Dr. David Kulla, DC provides individualized evaluation and conservative care for adolescents and adults with scoliosis at Synergy Wellness Chiropractic & Physical Therapy in New York City.
With more than 26 years of clinical experience, Dr. Kulla evaluates spinal mobility, posture, muscular imbalance, pain, function, and other musculoskeletal factors that may accompany scoliosis. Our Manhattan office is located at 237 First Avenue near East 14th Street.
Dr. Kulla’s interest in scoliosis is also personal. He was diagnosed with a spinal curve of more than 24 degrees as a teenager and wore a Milwaukee brace. That experience helped shape his decision to enter chiropractic care and his long-standing interest in helping patients better understand scoliosis and their treatment options.
What Is Scoliosis?
Scoliosis is a three-dimensional spinal deformity involving sideways curvature of the spine together with rotation of the vertebrae.
A standing spinal X-ray is typically used to measure the curve using the Cobb angle. A spinal curve measuring 10 degrees or greater is generally considered scoliosis.
Scoliosis is more than simply having poor posture. Structural scoliosis involves changes in the alignment and rotation of the spine that cannot necessarily be corrected simply by “standing straighter.”
Common Signs of Scoliosis
Possible signs include:
- One shoulder appearing higher than the other
- One shoulder blade appearing more prominent
- An uneven waistline
- One hip appearing higher or more prominent
- The body leaning slightly to one side
- A rib prominence or “rib hump” during forward bending
- Differences in the space between the arms and waist
Some people with scoliosis have little or no pain, while others, particularly adults, may develop back pain, muscular fatigue, stiffness, degenerative changes, or nerve-related symptoms.
What Causes Scoliosis?
The most common form in adolescents is adolescent idiopathic scoliosis. “Idiopathic” means that there is no single identifiable cause.
Other forms of scoliosis may be associated with:
- Congenital differences in spinal development
- Neuromuscular conditions
- Certain genetic or connective-tissue disorders
- Degenerative changes in adulthood
- Previous spinal surgery or trauma
Because scoliosis has different causes and behaves differently depending on age and skeletal maturity, treatment should be individualized.
Adolescent Idiopathic Scoliosis
Adolescent idiopathic scoliosis commonly develops during the years surrounding the adolescent growth spurt. The likelihood that a curve will progress depends partly on the size and location of the curve and how much skeletal growth remains.
Not every child diagnosed with scoliosis requires active treatment. Smaller curves are often monitored periodically, while larger or progressing curves may require bracing or evaluation by a pediatric orthopedic or spinal-deformity specialist.
Adult Scoliosis
Adults may have scoliosis that began during adolescence or may develop adult degenerative scoliosis later in life as spinal discs and joints change with age.
Adult scoliosis may be associated with:
- Back pain and stiffness
- Loss of spinal mobility
- Muscular fatigue
- Changes in posture or balance
- Spinal stenosis
- Sciatica or radiating leg symptoms
- Degenerative disc and joint changes
Conservative treatment in adults often focuses more on pain, mobility, strength, balance, and function than on attempting to substantially change a longstanding structural curve.
How Is Scoliosis Evaluated?
Dr. David Kulla, DC evaluates scoliosis patients individually. An examination may include:
- Health and scoliosis history
- Posture and spinal alignment assessment
- Forward-bending examination
- Spinal range-of-motion testing
- Muscle strength and flexibility assessment
- Neurological examination when indicated
- Assessment of the hips, pelvis, shoulders, and lower extremities
- Review of standing spinal X-rays when available
When scoliosis is suspected or curve progression needs to be evaluated, standing full-spine radiographs may be appropriate so that the Cobb angle and overall spinal alignment can be measured.
Does Every Scoliosis Curve Need Treatment?
No. Treatment depends on the size of the curve, age, skeletal maturity, progression, symptoms, and type of scoliosis.
Smaller curves in growing adolescents are often monitored. The Scoliosis Research Society generally describes observation as appropriate for curves below approximately 25 to 30 degrees, although individual circumstances vary.
Regular follow-up during periods of rapid growth is important because some curves may progress while others remain relatively stable.
Bracing for Adolescent Scoliosis
Bracing remains an important evidence-based treatment for selected adolescents who are still growing and whose curves are at risk of progressing.
Bracing is commonly considered for growing adolescents with curves greater than approximately 25 degrees and below roughly 45 to 50 degrees, although recommendations depend on skeletal maturity, curve progression, curve pattern, and other clinical factors.
The primary goal of bracing is generally to limit progression of the scoliosis during growth, rather than guarantee that the curve will completely straighten.
Brace design has evolved considerably. The appropriate brace should be selected and fitted according to the patient’s specific curve pattern and treatment needs.
Schroth and Scoliosis-Specific Exercise
Scoliosis-specific exercise programs are designed differently from general back exercises because they take the individual’s three-dimensional curve pattern into account.
The Schroth method is one well-known approach that incorporates individualized postural correction, breathing techniques, spinal stabilization, and exercises designed around the patient’s curve pattern.
Research supports the use of physiotherapeutic scoliosis-specific exercises as part of conservative scoliosis management in appropriately selected patients, particularly when supervised by clinicians trained in these methods.
Depending on the patient’s age, curve, symptoms, and treatment goals, Synergy Wellness may incorporate rehabilitation and physical therapy or recommend consultation with a clinician specifically trained in scoliosis-specific exercise.
Chiropractic Care and Scoliosis
Chiropractic care may be used as part of a broader conservative program for some patients with scoliosis, particularly when back pain, joint stiffness, muscular tension, or restricted spinal mobility are present.
Current evidence does not support promising that spinal manipulation alone will permanently straighten structural scoliosis or reliably reduce a patient’s Cobb angle.
For that reason, Dr. Kulla focuses treatment on the patient’s individual symptoms, movement, function, and musculoskeletal findings. Chiropractic care should complement, not replace, appropriate monitoring, scoliosis-specific rehabilitation, bracing, or orthopedic consultation when those treatments are indicated.
Can Chiropractic Help Scoliosis-Related Back Pain?
Some adolescents and adults with scoliosis experience mechanical back pain, muscular imbalance, stiffness, or limited spinal mobility.
For appropriate patients, treatment may include gentle mobilization or manipulation, soft-tissue treatment, therapeutic exercise, strengthening, mobility work, postural training, and physical therapy.
The goal is to improve comfort and function rather than promise structural correction that the available evidence cannot reliably support.
Does Scoliosis Always Require Surgery?
No. Most people diagnosed with scoliosis do not automatically require surgery.
Treatment can range from observation and exercise to bracing or surgical consultation depending on the curve and the patient’s age, growth, symptoms, and risk of progression.
Surgical evaluation is commonly considered for adolescent curves approaching or exceeding approximately 45 to 50 degrees, particularly when significant progression is expected. The decision is individualized and should be made with an appropriate scoliosis or spinal-deformity specialist.
When Should a Child With Scoliosis See a Specialist?
Orthopedic or scoliosis-specialist evaluation is particularly important when:
- The curve is progressing during growth
- The Cobb angle is approaching a bracing or surgical-treatment range
- The child has significant skeletal growth remaining
- There are unusual neurological findings
- Pain is severe or atypical
- The curve develops at an unusually young age
- There are concerns about congenital or neuromuscular scoliosis
Conservative care and specialist care do not have to compete with one another. In many cases they can be coordinated around the needs of the patient.
Scoliosis Videos From Dr. David Kulla
These videos from Dr. Kulla and Synergy Wellness discuss scoliosis, spinal alignment, exercise, and conservative treatment approaches.
Schedule a Scoliosis Evaluation in New York City
If you or your child has been diagnosed with scoliosis, has an uneven posture, has been told that a spinal curve is progressing, or is experiencing pain associated with scoliosis, Dr. David Kulla, DC can evaluate the musculoskeletal aspects of the condition and help determine appropriate next steps.
When bracing, scoliosis-specific rehabilitation, imaging, or orthopedic consultation is appropriate, those options can be incorporated into a coordinated treatment plan.
Synergy Wellness Chiropractic & Physical Therapy
237 First Avenue, 5th Floor
New York, NY 10003
Near East 14th Street in Manhattan
Call (212) 533-4900 or book an appointment online.