Dad has been in a steady decline these last few years. His back really seems to be getting worse and worse. Would a brace of some kind help keep him straight? He's started to get more and more twisted.

Conservative care for degenerative spinal deformities is definitely the first approach most doctors recommend. Bracing, physical therapy, and chiropractic care are tried first before surgery is ever considered.

Studies comparing different treatment methods for adult spinal deformities have not been able to identify one approach that works better than another. In general, there's only weak evidence that bracing works.

For some patients, bracing helps reduce the pain (if they are having any pain). Sometimes function is improved. For example, walking distance increases. If the person has other problems such as arthritis in the hands and/or shoulders, it can be very difficult getting the brace off and on.

Many older adults try a brace for awhile but eventually stop wearing it. They give different reasons for this such as forgetfullness, uncomfortable fit, difficulty putting it on and off, and so on.

It might be helpful to go with your father to his next doctor's appointment. Let him or her know your concerns. Find out what your father's options are and what the physician advises. You may have to try one or more approaches before you find something that works for him.

Clifford R. Everett, MD, MPH, and Rajeev K. Patel, MD. A Systematic Literature Review of Nonsurgical Treatment in Adult Scoliosis. In Spine. September 1, 2007. Vol. 32. No. Supplement. Pp. S130-S134.

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