Back pain is unfortunately very common in children and teens. Causes of back pain in children vary widely, from muscular strains to spinal infections. Understanding the root cause is key for finding the right treatment and prevention strategies.
This guide provides a comprehensive overview of the various causes of back pain in the pediatric population. We’ll explore anatomical concepts, outline risk factors, and overview diagnostic steps.
Prevalence and Impact
Up to 50% of children and teens experience back pain at some point. About 10% have pain severe enough to interfere with normal activity. Identifying and addressing the underlying cause early on is crucial for minimizing long-term impact.
An Overview of Spine Anatomy
The spine is comprised of small bones called vertebrae, stacked to create the natural curves. These vertebrae surround and protect the spinal cord. Between them are shock-absorbing discs. Ligaments and muscles add support and allow flexibility.
Keeping this layout in mind, we can now explore common culprits of back pain.
Physical Causes
Issues with muscles, bones, discs or spinal alignment are frequent reasons for back discomfort.
Muscular Causes
Muscle strains are the predominant source of back pain in growing kids.
Muscle Strains
Similar to sprained ankles, back muscles and ligaments can get overstretched. Young athletes are prone to such strains from sports collisions, falls or overuse. Symptoms often resolve with rest.
Muscle Imbalances
When certain muscles become very tight or weak, it alters posture and movement mechanics. It shifts stress to other areas, eventually causing painful strain.
For example, tight hamstrings and weak core muscles are common in teens. This pattern contributes to eventual pain. Simple stretching and targeted conditioning prevents recurrences.
Weak Core Muscles
The abdominal and back muscles play a vital role in stabilizing the spine. When weak, the other spinal structures bear more load. This can provoke gradual onset pain. Strengthening core musculature is thus key.
Skeletal Causes
Problems with the bones themselves can provoke back pain.
Stress Fractures
Repetitive motions like arching back into hyperextension can cause tiny vertebral cracks dubbed stress fractures. Gymnastics, dance and sports collisions carry higher risk.
Spondylolysis refers to fractures through the back portion of vertebrae, usually in the lower back. If this occurs on both sides, it can destabilize the spine. This severe slippage is called spondylolisthesis.
Spinal Alignment Issues
Disorders like scoliosis and Scheuermann’s kyphosis alter spinal positioning, putting mechanical strain on tissues. This contributes to painful muscle spasms and joint irritation over time.
Scheuermann’s kyphosis leads to excessive rounding of the upper back. Scoliosis causes abnormal sideways spinal curvature. Though not consistently painful early on, these gradually provoke worsening pain.
Spinal Disc Causes
In children, the discs are very elastic and resilient. However, excessive strain can still overwhelm tissues and cause injury. Sudden traumatic loading or cumulative minor impacts may spark disc bulging, tears or rupture. This can spark surrounding nerve irritation and referred discomfort.
Lifestyle Factors
Certain lifestyle patterns also raise back pain risks for kids.
Childhood Obesity
Excess body weight stresses the developing spine – loading vertebral bones, discs and joints beyond capacity. Reducing overload is key for preventing symptoms.
Heavy School Bags
Overloaded, improperly worn backpacks add substantial weight to small spines day after day. This tires tissues and strains vertebrae over years – eventually inducing pain. Guidelines suggest capping backpack weight at 10-15% of total body weight.
Sedentary Behaviors
Too much sitting prevents proper development of flexible posture and movement patterns. It also weakens deep core stabilizers. The resulting muscle tightness and weakness builds over years – contributing to eventual back discomfort. Regular balanced movement is preventative.
Other Factors
Sports Overuse
Year-round single sport athletics prevents adequate rest between sessions for young bodies. Repetitive motions accelerate wear-and-tear by adolescence – sparking chronic back troubles.
Spinal Infections
Though uncommon in kids, spine infections still occur. The irritation, inflammation and fluid buildup presses on nerve roots. This can definitely cause referred back pain, often accompanied by headaches or viral symptoms.
In serious cases like spinal meningitis, bacteria infiltrate the central nervous system via the vertebral column. This sparks severe deep back discomfort along with high fevers, headaches and neurological symptoms. Quick diagnosis and intravenous antibiotics are critical.
Diagnostic Evaluation
Since many factors may be responsible for pediatric back pain, doctors thoughtfully evaluate contributing issues. They aim to pinpoint a specific structural perpetrator to guide management.
Medical History Review – Patterns of symptom onset, aggravators, relievers and changes over time provide insight. Details about sports participation, backpack use and other activity establish context. Family history helps identify potential genetic predispositions.
Physical Examination – Postural analysis, palpation for muscle spasm, spinal mobility assessment and neurological testing screen for structural abnormalities. They may indicate muscular tightness, joint restrictions or nerve irritation.
Imaging Studies – X-rays, CT scans or MRI imaging confirm or rule out bony misalignments and soft tissue injuries not apparent on physical exam alone. However, doctors minimize radiation exposure risk and selectively order scans only when appropriate.
Other Testing – Bloodwork analyzes markers of inflammation and infection. EMG and nerve conduction studies also evaluate electrical function in ambiguous nerve injuries.
While this evaluation aims to pinpoint pain triggers, prevention remains key for pediatric back health. We’ll next discuss simple spine-sparing strategies to minimize pain development in growing children.
Prevention Fundamentals
Though numerous factors may spark pain, there are key prevention strategies to reduce risk:
Maintain a Healthy Weight – Extra body mass strains developing musculoskeletal tissues. Gradually reducing elevated BMI protects the spine.
Improve Posture and Body Mechanics – Sitting or standing with poor spinal positioning provokes eventual discomfort. Coaching good posture early helps kids avoid this outcome.
Perform Regular Stretching and Core Exercises – Flexible muscles withstand loading better. Toning core stabilizers shares the burden rather than overworking spinal ligaments and joints alone.
Use Proper Lifting Technique – When handing heavy objects, use the legs instead of the back. Keep loads close to the body instead of extended arms. These basic biomechanical principles reduce risk of muscle strains or disc bulges over time.
Limit Heavy Backpack Use – Fatigued spinal tissues are more vulnerable to injury. Setting weight limits based on body size protects kids. Lockers and pack distribution between home and school bags also minimize risk.
Take Frequent Breaks – Changing positions and moving around every 20-30 minutes prevents prolonged awkward postures during studying or screen time.
Limit Single Sport Specialization – Balancing different physical activities allows some muscle groups to rest while others work at developing strength and flexibility. This better distributes forces and stress.
Making spine-conscious decisions part of daily routine helps avoid pediatric back problems down the road. We hope this guide provided comprehensive insight into the common causes, risks and preventative tips for back health in growing kids. Paying attention to reduction of injury risks at home and school, gives children the best chance to reach their potential.
Written by Dr. Tony Mork
Orthopedic Spine Surgeon
I’m Dr. Tony Mork, MD, a Minimally Invasive Orthopedic Spine Surgery Specialist in Newport Beach, California. With over 40 years of experience, I’m dedicated to providing information for all topics that involve neck and back pain.
January 23, 2024
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