From the Guidelines
For chronic scoliosis pain, a multifaceted approach is recommended, prioritizing a combination of pharmacological and non-pharmacological interventions to minimize morbidity, mortality, and improve quality of life. When managing chronic pain associated with scoliosis, it is essential to consider the patient's overall well-being and functional status. According to the British Pain Society's guideline on low back and radicular pain 1, a structured management approach is necessary, despite the lack of high-quality evidence in some areas. The following management strategies can be employed:
- Pain management:
- NSAIDs like ibuprofen or naproxen
- Acetaminophen for mild to moderate pain
- Consult a doctor about prescription medications for severe pain
- Physical therapy:
- Tailored exercise program focusing on core strengthening and flexibility
- 3-5 sessions per week, 30-60 minutes each
- Posture correction:
- Ergonomic chairs and mattresses
- Practice proper sitting and standing postures throughout the day
- Bracing:
- For moderate curves, a brace may be recommended to prevent progression
- Wear as directed by your orthopedist, typically 16-23 hours per day
- Heat and cold therapy:
- Apply heat for 15-20 minutes to relax muscles
- Use cold packs for 10-15 minutes to reduce inflammation
- Massage therapy:
- Regular sessions (1-2 times per week) can help relieve muscle tension
- Lifestyle modifications:
- Maintain a healthy weight to reduce stress on the spine
- Avoid activities that exacerbate pain This approach addresses pain through multiple mechanisms, reducing inflammation, strengthening supporting muscles, improving posture, and managing symptoms, ultimately aiming to minimize morbidity, mortality, and improve quality of life, as emphasized by the British Pain Society's guideline 1.
From the Research
Management of Chronic Pain Associated with Scoliosis
- The management of chronic pain associated with scoliosis can involve various conservative treatment approaches, including bracing and exercise programs 2, 3, 4, 5.
- Bracing has been shown to be an effective treatment for chronic non-specific low back pain in patients with scoliosis, with studies demonstrating significant improvements in pain intensity and function 4, 5.
- Exercise programs, such as the Schroth exercise program, can also be beneficial in reducing chronic pain and improving function in patients with scoliosis 2.
- The use of a sagittal re-alignment brace has been shown to lead to promising short-term improvements in patients with chronic low back pain and spinal deformities, with significant reductions in pain intensity observed at 18 months 5.
- Rehabilitation programs, including postural and respiratory exercises, pain physiotherapy, and psychological intervention, can also be effective in reducing chronic pain in scoliosis patients, including those who have undergone surgery 6.
Treatment Approaches
- Bracing: can be used as a conservative treatment approach for chronic non-specific low back pain in patients with scoliosis 4, 5.
- Exercise programs: such as the Schroth exercise program, can be beneficial in reducing chronic pain and improving function in patients with scoliosis 2.
- Sagittal re-alignment brace: can lead to promising short-term improvements in patients with chronic low back pain and spinal deformities 5.
- Rehabilitation programs: can be effective in reducing chronic pain in scoliosis patients, including those who have undergone surgery 6.
Key Findings
- Bracing can be an effective treatment for chronic non-specific low back pain in patients with scoliosis 4, 5.
- Exercise programs can be beneficial in reducing chronic pain and improving function in patients with scoliosis 2.
- The use of a sagittal re-alignment brace can lead to significant reductions in pain intensity in patients with chronic low back pain and spinal deformities 5.
- Rehabilitation programs can be effective in reducing chronic pain in scoliosis patients, including those who have undergone surgery 6.