REVIEW OF LITERATURE ON THE RELATIONSHIP BETWEEN ADOLESCENT IDIOPATHIC SCOLIOSIS AND BACK PAIN

Back pain, especially in adolescents, is not uncommon. Some patients with AIS have do complaints of pain. Young patients and their families often blame scoliosis for various back pains.

This post reports briefly on overall findings in an article that reviewed literature and studies on the relationship between AIS and back pain. Simply, the results of this review finds that pain does not seem to be a major factor for the vast majority of adolescents diagnosed with idiopathic scoliosis and that there is not a strong correlation with pain and degree of Cobb angle. Even untreated AIS cases fared reasonably well from the perspective of back pain. (Note: This study did not include pain and other forms of scoliosis, only AIS and also did not include adults.)

Some of the more specific findings in this article include:

• Back pain was reported in 23% of 210 patients greater than 15 years of age. Pain intensity did not correlate with Cobb angle.
• Caucasian scoliosis patients reported more pain than Korean and Japanese counterparts which led the authors of this study to recommend taking into account cultural and ethnic differences among patients.
• No conclusions were drawn between scores (of child health questionnaire) in urban vs. rural groups.
• No significant differences in comfort/pain scores were found in relation to age, Cobb angle or curve location.
• On observation only, one study found back pain was reported by 21.3% with Scoliotic curves vs. 16 % without. Bracing did not appear to influence back pain in this study.
• Pain improved, even with bracing, when the patient received treatment from a rehabilitation team.
• Authors found no evidence to support that the result, in terms of reduced magnitude of spinal curve, correlated with decreased pain, even when corrected by surgery.
• Following surgery, pain reduction at 2 years was not clinically meaningful.
• At long term post-operative follow up, AIS patients had similar pain scores as control groups.
• A comparison of 3 groups of patients with AIS – 32 without brace, 41 with full time brace and 35 with night brace and all with significant differences in age, Risser sign and Cobb angle, found no difference in intensity of pain.

The authors of this review state that their findings argue against Idiopathic Scoliosis as the cause of most back pain in ADOLESCENTS. It is important to note that this does not hold true for adults and that the impact of Scoliosis on back pain in ADULTS is quite different.

I am of the opinion that back pain of any kind should never be ignored. Scoliosis, even small curves, should not go untreated. That being said, I do agree that in adolescents, scoliosis is not all that likely to be the cause of their back pain. All, however, should be addressed.