Scoliosis Treatments and Medications

The spine is a delicate mechanism of 33 bones (the vertebrae), as well as ribs, muscles, tendons, and connective tissue, joined together like the parts of a suspension bridge, keeping us upright and balanced. Sometimes, however, the overall structure of the spine starts to alter and curve, usually right at the onset of puberty, a condition called scoliosis. Scoliosis is a side-to-side curve in the spine. If you look at the spine from the back, it forms a straight vertical line. A scoliotic spine forms a “C” or “S” curve vertically and also rotates left or right. 

There are three main types of scoliosis. The most common type is idiopathic scoliosis, which means the cause is not known. Congenital scoliosis is a rare spine abnormality detected at birth. Neuromuscular scoliosis (abnormalities in the muscles and nerves supporting the spine) may occur with certain nerve or muscle conditions. We don’t understand what precisely causes the condition, but scoliosis can often be successfully managed with an arsenal of medical treatments, including braces, exercise, and surgery.

How is scoliosis diagnosed?

Scoliosis is most commonly diagnosed during adolescence, between the ages of 10 and 15 years, although sometimes adults are diagnosed later in life, especially if their condition is mild and may have been missed during childhood. 

Healthcare providers and school nurses often screen for scoliosis during childhood and the teenage years. They will have the child take off their shirt, stand up straight, and bend forward, looking at the posture, spinal shape, and alignment

If scoliosis is suspected, a healthcare provider will take a medical and family history, ask about symptoms, and order an X-ray (and sometimes additional imaging like a CT or MRI). They will also measure the curve of the spine. The severity of scoliosis is based on the degree of the curve, known as the Cobb angle:

• No scoliosis: <10 degrees

• Mild scoliosis: 10 to 24 degrees

• Moderate scoliosis: 25 to 39 degrees

• Severe scoliosis: >40 degrees 

If your healthcare provider diagnoses you with scoliosis, they may refer you to an orthopedic spine specialist. 

Scoliosis treatment options

Scoliosis treatment options are monitoring, bracing, physical therapy, and surgery. The scoliosis treatment used depends on the type of scoliosis, the extent of the spinal curve, and the risk of curve progression. 

Observation 

Mild scoliosis, defined by a Cobb angle of 10-24˚, often does not progress. So patients with mild scoliosis will be observed in follow-up visits and given serial X-rays to monitor the progress of the curve.

Scoliosis braces 

Children and young teenagers with moderate scoliosis may need to wear a brace. Braces prevent the curve from worsening. Healthcare providers typically recommend wearing the brace for 16 to 23 hours per day until the child has finished growing.

Physical therapy

Physical therapy and exercise may be recommended to help strengthen muscles, improve posture, and reduce discomfort. 

Scoliosis surgery

If scoliosis is severe or does not respond to bracing, surgery may be required. If possible, surgery will occur after the child’s growth spurt. The most common surgery for severe scoliosis in adolescents is called spinal fusion. This procedure uses metal rods, hooks, screws, and wires to stabilize the spine. 

Psychosocial support

The psychological and social impact of scoliosis can be serious, particularly for adolescents, and these impacts are often overlooked. Behavior problems, depression, low self-esteem, and social isolation may occur, so scoliosis patients may require both family and psychosocial support. 

Types of scoliosis medication

Scoliosis is not treated with medications. It is largely a mechanical problem treated with braces, exercise, and, in extreme cases, surgery. Many scoliosis patients will simply be observed to monitor curve progress.

Analgesics 

Back pain does not seem to be more prevalent in scoliosis patients than in the population as a whole, except in more severe cases. Patients with degenerative scoliosis (a type of scoliosis that develops in older adults), however, may experience more pain than other people because of the underlying disc degeneration rather than the scoliosis curve. This pain will typically be managed with over-the-counter pain relievers such as acetaminophen or NSAIDs (aspirin or ibuprofen). Pain due to more advanced disc degeneration or a severe curve may involve prescription NSAIDs or opioids in the most severe cases. 

Other medications 

Neuromuscular scoliosis or syndrome-related scoliosis are secondary effects of other conditions such as cerebral palsy, myelodysplasia, Duchenne muscular dystrophy, or neurofibromatosis. These conditions may be treated with condition-specific medications, but these drugs will not affect scoliosis (which will be treated with braces or surgery).

Over-the-counter scoliosis medicine

People who have pain due to scoliosis may benefit from over-the-counter pain medication such as Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) like Motrin (ibuprofen). Check with a healthcare provider before using an OTC drug to treat scoliosis pain. 

What's the best medicine for scoliosis?

Scoliosis is not treated with medications. However, patients with degenerative scoliosis or a severe curve may experience pain, which can be debilitating. Over-the-counter pain relievers such as acetaminophen or ibuprofen, prescription NSAIDs, and, in rare cases, opioids may be used or prescribed to relieve the back pain.

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