Observation and analgesics

Most hemangiomas are found incidentally. In this case, there is no need for treatment or follow-up.

When a hemangioma is believed to cause axial back pain, the first line of treatment should be conservative with analgesia.

Aggressive hemangiomas, however, should not be dismissed as they have the potential to grow to cause neurological injury or vertebral fracture.

Osteoid osteomas typically cause nighttime pain and painful scoliosis in adolescents.

Initial medical treatment consists of nonsteroidal anti-inflammatory drugs.

Alternative treatment includes radiofrequency ablation and surgery.