Images 1A and 2A show normal alignment of vertebrae versus scoliosis.
(Source: Scoliosis Research Society)

This is the second post in a three-part series on scoliosis—“curvature of the spine,” a condition that can cause postural abnormalities and back pain. The first post  went over basic concepts: a definition; descriptions and types of childhood and adult scoliosis; and information on genetic influences, clinical presentation (signs and symptoms), and the initial role of the physician. This article will attempt to cover (from a physician’s perspective) key treatments and strategies in the medical management of scoliosis. The third and final post will discuss (from a physical therapist’s perspective) physical therapy and exercise-based treatments that are utilized to treat scoliosis.

Most adults who come to my office for an evaluation and/or treatment of scoliosis are already aware of their diagnosis, can recall when they were diagnosed, how severe their curvature is, and know which side of their body shows the curve. Less commonly, adults come in concerned that they are developing scoliosis. Under these less common circumstances, their primary-care physician, family member, friend, or even their spouse may have told them that their spine is becoming curved or their shoulders are uneven and they should get it “checked out.” Under either circumstance, your physician’s responsibility is to obtain a detailed history, perform a physical examination, and if necessary obtain X-rays to determine the type and severity of scoliosis.

Once a specific diagnosis is made, your physician will help you establish a plan to manage your condition. At times, acute management of scoliosis is necessary. For example, scoliosis may contribute to muscle and/or joint pain from the spine. Under these circumstances, medications, physical therapy, or even spinal injections may be necessary to relieve pain and improve function.

Another example of acute management of scoliosis would be the development of a pinched nerve at the spine, due to scoliosis, that requires consultation and management with and by a physiatrist and/or spine surgeon to restore function and relieve pain.

More commonly, patients come to my practice for long-term plans to manage their scoliosis. Their primary goal is typically to prevent worsening of their scoliotic curve or even to reduce the degree of the curve. I usually take the time to explain to my patients that reasonable goals are to prevent the progression of your scoliosis. The most important goal may be to prevent secondary postural problems (e.g., kyphosis) and to help them maintain their active lifestyle despite a chronic spinal condition. If you are nodding your head while reading this post, then a physiatrist (aka a doctor of physical medicine and rehabilitation) might be the right specialist to help you accomplish your goals.