Scoliosis: The treatment of pain

An analgesic treatment can be prescribed in case of pain related to scoliosis. In children, in case of mild to moderate pain, the doctor may offer paracetamol.

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Scoliosis: the treatment of pain

An analgesic treatment can be prescribed in case of pain related to scoliosis. In children, in case of mild to moderate pain, the doctor may offer paracetamol. In case of moderate to severe pain in children over 3 months, a nonsteroidal anti-inflammatory drug (NSAID) may be prescribed such as ibuprofen. It is advisable to respect the prescribed doses. There are also other NSAIDs such as mefenamic acid, niflumic acid and tiaprofenic acid.

Adults can benefit from infiltration for analgesic purposes. This involves an injection of an anti-inflammatory and analgesic solution into the affected area. This injection is done under radiological guidance.

Orthopedic treatment of scoliosis

Corsets are the mainstay of orthopedic treatment for scoliosis. They are required for moderate to severe forms of scoliosis (20 to 40% curvature).

The purpose of corsets is:

• To stop the worsening of scoliosis;
• To partially correct the scoliosis.

Of several types, these corsets are adapted to the shape of the curves and the age of the children. Made to measure and adjustable to adapt to the growth of the spine, they are renewed to follow the growth of the child. The use of a plaster corset for a short period of 2 to 4 months before the placement of a removable plastic corset helps to reduce the deformity and stiffen the spine in a position of maximum correction.

The plastic corset then plays a role of restraint. Dreaded in the past because they were unsightly and uncomfortable, modern corsets are now much less visible and much better tolerated. When the growth is finished, one can sometimes use thinner, light and close-fitting corsets.

For maximum efficiency:

• The corset must be worn at all times (there are several protocols for wearing the corset depending on the degree of curvature and the type of scoliosis);
• The continuation of physical and sporting activities is recommended;
• Orthopedic treatment for scoliosis must be accepted by the child and allow him to lead a life as close to normal as possible.

Treatment of scoliosis: physiotherapy

The aim of physiotherapy is to increase the musculature of the thorax, to correct bad postures and to improve respiratory capacities, but it cannot in any way prevent the aggravation of scoliosis and must be considered in addition to treatment. . The physiotherapist often helps the child to better support his corset, to learn to live with it. He has a role of educator, in particular in the training of the good postures and the gestures to avoid.

In adults, the physiotherapist is called upon after surgery and/or to relieve pain related to scoliosis.

Surgical treatments for scoliosis

Surgery concerns the most serious forms of scoliosis, beyond 45° of curvature.

Surgery in practice

The operation consists of correcting the curvature and restoring the aesthetics of the spine by welding together the deformed vertebrae in the best position for correction. To do this, the surgeon performs an “arthrodesis” or graft of the vertebrae. He also places one or more metal rods to maintain the corrected alignment of the vertebrae. The major drawback of this surgery? Blockage of spinal growth. It must therefore be carried out when the child has reached a sufficient size. This operation remains heavy but surgical techniques have made a lot of progress to increase the effectiveness of the correction and reduce postoperative immobilization times.

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