No opiates for chronic back pain

Dear Dr. Roach: I’m a 65-year-old male. I’ve had scoliosis since childhood. I experience stiffness and soreness. What is the best treatment for scoliosis? Chiropractic was not helpful, and although I had mixed results with physical therapy, I still do those exercises. What other treatments are available? I would like to avoid surgery; I’m not in extreme pain and don’t want to risk it. Your thoughts? — P.S.

The cause of childhood scoliosis is not known. Scoliosis is more likely to progress and require corrective surgery in girls than boys.

It does not get better on its own, but usually does not progress during adulthood.

In general, there are three types of treatments for back pain, and scoliosis is no exception: medications, physical treatments and surgery. You haven’t mentioned medication, and while many people don’t wish to take medications all the time for symptoms, they can reduce discomfort and improve your quality of life. Plain Tylenol or low-dose anti-inflammatories carry a low risk and probably are worth a try.

I recommend strongly against opiates for chronic back pain. If the pain is that bad, other treatments (including surgery) should be considered.

A review of nonsurgical treatments for symptomatic scoliosis in adults suggested that while physical therapy and chiropractic treatment do not provide long-term benefit, they may halt or slow worsening of symptoms. However, they may help some individuals.

Surgery is not commonly done on adults with childhood or adolescent scoliosis. If it is, it is generally reserved for people with severe curvature and symptoms.

Fortunately, complications from childhood scoliosis are rare in adults, and there is no reduction in life expectancy.

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