How to become the scoliosis professional in your community

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How to become the scoliosis professional in your community
2005
By Marc Lamantia, DC,DACNB
Chiropractic Economics

Non-surgical scoliosis treatment is reaching its highest acceptance level since the advent of the Boston brace. Despite the orthopedic communityÌs reluctance to refer scoliosis patients to chiropractors, recent research confirms that chiropractors accept scoliosis patients and offer physical therapeutics and exercise as adjunctive treatment.

Research also confirms the use of physical therapeutics and spinal bracing are effective in reducing scoliosis. Because parents are more aware and more willing to challenge the standard Ïwait and seeÓ management for scoliosis, the need for non-surgical specialists is growing.

More than 1 million new cases of adolescent idiopathic scoliosis (AIS) are diagnosed every year, affecting nearly 3 percent of the population. The problem is real. The question is: How can you become the professional people will seek out for non-surgical management of both AIS, as well as for adult scoliosis?

Chiropractors have the opportunity to position themselves as the non-surgical provider of choice for the 21st century. Here are the steps that can lead you to this:

1. Embrace a rehab philosophy. Managing scoliosis with only manipulation or upper cervical care has not been shown to be effective. It also has served to isolate us from the rest of the healthcare community, and lessen our potential for referrals.

Although manipulation has not been shown to be effective in slowing a progressive curvature, it can be utilized to restore normal biomechanics and be used as a tool to retrain movement strategies.

Physical therapy and vestibular rehabilitation can be utilized a complement to manipulation and chiropractic adjustments. DonÌt turn a blind eye to a deforming disease that may have responded to other methods.

Some things you can do:

Ô Take postgraduate programs in scoliosis. This is an important part of becoming an expert.

Ô Offer physical therapy. Consider hiring a physical therapist. A PT can train patients in home-exercise procedures as well as offer in-office therapy. Surrounding yourself with quality professionals will serve to improve your Ïpractice personaÓ and the number of referrals you receive from other healthcare professionals.

A number of physical therapy programs have been developed in Europe and have been shown to be quite effective in managing scoliosis when used with a truncal orthosis.

One such program uses respiratory exercises along with a six-week intensive rehab program. The patient uses respiration in specific positions to induce derotation of the rib cage. Results of this therapy have been quite good, and with training, can be offered by you or a physical therapist in your office.

Most exercises do not need special equipment, only a therapy ball, a few wobble boards, an EMS unit, and some stretch bands.

Another program uses postural re-education and resistance training to restore more normal muscle recruitment patterns and can be performed in-office without expensive equipment.

Some equipment, made specifically for scoliosis rehab, is available; however, research on its efficacy is not available.

2. Develop proficiency in vestibular evaluation. Vestibular pathology has long been identified in the scoliosis community. Becoming an expert in vestibular neurology and rehabilitation may be the single most important factor in your ability to get referrals from medical professionals.

Most orthopedic doctors understand the relationship of vestibular dysfunction to scoliosis and will refer to a professional who has demonstrated skill and knowledge in evaluation and treatment.

You can develop your expertise through post-graduate programs in scoliosis vestibular rehabilitation or become trained to use advanced neurodiagnostics, such as video electronystagmography (ENG) and by providing the necessary rehab-ilitation as an in-office procedure.

3. Market your expertise. After you have developed your expertise in scoliosis, itÌs time to market your practice.

Some ways to do this include:

Ô Inform the press. Send out a release whenever you take a program in your advanced training.

Ô Offer programs to the community. Of high importance Û scoliosis screenings in elementary schools. You may also want to offer screenings to local karate groups, dance classes, and summer camps.

Your involvement with the community and your interaction with parents will serve to show that you are a non-surgical expert. If you find children who have signs of scoliosis and require further evaluation, send a letter to their parents, outlining your findings and your recommendations for further evaluation Û including referral to the nonprofit Scoliosis Care Foundation.

The Scoliosis Care Foundation (www.scoliosiscare.org), founded by a chiropractor (Dr. Gary Deutchman), offers form letters you can download and personalize. It also offers free brochures that teach parents how to recognize the physical signs of scoliosis.

Ô Inform the local chiropractic community. Promoting within the local chiropractic community can also serve to position your practice. Chiropractors can be one of your best sources of referral. Many chiropractors in your area will be willing to refer scoliosis patients to a colleague who is trained and equipped to manage the case.

4. Offer comprehensive care. Provide care appropriate to the needs of your patients, including fitting them with an appropriate thoraco-lumbo-sacral orthosis (TLSO).

Recent advances in biomedical engineering that allow flexibility and full movement have provided alternatives to traditional rigid braces that may produce skin lesions and muscle atrophy.

Marc Lamantia, DC,DACNB, holds a diplomate from the American Chiropractic Neurology Board, and is a member of the adjunct faculty for New York Chiropractic College and Life Chiropractic College West. Dr. Lamantia is the co-founder of Scoliosis Systems, and holds a position on the Science Advisory Board for the nonprofit Scoliosis Care Foundation. E-mail questions to info@scoliosissystems.com.