Is scoliosis painful?
Sometimes. Dr. Winter, a spine expert, states that pain is very rarely a symptom of scoliosis in the adolescent. Some adolescents do experience a muscular type of pain which occurs because the muscles on one side of the curve are working overtime trying to control the curve. When these muscles are overworked, they hurt. But with adults, the question is more complicated. Back pain is experienced by much of the population with no known cause. Often, back pain in adults is caused by natural disc decay or arthritis (an inflammation of the joints.) It is therefore sometimes difficult to tell the difference between pain that is caused by scoliosis and pain that is not. Scoliotic pain in the adult is thought to be due to disc decay that is uneven and faster than normal. This occurs because of the scoliotic curve puts uneven weight on the spine. This type of pain usually occurs in people in their forties and beyond. To differentiate between scoliotic pain and conventional low back pain, doctors use physical examination and x-rays and may progress to more specialized diagnostic techniques such as a myelogram (an x-ray where a special die is placed into part of the spine to make it visible); Magnetic Resonance Imaging (a scanner that uses magnetic waves to see the structure of bones and nerves), and/or discography (an injection of a dye into a spinal disc which provides pictures of the discs when photographed in a certain way.) There is no connection between the magnitude of a curvature and the amount of pain patients feel.

People do not understand scoliosis. Even as an adult I found people to be unsympathetic. One feels almost embarrassed about it because people don't take the pain seriously. The cannot relate to it. It makes you wonder if you are exaggerating until you see a doc who confirms that this is a serious condition.

Both adolescents and adults with scoliosis report back pain. One study found that 10 years after diagnosis, people with scoliosis had pain that was more frequent, intense, continuous, and generalized than people without scoliosis. In addition, those with scoliosis were more restricted in many usual daily activities. Another study found that between 23 and 32% of people with idiopathic scoliosis have experienced pain. There is also a study which shows that people with adolescent idiopathic scoliosis who had surgery had more back pain nine years after surgery than they had before.

How do I treat the pain?
There are a variety of ways you can treat your pain.. You should talk to your doctor about what might work for you.

MEDICATION

You can use an over-the-counter pain reliever such as aspirin, ibuprofen (Tylenol), sodium, and acetaminophen (children’s aspirin) to effectively relieve pain. These medications are relatively safe, but they can cause side effects such as stomach upset, and may result in complications from excessive dosing or prolonged administration. For this reason, these medications should be taken according to the doctor’s or manufacturers’ directions. Before increasing the frequency of use or the dosage, you should check with the doctor or pharmacist.

Your doctor may recommend that you try a non-steroidal anti-inflammatory medication (NSAID) These drugs treat both pain and treat inflammation. Aspirin is a NSAID. Also, there are a variety of topical creams which may relieve pain when they are rubbed directly into the painful area. While some of these creams are available by prescription only, others may be purchased from a local drug store.

If these treatments do not work, your doctor may prescribe a narcotic pain medication. Narcotics are powerful pain-relieving medications derived from opium or synthetic opium. Narcotics alter a person’s perception of pain and can also induce euphoria, mood changes, mental cloudiness, and deep sleep. These drugs may also cause nausea, lethargy, and constipation. Narcotics can also affect a person’s balance and increase the chance of falling. After repeating and prolonged use, some people may become may become dependent on or addicted to these medications. There are new medications that appear to relieve pain without the serious side effects of narcotics. There is also a skin patch that releases small amounts of a narcotic into the body through the skin. There medications can only be prescribed by a physician.

People who suffer from chronic pain frequently suffer from chronic depression as well. Several studies using antidepressant medications have noted that these medications may not only improve depression but may also relieve or reduce the amount of pain a person feels.

In some cases, a physician may perform a nerve block. This involves the injection of pain-relieving medications into the tissues around an affected nerve. The block numbs the nerves and surrounding area and eliminates the sensation of pain. Pain relief may last for hours or months, depending on the medications used and the your response to them.

SURGERY

If your pain has been determined to be due to scoliosis, there are some surgical techniques that can be used to help relieve the pain. It is crucial, however, for this diagnosis to be accurate. Among the surgical procedures used surgical procedures are diskectomies and laminectomies. A diskectomy is a common surgery in which part of the spinal vertebrae is removed in order to relieve pressure on a nerve (which is causing the pain.) A laminectomy is similar to a diskectomy but it removes a larger part of the vertebrae.

EXERCISE

Many people including some doctors say that exercise such as those discussed in the "Supplemental Treatment" section may reduce pain. Reduction in pain can often be achieved by reducing the amount of stress of the back. This can be done by increasing hip flexibility through daily stretching of the ham-strings, quadriceps, hip flexor and muscles. Improving the strength of the back muscles can also help to reduce pain and improve tolerance for daily activities. This can be accomplished by performing vigorous strengthening exercises at home or in a fitness facility several times per week. Doctors recommend that if you are exercising to reduce pain you should stay away from exercise that is jarring to your joints and pick exercises like swimming or weight machines that are more gentle.

TENS

TENS is a treatment for pain which an accepted by the medical profession. There have been some studies have shown mixed results, and as a result, not all doctors prescribe it for the treatment of pain.

TENS stands for Transcutaneous Electrical Nerve Stimulation. It is an electrical unit with two electrodes which are placed on the skin. The unit emits an electrical signal which stimulate your nerve cells through the skin. This stimulation prevents pain signals from the painful area from getting to the brain. The sensation is said to be like the tingling and numbness of your jaw after dental work. The amount of electrical signal is controlled by a dial on the control box. TENS should be fitted by a physiotherapist or doctor and used only under supervision of a physician. TENS does not work for all people.

Some people can use TENS in a small, portable, battery operated units that have electrodes attached with adhesive pads. You can move around during it operation. The pain relief can last up to a few hours. TENS is safe and has no known side effects. It does not interfere with any drugs and in non-addictive. It can be used all over the body except over the heart or on the front of the neck. TENS can purchased or rented from hospital supply or surgical supply houses. For examples of TENS units, see the pictures below. CHIROPRACTIC

There is evidence that chiropractic care is useful for backache associated with idiopathic scoliosis. Chiropractic is a widely accepted treatment for the relief of various kinds of back pain. For more information on chiropractic see the "Supplemental Treatment" section .

Are there any supplemental treatments for pain?
Other treatments that have been found by some to reduce back pain include: meditation, relaxation training, psychological treatment, Other treatments include acupressure and acupuncture. Acupuncture an ancient Chinese practice of puncturing the body at specific points with needles in order to cure disease or relieve pain. Acupressure is direct pressure over trigger areas of pain. This technique can be self-administrated after training with a certified instructor.

While there are some studies that support all of these treatments for back pain, not all the studies are well designed. In addition, some treatments have received mixed results which means that some studies say they work and some studies say they do not. Also, these many of these treatments were studied for their effect on general or chronic back pain, not specifically on back pain related to scoliosis. So it is unclear how well these treatments will work for that specific type of pain.

Some doctors and people with scoliosis recommend the following as having been helpful in reducing pain:

• Heat and cold These can be applied in the form of hot/cold showers, hot/cold packs, hot/cold towels or a heating pad. The heat or cold should be applied for 15 or 20 minutes. A towel should be placed between the skin and the source or heat or cold to protect the skin.
• Massage Massage therapy can be a light, slow, circular motion with the fingertips or a deep and kneading motion that move from the center of the body outward toward the fingers or toes.
• Relaxation Relaxation training involves concentration and slow, deep breathing to release tension from muscles. Learning to relax takes a great deal of practice, but some people find that eventually relaxation training can successfully focus attention away from pain and reduce it by relaxing their muscles.
• Visual imagery or distraction Imagery involves concentrating on mental pictures of pleasant scenes or events or mentally repeating positive sayings to reduce pain. Distraction techniques focus your attention away from negative painful images to more positive thoughts. This technique may include watching television or a favorite movie, reading a book or listening to a book on tape, listening to music, or talking to a friend.
• Hypnosis Hypnosis can be used in two ways to reduce a person’s perception of pain. Some people are hypnotized by a therapist and given a post-hypnotic suggestion (an instruction given while hypnotized) that reduces the pain they feel. Others are taught self-hypnosis and can hypnotize themselves when pain interrupts their ability to function.
• Individual or family therapy A psychologist, psychiatrist, or psychiatric social worker can help people cope with feelings of depression, frustration, and anger that often accompany chronic pain.

One woman writes:

I have tried NSAIDS, narcotics, meditation, relaxation music, visualization, lumbar supports, lumbar seat cushions, physical therapy, massage, yoga, 3 months of nerve blocks, diskectomy, and aqua therapy. I use narcotic analgesics only when I must - maybe once a week. Wearing a snug lumbar support has enabled me to work full time in my office job, in spite of constant pain.
I would recommend rest, visualization, relaxation music, and above all-aqua therapy in a warm pool. In a pool, gravity is not an issue, and motion is fluid, with no stress on deformed spines.

Other tips include: