SOSORT - a group of professional focused primarily on non-surgical treatments - has a consensus paper about the treatment of idiopathic scoliosis.

There's a great depth of material here on all forms of conservative treatment, including bracing and scoliosis-specific exercises, and one of the authors is our own Joe O'Brien.

I'm not going to summarize the treatment plans - they are *very* detailed, broken down by riser/curve/pain no pain (have a look at them here - - but I did want to emphasize their goals, which appear very different from the goals of the surgical/medical treatment of scoliosis.

"1. to stop curve progression at puberty (or possibly even reduce it),

2. to prevent or treat respiratory dysfunction,

3. to prevent or treat spinal pain syndromes,

4. to improve aesthetics via postural correction,"

Some notes:

For #1, note that the goal is *not* just to keep the curve below the surgical level in children, but to stop it as soon as it is found. In children, exercise to control the curve is recommended (as the maximum treatment) all the way down to an 11 degree curve, and as a minimum treatment starting at 20 degrees.

For #2 and #3, note that the treatment includes *preventing* respiratory dysfunction and pain, and not simply treating it once it occurs.

Overall, it's a more proactive approach then the standard medical one, with the idea that you want to keep the child as close to the first diagnosed level as possible. (Or, at least, that's how it reads at first scan)

They do include surgery in their treatment plan. It's recommended as a maximum (but *not* a minimum treatment) starting at 46 degrees in children. In adults, it's recommended (again, as a maximum treatment) all the way down to 30 degrees if there is chronic pain. Interestingly, that rises back to 46 degrees in the elderly with chronic pain. I'm not sure if that's due to the additional risks of surgery in this age group or if there's some other reason.

Another interesting note - the maximum treatment for chronic pain *below* 30 degrees in adults is part-time rigid bracing. I know we had one adult on this forum who was braced, but I didn't realize that that was a consensus (maximum) treatment among the conservative treatment professionals.

Anyway, lots and lots of info to chew on.