcia says at first, it was hard for her to accept the adaptation. “Everything I do and participate in came to a sudden halt. [But,] I no longer have any challenges. I have a normal teenage lifestyle and don’t have to think about the ‘what ifs’ any more.”

Moving Forward

The biggest challenge Garcia faced in the beginning was with doctors, chiropractors and therapists’ “distrust or lack of believing in choosing an alternative method.” She says, “Their thoughts were ‘there is no cure or treatment and ultimately surgery is the only answer.’” Since physicians said surgery was her only option, Garcia says, “I had nothing to lose.”

Now, the 2007 Miss California’s Outstanding Teen contestant has started the Gabriella Garcia Scoliosis Foundation to raise awareness about scoliosis treatment and assist patients without insurance coverage. Garcia says, “The most important thing for doctors and physical therapists to know about scoliosis is to keep an open mind about alternative treatments.”

Kate DeBevois is the staff writer for Therapy Times. Questions or comments can be directed to editorial@valleyforgepress.com.