Back pain during orthotic treatment of idiopathic scoliosis

The incidence and etiology of back pain during orthotic management of idiop athic scoliosis was determined for 303 patients treated from 1980 through 1 990 for a minimum of 1 year. All patients denied back pain before orthotic prescription. Thirty-four (11%) patients reported back pain after instituti on of brace treatment. A family history of scoliosis (p = 0.014) and vigoro us sports activities (p < 0.001) were correlated with pain. Seventeen of 34 patients with pain showed >10 degrees of curve progression during bracing, whereas 67 of 269 patients without pain progressed (p = 0.002). Four patie nts with pain and 11 without were eventually found to have an underlying pa thology (spondylolysis/listhesis). No other underlying pathologies were fou nd. Night pain or a left thoracic curve pattern were not correlated with a serious underlying etiology. Back pain occurring after institution of brace treatment for idiopathic scoliosis is often associated with curve progress ion and is poorly correlated with a serious underlying pathology.