Back pain in children can stem from fairly innocuous, non-specific causes - such as growing pains, an insufficient backpack, poor posture, or even playing video games for prolonged periods. However outside of these causes, and any other easily determinable cause, such as a minor sporting injury, back pain in children can indicate underlying issues that require medical attention.
There are certain symptoms that may suggest a clinical cause for back pain. Such conditions are known clinically as specific back pain - following the medical diagnosis of the identified cause. In the case of constant pain, night pain, or pain that spreads into the buttocks or legs, seek medical advice.
In the case of severe pain in children accompanied by a fever, urgent medical attention should be sought. Additional symptoms accompanying back pain - such as bladder or bowel problems and general weakness - can indicate infection, or nerve or problems. Furthermore, in some cases low back pain can indicate a kidney infection.
Depending on the age of the child, they may or may not be able to express their symptoms fully. In the case of older children, communicated symptoms may include the following.
- Pain felt on the spine
- Inhibited range of motion
- Stiffness and discomfort in the back
- Difficulty walking
- Increased pain and sitting after sitting or standing for long periods.
- Pain with loading the spine as when lifting and carrying.
- Pain that spreads to the buttocks or legs.
Your health care professional will perform an examination and assess any possible causative reasons for the pain. The doctor will enquire about any past incurred injuries, any other physical symptoms (such as fever or bladder issues), your child's sporting activity, and ask what causes the pain to improve or get worse. A physical examination of the child's back will be performed to assess the curves of the spine, possible areas of muscle spasm, and for any unusual markings of the soft tissue and skin along the spine. Neurological examination is likely to include checking the child's reflexes, muscle strength and sensation.
The doctor will also assess range of movement and mobility in the child, evaluating the range of motion present in the spine and general mobility.
The need for a thorough diagnosis means that x-rays are recommended for all children experiencing severe or ongoing back pain. The bone and disc spaces of the spine will be assessed from a series of angles in order to rule-out or ascertain, the condition resulting in back pain.
Common Conditions That Cause Back Pain in Children include:
Spondylolysis is a relatively common cause of back pain in sporty children. The resulting pain is caused by the fracture of the pars interarticularis, or pedicle, in the final lumbar vertebrae. Often however the injury is not detected in x-rays, so an MRI scan may be required for correct diagnosis. The symptoms of spondylolysis are specific low back pain, often accompanied by pain that spreads to the buttocks and thighs, accompanied by spasm of the muscles along the spine This condition is often the result of a direct injury - often from sport, but can also be the result of repetitive movements. The sporting activities that are most likely to cause spondylolysis are those that require a lot of rotation and extension. Sports with a higher risk of causing spondylolysis include gymnastics, diving, football, ballet, weight-lifting, rowing, and weight high jumping. As such the main treatment for this cause of back pain is sufficient rest, and refraining from sports and movements such as rotation and hyper-extension until the pain has cleared.
Generalised Joint Hypermobility
GJH is a blanket term used to describe an individual with several joints that are more flexible than is usual amongst the general population. Hypermobile individuals, who make up 3% of the population, have a heightened flexibility than that of the general population. More of a physical 'quirk' than a condition, hyper mobility is simply a variation in the way in which the joints are formed. This heightened flexibility is the result of the connective tissue of the joint structures (the ligaments and capsule) being more compliant than the usual range. Hypermobile individuals possess a greater range of extension and flexibility than the general population. While generalised joint hypermobility is quite a common occurrence, heightened flexibility can be both a blessing and a curse. Mosts gymnasts and ballet dancers, for example, possess a degree of hypermobility, however they also have the conditioning, strength and muscle-control to be able to harness their hypermobility in a controlled and effective manner.
On the other hand, for many individual without sufficient conditioning and fitness levels, GJH can cause injury and pain - particularly in the lower back, knee and pelvis. The lack of stability in the joints raises susceptibility to injury. A certain degree of general fitness, activity levels and exercise are vital for hypermobile individuals in guarding against the risk of pain and injury. Working with a physiotherapist will help ease symptoms, and will often be accompanied by recommended exercises for the child in order to ease pain and prevent future pain from occurring. Maintaining a healthy weight is also crucial in avoiding pain in the hypermobile individual. Excess body weight places additional strain on the joints.