OBJECTIVE: The purpose of this study was to investigate the pain after the orthotic management in adolescent idiopathic scoliosis patients. METHOD: We retrospectively reviewed the medical records and radiographs of all patients with idiopathic scoliosis seen in our institution from March, 1997 to February, 2002. Inclusion criteria in this study included a diagnosis of adolescent idopathic scoliosis, with no history of back pain before brace prescription, with Cobb's angle 15-degree or more. All subjects were educated to do scoliosis correction exercise, educated for correct posture, and to wear the orthosis over 22 hours per day, even during sleeping. RESULTS: Forty-nine subjects were reviewed, treated with the orthosis. We found that pain regions occurring after institution of modified Boston orthosis were chest wall (contacting with pad), lower back, neck and pelvis orderly. We also found that aggravation of Cobb's angle in patients with pain more than without pain, but any disease was not found in the former. CONCLUSION: There were no serious conditions with the patients who had the pain after institution of the modified Boston orthosis, but the pain was often associated with curve progression in adolescent idiopathic scoliosis patients.