Natural Scoliosis Care: Interview with Dr Tony Nalda

welcome back to another episode of

Christian Natural Health today I'm very

pleased to have Dr Tony nalda with us Dr

nalda holds a doctorate of Chiropractic

from Life University uh and built one of

the most successful chiropractic clinics

in Central Florida his expertise has

made him a highly sought after scoliosis

specialist in both the US and abroad Dr

nalda is a clear institute's chairman of

the board this is the only nonprofit

Chiropractic educational and

certification Center devoted to

non-surgical scoliosis treatment and

research

he's also a Max living board member and

instructor and a keynote speaker who

teaches chiropractors across the world

he's written several books including

scoliosis hope how new approaches to

treatment are transforming lives and he

successfully LED his family practice for

20 plus years and continues to seek out

the latest and most effective modalities

for treating patients naturally welcome

Dr nalda thanks so much for joining us

I'm glad to be here it's it's really a

pleasure yeah absolutely so you have a

really interesting backstory of how you

got into medicine and also specifically

Chiropractic tell us that before we get

into scoliosis specifically yeah it's

kind of reliving that is least not the

best experience but it's yeah yeah it's

the truth um unfortunately I was not a a

healthy child I started developing um

really dilating migraines at a very

young age um around 10 years old and um

they were became to the point where I

was almost nonfunctional as a as a child

and I my parents sought out all the

professionals down in Miami I mean I had

No Lack of resources and try to search

for the problem and uh only the only

thing that happened was laring more

medications and top of medications and

to of medications until I was completely

um drugged out of my mind and it was not

until a very year weird scenario that my

mom was in a pharmacy buying me my

migraine medication and somebody

happened to say to her you know I I had

migraines and I went to a chiropractor

and I and I don't got them anymore and

my mom had no idea why to take me to a

chiropra I didn't have a spine problem I

didn't have back pain I I had like you

know migraines but she did so she take

me to a chiropractor and that's what

changed my life I started getting

chiropractic care I started getting my

spine corrected migrain started

resolving themselves and then I realized

you know hey there's something to this

Chiropractic and it made me want to

become a chiropractor I knew I wanted to

go into Healthcare yeah I just did not

know it was going to be Chiropractic

because I was actually gearing more

towards like you know traditional

Medical Care and traditional type of you

know like like neur neurology or

something along those lines and and um

but I ended up becoming a chiropr

because of my personal experience

because it worked yeah absolutely great

so and then how did you end up becoming

a specialist in scoliosis how did that

happen yeah so that's a great question

too because I I I graduated Chiropractic

College and I started practicing in

Central Florida and I I I rebuilt a

relatively large family practice really

early in my career and I was seeing lots

of patients but and I was seeing

patients also with scoliosis and I had

this intrinsic desire to try to improve

the shape of patient spine um not only

to improve the function but to improve

what we see structurally and we got

patients with scoliosis and I was doing

what I was taught to do in terms of

General patient population and I wasn't

getting the results that I should or I

felt I should and I had one girl in

particular that she was a um a horseback

competitive horseback rider and we

wanted really to try to preserve her

scoliosis and it was worsening and we

didn't and I started searching and that

girl like sparked me becoming like

there's got to be a way to deal with

scoliosis more naturally because she was

looking at this invasive spinal fusion

though which not only going to end her

career but potentially alter her entire

life so therefore I was very so I mean I

literally traveled with her I took her

with me to places trying to figure out

you know okay how are we going to figure

this how we going to get this better and

um and thankfully we did and then that

kind of sparked this idea of like

there's got to be a better answer yeah

yeah and now you know funny my wife now

has scoliosis one of her daughters

developed scoliosis we treated it

earlier we reduced it she never

progressed and she was like a high-risk

case that she should have progressed

into a more severe number so now it's

personal like now it's part of my life

and my family obviously country but of

course it's been part of my life for 26

years my my practice yeah yeah yeah

definitely makes sense so okay so can

you anybody who might be listening and

isn't aware of what scoliosis is give us

a real brief overview what is it and

then what are some of the ways that it

can manifest if not treated from a

symptom standpoint yeah so it's funny

scoliosis has like two lives it has the

Adolescent form and then it has the

adult form and basically what scoliosis

is it's a curvature of the spine meaning

a Bend looking from the front and it has

to have an Associated rotation or twist

associated with it and to be technical

the angle of degree needs to be degrees

are greater on the measurement of the

cob angle which is the way they an the

way they measure the scoliosis on an

X-ray so 10 degrees are greater with

Associated rotation the man the symptoms

are very different depending upon what

happens and this is the weirdest part

like because it's not related to the

magnitude of the curve like you you

would think that the more severe the

curve the more symptoms somebody would

have meaning pain or discomfort yeah but

the truth is it's not that because the

majority of cases the curve is developed

in while somebody's growing and we don't

we never not say never in the majority

of cases we don't know what's causing it

it's a multifactoral causation it's kind

of like finding out the cause of

inflammation right right right there's

so many factors that cause inflamation

is so seeing somebody has scoliosis it's

like there's so many variables that we

think be involved in development of the

scoliosis we consider it a multifactoral

problem but when it initiates it

progresses during growth and of course

we know kids while they're growing are

very adaptive and they grow around the

curves and they feel no symptoms no pain

no nothing very small amount of kids

with scoliosis feel pain so the only way

the curve gets diagnosed if it becomes

big enough to be seen it's a postural

evaluation it is like uneven shoulders

uneven hips so in children the only

symptom they have is asymmetry some type

of asymmetry and a lot of times it gets

blown off like it's not like that big of

a deal because it's not causing

dysfunction it's not causing limitations

so a lot of patients don't get diagnosed

we think we only find about 30% in

children because they become big enough

to be treated because they can really

see the differences right but in the

adult form the progression becomes a

whole other animal meaning now the as

they're growing and they stop growing

the body can no longer adapt and now

they have these Curves in their spine no

matter what the size and now gravity

takes over and gravity starts pushing

down on these curvatures in an

asymmetrical Manner and it causes very

slow progression in the adult form but

the slow progression is now compressive

and it's now compressing asymmetrically

which now can lead to pain and

dysfunction so the number one symptom in

the adult form is pain that's what

brings on treatment the number one

symptom in the Adolescent form is only

asymmetrical posture so it's two

different things and it can almost be

weird for some for a patient that knows

they have scoliosis because they say hey

I had a big scoliosis as a child and I

don't have had no pain and now I have it

an the adult so they almost discount

their scoliosis as the cause ah yeah

okay that makes sense yeah yeah and

because they don't realize that it's

it's progressing for two different

reasons sure so the way I like to

explain it is that the the likelihood of

it developing pain in the adult is not

relative to size it's relative to how

much you worsen so you can have a 100

degree curve as a child zero pain

biggest curve I've seen in an adolescent

155 degrees wow yes no pain walked in my

office yeah because the body has this

amazing ability to compensate especially

during growth right so you we know that

it's it's reacting and and adapting and

growing around everything and and so

walks in my office like any other kid

like you know going to high school like

it's this crazy 150 degree curve right

so you're looking almost like a U-turn

in somebody's spine where somebody could

have a 25 degree curve in the adult form

and be in excruciating pain because of

their scoliosis right so it's relative

to what happens in the adult form the

acquired agression in the adult it's the

most likely thing now what's the most

common pain you're going to feel by far

low back pain going down into the left

side of the body left low back pain left

leg left numbness left sciatica because

left lumbar curves are by far the most

common um yeah yeah so the most classic

pattern is a left lumbar right thoracic

and that's because the body innately

moves the spine away from the

cardiovascular system and yeah yeah and

that's just the innate reaction so 95%

curves are that pattern

so and if you catch it in a child what

would you do to prevent the adult

manifestation and versus if somebody

comes in as an adult and they didn't

catch it in childhood or as they as a

teenager what does treatment look like

from your perspective and also

conventionally what would there yeah

yeah so let's talk about con excuse me

let's talk about conventional first

because conventional is where if I again

this is I think the most important uh

factors that we have to look at because

the management of scoliosis in both

sides in Adolescent and adult form is

and to me horrific like it's like the

worst management model in the world when

it comes to treating a problem it is

literally almost no treatment until the

curve becomes big enough to consider

surgery um there's very little options

um and it's because they don't consider

um the the the scoliosis to be an issue

and they can do something about it to

reduce it and the only thing they can do

something about it is to reduce it is

they spinal fusion and and and surgeries

which fuse multiple I mean you're

looking 13 you know 12 13 14 vertebras

in the spine so it's in mobilizing the

spine and they know this surgery is a

very high risk surgery nobody is going

to Discount that so they have to wait

until it justifies correct we justify

the surgery so because of this no

treatment's offered in the majority of

cases the only cases that are treated is

one very specific group and that's going

to be adolescent cases that are rapidly

going through puberty and they put them

in a brace to try to slow down

progression and they're not trying to

reduce it not trying to make it better

they're just trying to slow it down

that's the only case it's treated yeah

outside of that they're only treated for

the symptoms like they're treating for

pain they'll give them medications

they'll give them injections but the

curve itself isn't treated and it's

still progressing and still causing

problems so it's a really really poor

treatment model and in fact in the adult

form they're almost the scoliosis is

almost discounted they say oh yeah you

have scoliosis don't worry about it

don't worry about it until it becomes

yeah bad enough causing more

debilitating pain more debilitating

problems and then when that happens

they'll say oh yeah you have scoliosis

that's your problem but now things are

so bad and normally you're in an older

stage bracket of life we can't do the

surgery now anyway because you're not

going to survive it so it's this really

bizarre treatment model and patients

come in very frustrated I I see two

groups I see kids and I see older adults

and I very rarely see the middle group

because that middle group kind of does

okay because the curve is progressing so

slow they're not feeling the effects yet

not too much they're normally having

like what I call um like almost every

day or with common back stiffness and

pain and fatigue issues but not like

debilitating or life stopping like they

can still function every day somewhere

Post 40 to 50 is where things start to

change right this has been slowly

growing and developing over their life

so for an adult who has back pain and

they get IM done and they see that

there's maybe some scoliosis but then

there's possibly other incidental

findings possibly other causes like

maybe they've got a herniated disc cure

there maybe they've got like a little

bit of osteoarthritis or you know that

do people usually say oh it's something

else other than this scoliosis or I mean

how yeah so that's exactly what happens

the orthopedic doctors will chase the

other findings and not the scoliosis and

the scoliosis is causing all the other

findings got it okay there's no way you

can have scoliosis and not have bulging

and herting disc there's no way you

can't have scoliosis and have

asymmetrical degeneration and

osteoarthritis there's no way those

things can't exist because if you have

an asymmetrical spine it's just physics

right car is out of alignment it's going

to degenerate abnormally things are

going to wear out asymmetrically you're

gonna have problems same thing is true

with your

spine and and so therefore it just gets

neglected they don't even a lot of times

I have patients come in and they'll show

me Imaging and they had scoliosis you

know 10 years ago and they didn't even

talk to them about it because they

couldn't treat it it wasn't big enough

to put a rod in their spine so they just

you know oh send out for injections or

give them some over counter medications

or some prescription medications or some

of those things sure oh my goodness so

okay so if you have a child coming in no

symptoms but you see something

progressing yeah what would you do for

them to prevent and then same question

for yeah yeah so what's interesting is

these days the treatment model is very

similar meaning we use the same

approaches yeah even though they're in

different intensities and then I'll

explain right so for um the goal of all

treatment should be to first stop

progression but the best way to stop

progression is to try to reduce the size

of curve because the number one factor

that dictates how fast the curve is

progressing or How likely it is to

progress is the size of curve so the

only thing we G we can try to influence

is the size so if we can try to make

some curve smaller especially in the

midst of development we really mitigate

risk of progression and they're going to

go into the adult form with a smaller

curve which is very beneficial so the

Adolescent Cas is we're working very

aggressively to reduce curves as quickly

as we can you know in a younger stage of

life I would say 18 years 20 years or

less even young adults can change really

well because your spines are vertiv be

flexible but if we can get them while

they're growing and reduce the curve

during growth it's by far the best

because now they adapt around a

straighter spine and we get the best

results right so normally we're

condensing treatments into a more closer

program or trying to trying to think of

it like orthodontistry as opposed to

therapy it's like reduction stabiliz

holding reducing and we're layering

reduction and reduction and reduction

over time to get it as straight as we

can get it okay now we hit plateaus we

always expect to hit a plateau because

like I said we don't know what's causing

this in the majority of cases and

normally we're catching it in a point

where scoliosis is structural and this

is what makes scoliosis different than

an injury it is structural so it is a is

inherently growing or developing like

this so it's structurally embedded in

the spine so we reduce it reduce it

reduce it reduce it and then we wean

them off and then we manage them in the

adult form now in the adult cases we do

the same thing we want to reduce it but

normally it's not as as aggressive we're

not laring treatments as quickly close

together we're seeing them more spaced

out a little bit further apart which

I'll explain that in second and the goal

is still to reduce it but normally a

lesser percentage so with with an

adolescent we can reduce curves 30 35%

yeah yeah where in an adult case we're

looking you know 20% 15% depending on

the adult but this is like a later stage

adult the group in the middle the 20 to

45 year olds they're like a whole group

that could have potentially amazing

changes because they're still relatively

young and their spine is still

relatively flexible but normally they're

not motivated because they're not

feeling a lot of problems yeah

unfortunately so it's not for the

younger kids is it braces or is it like

the same way or is it yeah yeah it's

braces too okay yeah yeah I'll tell yeah

we use both things in both groups we use

three types of treatments and I'll

explain what they are we use something

called intensive Rehabilitation now

where most scoliosis patients fail with

the treatments that they receive is

they're treated like they're injured so

adult patient they have back pain

they'll go into a chiropractor massage

therapist physical therapist and they

say okay you have back pain we're going

to go through injury Rehabilitation

which is lowd dose long duration they do

a little bit of care over a very long

time to help somebody heal from the

injury they received and it makes

perfect sense that's what I was trained

to do and that what doesn't work for

scoliosis because scoliosis itself is

not an injury right yeah it's a

developmental problem that somebody's

grown and developed with over their over

their whole life so treating it long and

slow produces very little structural

change but it can help them

symptomatically okay so I'm not

discounting the symptomatic Improvement

but it's not going to structurally

reduce to curve so the founder of clear

Institute Dr wogan out of Minnesota he

came up with this concept is that maybe

if we just worked at it really hard in a

shorter dose in a shorter time and

increased the dura the intensity but

decrease the duration could we reduce

this curve in a more aggressive manner

because what we're fighting is the curve

always wants to go back like it's this

bounceback effect it's is a rebound

effect right you know the plasticity

that exists naturally in somebody's body

so what he came up with what what if we

saw them every day and instead of only

seeing them like one session we did four

or five six sessions per day and we gave

go through like four to six hours of

care daily for a period of 5 10 or 15

days and try to reduce this curve so it

can't bounce back right and this this

the the literally the culmination of

this thing called intensive care you now

intensive care is not like intensive

care in a hospital it's just condensed

therapy in a very short duration to get

this rapid reduction and the amazing

thing is it's it's amazing how well it

can reduce the scoliosis because the

spine has the ability to change shape

it's just always wants to bounce back if

there's long breaks between therapies

sure okay this intensive model is the

key because we reduce it quickly right

however if nothing happens after this

intensive model the Curve will go right

back yeah yeah so now we have to hold

this new position and now we hold it

with using home therapy and home

exercises that are designed for

scoliosis right they're called SS

scoliosis specific exercises not General

exercises not like abs and biceps that

stuff doesn't um and against it it

doesn't really manage the curve so it's

something designed based upon your curve

type okay so we give scolio specific

exercises and then we use bracing and

braces that we use are something called

corrective bracing now the difference

between the braces that we designed and

what I mentioned the orthopedic doctor

would use to try to stop growth is they

designed something called a Boston Brace

and a Boston Brace is a squeezing style

brace to try to slow progression so it's

squeezing the body trying to acting like

a cast and trying to hold it in place

where we build something called a

corrective brace and a corrective brace

doesn't squeeze it pushes and by pushing

you're trying to push the spine

straighter into a more corrected

position not squeezing and just hoping

it doesn't

worsen like yeah I think of like a

retainer for your teeth versus

corrective braces of your teeth nobody

wear braces on their teeth that the best

thing the brace would do was slow down

how people wear braces on their teeth

they make their teeth straighter so we

use the same principles got

it and I'm envisioning

that if you are doing that level of

intensive treatment there's going to be

a lot of muscles that are angry during

that period of time right I mean well

well interesting enough you would think

that it would be like okay patients are

gonna get a lot of pain or S well no

it's actually not no it's not most

patients are have relief because the

number one reason they're feeling pain

is something called stiffness so

scoliosis has an inherent stiffness what

I mean by that is when you have a

patient with no scoliosis and they Bend

left and right they have symmetrical

bending pretty close we have patient

with a scoliosis they have a curve built

in and then when they bend that curve

doesn't come out that's the structural

component they can't bend the other way

when we do our therapy we're actually

trying to push the curve into that

opposite position and it creates a

tremendous amount of relief because what

ends up happening these joints become

stiff they hold their toxins and all

their things in them and they can't get

them out because there's not enough

motion so when we induce that motion

they feel better they may get like

soreness like exercise soreness but not

like bad like they know it's inherently

good yeah because they can feel like

they're moving better and being more

flexible and those kinds of things so so

that's what the in kive hair does it

really opens up the flexibility

component that way they can exercise

their spine better using the scoliosis

exercises and then we can use the

bracing to help push and hold everything

and then it's exactly like

orthodontistry every three months we

evaluate we see what we have and do we

make modifications to try to reduce it

again or do we keep holding with

adolescence we're more likely to make

modifications to to make um future

reductions with adults we're more like

okay maybe we're just stabilizing right

now so that's the main difference okay

so and as far as achieving results it

sounds like it probably varies depending

on level of curvature and age and all of

that but on average how long does it

take for people to it sounds like they

feel relev pretty quickly in that yeah

so that that's the the craziest part

like within we nor know whether this

thing is going to be successful within

90 days right they're seeing right we're

seeing a change within the initial

intensive program um but but an initial

change doesn't mean it's going to stay

so I always say what really matters is

the 90-day evaluation and then in 90

days we evaluate them if we're seeing

some improvement at that point and

things are holding it's a very high

chance we're going to be successful very

high chance now unfortunately not

everybody is but the I would say that if

we accept somebody as a patient I mean

we can qualify them we take the right we

have a very high success rate if we

accept you right got because we read out

the ones that we think yeah yeah we know

we're not gonna make a go through

something if we think it's not going to

work sure okay yeah um but very high

Sixx rate with with with getting there

so if we get a hold at 90 days then as

long as patients are compliant and

they're doing what we ask them to do and

we'll be weing them down really slowly

and keep an eye on things we're gonna

get a good result great yeah and so you

see people from all over not just in

Florida so people will come in for this

intensive session and then go home and

monitor remotely how does that work yeah

exactly like that we normally send them

back to their local doctor typically a

chiropractor physiotherapist along those

lines and we co-managed uh we co-manage

them for those 90 days 90 days we

request x-rays they'll email me x-rays

email me posture photos we talk on the

phone we figure out okay what happened

and then we give FAL recommendations so

a lot of patients will travel in for one

two weeks we take care of them initially

send them back to their local doctor

because you know the thing with

scoliosis is a lot of patients get

treated by doctors and they have

scoliosis but very few doctors will

treat their scoliosis right ex treat the

symptoms of their scoliosis right and

that's a completely different thing sure

right so we're totally okay and I'm

totally a proponent of patients

continuing to seek out that treatment

for the symptoms of their scoliosis we

just help manage their scoliosis in the

process of it yeah so that intensive

period it's just one to two weeks

typically yeah it depends on the size of

curve it could be it could be a five-day

treatment it could be a 10-day treatment

and then normally with the most severe

cases 15 days it never goes beyond 15 I

tried hey more is better right so this

this go longer there comes a diminishing

return the body can only accept so much

change in one time it's kind of like

magic getting braces on your teeth too

tight day one got it yeah and that'd be

aw it just won't it won't take it it

won't take it that's why yeah so that's

why orthodontist they layer it over a

period of 18 months and that's exactly

what our corrective phase tends to be

somewhere that 12 to 18 month range and

then right around there we're we're

plateauing and then we're weaning people

out and we're just monitoring um that's

that's R in treatment model so just

curious I know you've already alluded to

the fact that there's lots of different

possible causitive factors for scoliosis

and so I mean I've heard because you're

using the analogy of of Orthodontics um

I've heard people suggest anyway that

part of the reason why teeth end up

becoming out of balance where

historically possibly that wasn't

happening nearly as much has to do with

you know smaller mouths and sinuses

getting smaller and things like that can

you speculate on some of the reasons why

scoliosis occurs like I know I know you

there's a lot of ideas but just kid yeah

there's many many theories but I would

break these theories down into three

main right so something called a

neuromuscular problem some type

neuromuscular issue now neuromuscular uh

issues are like autism right there's a

huge spectrum and some people know they

have a neuromuscular disease and it's

very very obvious they have

multifactoral system problems but some

people have neuromuscular findings and

not be diagnosed because it's not big

enough to diagnose okay okay so what

something that affects the nerve system

something affects the ligament system

something affects the muscle system so

either laxity or rigidity in the in the

and like I saw you had a Blog about erer

syndrome aler syndrome is associated

yeah it's associated with scoliosis

because it's laxity there's a lot of

laxity conditions Marfan syndrome and

then there's um syndromes that create

rigidity stopy neurofibromatosis so some

type of underlining neuromuscular

condition that may be diagnosable but

they could be a very they could be the

spectrum of this yeah yeah but they

can't diagnose it right something there

um genetics we know there's a genetic

component they've done studies on

identical twins they found 60% of

identical twins to share scoliosis but

40% don't wow but 60% do so there is a

genetic tendency I we we I think it's

more like an epigenetic approach but

there is something there because I'll

see some families every person in the

family has it and I'll see some families

one person has it right and then the

last one I would say is something

Environmental M uh traumatic

exposure um something nutrition wise

malnutrition that affects hormonal

development growth mdle of those lines

um and the problem is all those factors

will Express them all those causes will

Express a curve in the spine got it and

the Curve will be really small and then

it will progress really slow until they

go through growth and then the Curve

will prog has a potential to grow with

them right while they grow got it and

possibly if it was something epigenetic

or something toxic when they were

growing by the time you see them if

they're adults it's long gone it's just

now we're dealing with this equ right

100% like I always tell patients if we

knew the cause it may not affect your

treatment in fact in the majority of

cases I would think

99% right we're gonna treat you the same

way right because if somebody truly has

a diagnosable neuromuscular condition

they have something that we we know it's

there Facey we still treat the curve

like a curve right yeah yeah yeah that

makesense you you don't treat the supery

and the curve gets better because by the

time we treat them the curve is

structureal already it's developed its

own problem it's becoming its own thing

sure yeah that makes sense so what have

I not asked you that you want to make

sure you leave with our audience yeah I

mean you can see there's a lot to talk

about right you know yeah I would say

the most important thing is that if you

have scoliosis and especially in the

adult form and you know you have it the

worst advice you can ever be given is

not to worry about it right minimally

monitor it minimally take X-rays every

you know every couple years see what

it's doing we expect very slow

progression but slow progression is what

leads to more rapid progression as they

get as you get older and then if if you

have it I would always recommend try to

treat it try to treat it reduce it you

know you don't have to you're not going

to cure it but you have to manage it

because you're not going to get rid of

it so you have to at some point the

curve is going to progress to a point

where it's going to require your

attention right we know spinal

disability is one of the number one Cult

of disabilities worldwide right right it

is growing it is not going down you know

we expect patients over age 60 somewhere

around 30 to 50% of patients have

scoliosis so it's a big deal right it's

a big deal so I would say manage it

treat it do something about it and

minimally monitor it because if you

don't monitor it you and then the first

question ask is you have any me memory

of what your curve was we don't know how

much you worsened over time and and

that's a hard makes it harder to manage

right yeah that makes sense so where can

people go to learn more about you and

your clinic yes so my website scolis

scoliosis ruction center.com is you know

a great resource there's a lot of videos

on there a lot of blogs I have lots of

information I have a YouTube channel

with hundreds of videos on scoliosis

again this Google scoliosis reduction

Center or YouTube search schol reduction

Center and then of course I have the

nonprofit that I'm a chairman of board

of which is clear Institute and they're

based out in Minnesota and we have a

nonprofit that we have you know doctors

that are kind of learning the process

and supporting this process uh worldwide

so we have like 30 or 40 doctors that

have gone through the certification and

those are your main resources I think

that would be that'll guide you in the

right place fabulous okay I will put all

of that in the show notes thank you Dr

nalda this has been really enlightening

I appreciate it yeah thank you for

having me

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