The “ScoliPAIN-Progamm” – Scoliosis treatment for adults

4. Interview with Dr. Clayton Stitzel

What is the ScoliPAIN-programm?
The ScoliPAIN program is a less intense 5 day program designed to reduce pain, increase function, and get the patient started on a home rehab program to provide long-term stability

How old are the ScoliPAIN Patients?
There are no actual age requirements for the program, as each case is accepted or declined individually, but ultimately the program is really about helping patients reach their treatment goals for when curve reduction isn’t the top priority.

What is the difference between treating mature patients and adolescent patients? Are there different treating methodes?
The goal in each case is the same, improving biomechanical function of the joints, but there are many different ways of doing it and all can be modified to meet the needs of the patient.

Do the patients continue the programm at home?
They do. In many cases, scoliosis is a life long journey, thus a rehab program has to reflect that as well.

Do the ScoliPAIN patients come for a reevaluation?
No, they don’t. Since the primary treatment goal is not curve reduction, a x-ray re-evaluation is not necessary.

Do ScoliPAIN patients reduce their curves?
I’m sure many do, but often to insignificant amounts do to the structural limitations of their case and the design of the program.

Are there any long term studies?
The program is relatively new, so no long term data is available at this time.

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ScoliScore? Neurotransmitter?

The third Interview with Dr. Clayton Stitzel about ScoliScore Testing and Neurotransmitter

What is ScoliScore Testing? Does every patient get tested? 
Stitzel:  ScoliScore is a saliva test for genetic pre-disposition that identifies 53 markers that are associated with severe scoliosis progression.  “Test-able” patients have to be between the ages of 9-14, non-Asian (unique genetic markers for scoliosis), and have a curve between 10-25°.  They can be male or female and about 15% of the “ScoliScore” (0-200) is based off the genetic markers and 15% is based off other measures like age, cobb angle, ect.

How does the testresults influence the treatment of the patient?
Stitzel:  I can’t speak for how it influences the treatment protocols for other doctors, but we find that it allows us to “gage” the most appropriate level of treatment invasiveness for the patient prior to the curve progressing.  For example, a patient with a very high ScoliScore (<180 out of 200) may elected to have a minimally invasive, non-fusion procedure like vertebral body stapling or tethering done in anticipation of a major growth spurt.  Likewise, a patient with a low ScoliScore (>50) may choose to only engage in a rehab based program like the Scoliosis BootCamp program to minimize curve progression risk.  We have even developed an alternate treatment model flow chart based off the patient’s ScoliScore, rather than Cobb angle, witch is much more accurate.  I have provided images for of both the ScoliScore directed treatment model and the Cobb angle vs ScoliScore curve prediction graph.

ESSI.Flow.Chart9-19-2013 11-53-46 AM
One part of your treatment is “neurotransmitter-rebalancing”. 

What are neurotransmitter?                                                                                    Neurotransmitters are the chemicals in your brain that allow your brain and body to communicate with each other.  Serotonin, Melatonin, and Norepinephrine are some of the more common ones people have heard of.

How do neurotransmitter imbalances relate to scoliosis? How does “neurotransmitter-rebalancing” work? 
Our research has uncovered a common pattern of neurotransmitter imbalance in scoliosis patients that seems to revolve around the Serotonin-Melatonin conversion pathway, which is especially significant given the compelling research linking Melatonin to the development of idiopathic scoliosis in adolescent patients.

Re-balancing neurotransmitters is a very safe and simple process involving mostly specific amino acid supplements.  The trick is doing the testing to identify the imbalances and making the appropriate recommendations.
What kind of supplements do the patients take? 
Generally amino acids, but sometimes specific enzymes, minerals, or vitamins may be required to increase absorption or active a specific conversion pathway.

How long do patients need to take the supplements?
Most patients will need to take them for 4-6 months before re-testing and further recommendations can be made at that time based off the new testing information.

Do adult patients also have unbalanced neurotransmitters? Would you recommend “neurotransmitter-testing” and an supplementation for adults,too?
I’m sure they do have imbalances.  We haven’t done enough work with the testing and treatment to know how much benefit it may have for adult patients, but there is certainly no downside to having your scoliosis specific neurotransmitters in balance, so I don’t see the harm.

Are there any studies about the correlation of Neurotransmitter imbalances and scoliosis?
ScoliSMART Clinics are really the ones to bring this new information and technology into the field of scoliosis treatment, so the published research is limited, but we do have a peer reviewed study comparing to groups who went through treatment (one with re-balancing, one without) programs in one of our offices that should be published literally any day now.  Also, Dr. Mark Morningstar has presented his findings at the 2013 Chicago SOSORT conference and even done some lectures that are available on YouTube

German version:

Interview “Scoliosis Activity Suit™”

Second interview with Dr. Clayton Stitzel, Chiropractor of the ScolioSmart Clinic Lititz Pennsylvania
What do you think about common bracing?ScoliosisBrace
 Bracing is generally ineffective, especially when patients are risk stratified by common genetic likelihood of curve progression (comparing patients with similar genetic pre-dispositions (see chart)) with the ScoliScore test.  If we are correct that Adolescent Idiopathic Scoliosis is primarily a neuro-hormonal condition that creates the spinal curvature as the primary symptom, it would only make sense that simply immobilizing the spinal curve with a brace would have little to no effect on the primary neuro-hormonal condition.
SAS.FB.Text.PicWhat´s the difference between common bracing and the Activity Suit?
The SAS is basically exactly everything opposite of a brace. Designed to work with the natural torque pattern of human locomotion, the Scoliosis Activity Suit™ is the latest innovation in scoliosis treatment.  Scoliosis Activity Suit harnesses energy of human’s natural movement to create new muscle memory. This new muscle memory reduces and stabilizes asymmetrical muscle firing thereby reducing risk of curve progression and helping the spine unwind naturally, never forced. With each step, the body resists the Scoliosis Activity Suit’s force, changing the muscle’s stored energy and firing sequence. Like muscles, the spine adapts in terms of time and need according to demand.  Unlike bracing, the Scoliosis Activity Suit™ does not use direct pressure on the peaks of the curves to force correction as forcing correction does not induce new muscle memory.
How long do your patients wear the Activity Suit in a day? And how long do they need to continue the Activity Suit training after the bootcamp?
The SAS can be used reactively for short periods of time (20-30 min, 2-3  times per day) or supportively for much longer periods of time (6-8 hours) depending on the age of the patient, curve size, and pattern.  The overall length of time the patient will continue to use the SAS is very case specific.
How does it feel wearing an Activity Suit? Is it comfortable?
It is EXTREMELY comfortable and patients who are using is reactively often have to set a timer, so they don’t forget they have it on and wear it too long!  The reaction is very subtle and most patients don’t even feel like they are wearing it a few minutes after putting it on.
Is the Activity Suit also part of the treatment for adult patients?
Yes, in fact adult patients were included in the 1 year follow up study of patients using the SAS (
How long is the Activity Suit part of your therapy and what´s the success so far?
 We only officially launched the SAS as part of the ScoliSMART Clinics program January 1, 2014, but the 1 year follow up study conducted before that time found a 90% success rate (per bracing standards).
Is it possible to order an Activity Suit to Germany? ( I think this is going to be the most frequently asked question)
The SAS is not intended to be used as a stand alone treatment, only part of the overall ScoliSMART clinic treatment effort (especially for skeletally immature patients), but we are looking into making the “Suit only” option available for adult patients in the future.  However, the SAS would still have to be fitted and instructed by a certified doctor on a case by case basis.

ScoliSmart and BootCamp interview

with Dr. Clayton Stitzel, Chiropractor at  the ScoliSmart Clinc Pennsylvania USA

What does scoliosis mean?
Traditionally scoliosis has been defined simply as a curvature of the spine, but in recent times we are subdividing the condition into various kinds of scoliosis with Adolsecent Idiopathic Scoliosis (AIS) being the most common. We now now AIS has a genetic predispositon and almost certainly a neuro-hormonal cause that creates the spinal curve as the primary symptom.



“Activity Suit”on the left and “Torso-Trainer” on the right

What is the concept of ScoliSmart?
ScoliSMART is an effort to create a more comprehensive program that treats the whole scoliosis condition, not just the curve. Our triad of care includes dynamic rehab with the Scoliosis Activity Suit, neurotransmitter re-balancing, and static rehab with the torso trainer.




What is the difference to other non-surgical treatments like Schroth?
Schroth was the forerunner of all scoliosis exercise approaches, but relies on voluntary movement exercies, which is a bit out dated since we know spinal alignment is controlled by automatic postural control centers in the brain. Our approach is re-training those automatic postural control centers with subconscious rehab techniques.


What´s the Bootcamp and how long does it take?
Scoliosis BootCamp is our 10 program for patients with spinal curves larger than 25 degrees.


Is it necessary to continue the treatment all life long?
In most cases it is not necessary. Most patients can dyscontinue the rehab once they are done growing, although patients with curves larger than 30° do have an increase risk of adulthood progression and may benefit from continued rehab on a less frequent basis.


What happens after the Bootcamp? Is there a homeprogramm and a follow up?
We provide each patient with a personalized home rehab program and recommend re-evaluation 4-6 months later.


Do the results of your patients last?
We are in the process of publishing several long-term results studies that suggest the results do last, but each scoliosis is it’s own to a certain degree (pun intended)


Is it necessary to treat small curves?
The one thing all large scoliosis curves have in common is that they started out as small curve first.


Is the Bootcamp treatment also suitable for adults?
Yes, we have successfully treated many adults with the Scoliosis BootCamp program.

German version: