Medication
In adults, painkilling medication is usually the first recommended treatment option to help relieve the painful symptoms that are associated with scoliosis.
Paracetamol is the painkiller that is usually recommended as the first treatment for acute backache.
If paracetamol is not effective in helping to control your pain, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used.
If you are experiencing nerve pain as a result of your spine compressing or irritating the nerve endings, a nerve block may be recommended. This involves having local anesthetic injected directly into the affected nerves. A nerve block should provide short- to medium-term relief from the nerve pain because the local anesthetic will stop the pain signals that are being transmitted from the nerves reaching your brain.
If it is thought that the weakening of the bones of your spine (osteoporosis) is contributing to your symptoms, you may be given medication and supplements to help strengthen your bones. Find out more about treating osteoporosis.
Exercise
Research has found that regular daily exercises adding up to about 150 minutes a week (2 hours and 30 minutes) can help to improve posture and relieve the symptoms of pain.
A physiotherapist is a healthcare specialist who uses massage and manipulation to help promote health and wellbeing. They will be able to devise an exercise routine for you to help strengthen the muscles around your spine and correct your posture to compensate for the effects of the scoliosis. See Physiotherapy for more information.
Activities that do not place pressure on your spine, such as swimming, may also prove useful.
Braces
In adults, wearing a brace cannot correct your scoliosis but it can provide pain relief. If you find that walking irritates your spine because one leg is longer than the other (due to the curve of your spine), you may benefit by using special shoe inserts called orthotics. Orthotics can help to correct your posture.
Surgery
Due to the relatively high risks associated with spinal surgery, surgery for scoliosis is usually only recommended if:
- You have severe pain that is not responding to non-surgical treatments.
- The curvature of your spine is getting progressively worse and it is thought that it could damage your heart and lungs at some point in the future if left untreated.
Surgical options for scoliosis include:
- decompression – if a disc is pressing down on a nerve, the disc can be removed to reduce the pressure on the nerve
- spinal fusion surgery – where the position of the spine is corrected using metal rods, plates or screws before being fused into place using a graft of either donated bone or artificial materials, such as ceramics
Common complications of spinal surgery include:
- the surgery fails to achieve a significant reduction in symptoms of pain; this occurs in around 30% of adults with scoliosis
- in cases of spinal fusion surgery, sections of the spine may fail to fuse together properly; this occurs in an estimated 5%-10% of cases
Less common complications of spinal surgery include:
- infection – which occurs in an estimated 1 in 50 cases
- blood clots – which occur in an estimated 1 in 100 cases
- retrograde ejaculation – where sperm travels backwards into the bladder when you ejaculate rather than out of your penis; this happens as a result of nerve damage and occurs in an estimated 1 in 100 cases
More serious nerve damage can result in the loss of bladder or bowel function and cause urinary and bowel incontinence. However, this type of complication is very rare.
