Throughout the nineteenth and early twentieth centuries, Scoliosis patients used braces and other stabilising devices in an attempt to correct their spinal curves.
Some of these devices were created and prescribed by physicians while others were produced by an individual or company, and had no scientific basis for correcting Scoliosis. In either case, the braces and plaster jackets worn by scoliosis patients disrupted their lives. They were painful, restricted movement and could not be removed for bathing. The physical disability caused by Scoliosis often made children and adolescents self-conscious; the cumbersome devices only added to their problems.
The treatment prescribed most often for Scoliosis patients was a plaster jacket worn to halt progression of the curve. Unfortunately, the jackets failed to do this. Further, they were poorly constructed and often disintegrated while a patient was wearing it. Leather, metal and flexible textiles were also used to construct the jackets. Jackets might be worn for years at a time, and occasionally changed to accommodate growth. In the end, plaster jackets were most often worn to hide deformities.
In 1904, metal "pressure pads" were introduced in an attempt to prevent development of severe curves. These pads, sewn into Scoliosis jackets, applied pressure on the spine and chest. The plates were intended to correct asymmetries of the pelvis and stooped shoulders by reducing lung expansion on the concave side of the spine while increasing it on the convex side. Physicians hoped this would cause the spine to move toward the mid-line of the back. The vertebral rotation that accompanies Scoliosis was yet undiscovered. Once recognized, its correction became another goal of treatment.
By the 1910s, jackets and other Scoliosis treatments were abandoned due to the pain and discomfort they caused. However, they were revitalized in the 1920s in the form of padded jackets that applied pressure to only the convex side of a curve. Without any force on the concave side, a curve might be able to move toward the middle line of the back. Patients wearing the jackets were also advised to do muscle exercises that were thought to assist in this process. Patients were still put in traction at this time, but for only four to six weeks. Some patients opted for the newest surgery, to fuse the spine, and suffered through long recovery periods. Removable braces were also available by the late nineteenth and throughout the twentieth centuries. Most braces were made of metal rods that were connected to one another by leather hip-bands and straps.
Early braces had some success in the prevention of severe curves, and provided a model for more modern braces. Patients could now be examined with greater ease. They had more freedom of movement and could resume normal activities. However, most braces were as uncomfortable as the jackets had been. They were usually heavy, bulky and damaging to the skin. As braces became easier to remove, a new problem developed; frustrated, uncomfortable patients removed braces too often, allowing the curve to worsen.
Several ineffective devices were used during the nineteenth and twentieth centuries as well. Some women wore fashionable corsets with no medical value, believing the corset would hold their spines in place. Medical corsets were typically prescribed for those who wanted to hide deformity. They resembled fashionable corsets and were made of plaster of Paris, leather, woven wire, celluloid, felt saturated with a gluey substance, or perforated aluminum.
The corsets were reinforced with metal rods or strips of steel. Suspenders and brassieres were also sold as corrective gear and were claimed to straighten the shoulders and support the back, which supposedly corrected scoliotic curves. Many commercial braces were also available.
Although constructed to look like medical braces, they had no effect on Scoliotic curves. Most of these braces had no pressure pads, and those that did, had pads that were improperly placed within the brace. None of the braces were custom-made for a good fit. They were simply mass-produced and sold though women's magazines and catalogs.
Braces are commonly used to halt curve progression in Scoliosis patients today. They are usually made of plastic and are easy to remove for bathing and other activities. Each brace is custom-made for a patient. As a result of this, and of pressure pads, braces are used with success in many Scoliosis patients. However, not all patients can be helped with bracing. The degree and type of curve may have an effect on the success of the brace.