I have worked with kids that have tourette's and I totally understand your concern. I, too, would be wary of medication (thats a personal opinion) but if it eases his discomfort it should be considered; or at least search for a herbal remedy. Since it is neuro-muscular, I'm not sure if herbs will help but you might find something that will reduce his anxiety. Anxiety seems to make it worse.
The reason I am wary of medication is that when medicated, the motivation for learning to cope with toureetes may be limited. Seems to me to be a choice of learning to live with it or "trying to medicate it away."
He will have to learn to live with this. There are plenty of people who do and remember to keep it in perspective. At least its not MS or cerebral palsy or ...
There are severe cases of tourettes and maybe thats when medication is necessary. I think if you pay attention now, you may be able to help him overcome the associated social anxiety.
It sounds like he is already learning some coping strategies. It might be a good idea to ask the teacher for some help in socializing the others in his class. It might take the form of a group discussion (with you son's permission) to explain that it is a medical problem that he is trying to control. Kids that age are usually kind and helpful.
Seek out therapists who can help him devise coping skills. A speech and language pathologists might be able to help. Occupational therapists are also a good source.
Good luck to you and your family, John. It will be an ongoing challenge but he will learn to live with it.
If it makes you feel any better, I know a very good mechanic who has tourettes and unless you know him very well, you probably wouldn't notice his facial and shoulder tic. It doesn't seem to have made a difference in his life.