Back Pain in Teens
Back pain is the most common problem worldwide. Generally, it occurs in adults, elderly people and pregnant women. As compared to the adults, back pain is observed to a less extent in teenagers and children due to their spine flexibility. Back pain is more evident in teenagers or adolescents of age group 18-20 years. Incidence of back pain in teens or children has been growing of late.1 In most cases, it is not a serious problem since back pain results from muscle or ligament injury without any structural changes. However, when the pain occurs in children <10 years and is persistent and interferes with daily activities, then it is a serious issue which requires immediate medical attention.
What Can Cause Back Pain in Teens?
- Common Causes of Back Pain in Teens: The general cause of back pain in teenagers and children (of any age) is due to muscular sprain and strain resulting from:
- Poor posture 2
- Sedentary life style, continuously sitting in front of the computer or watching television tends to cause back pain in children.
- Carrying heavy school bags can also cause teenage back pain
- Injuries caused during sports activities.
- Medical Conditions that Can Cause Back Pain in Teens: The cause for chronic back pain in teenagers due to medical conditions includes:
- Overuse and back strain injuries
- Scheuermann’s disease
- Osteoid osteomas
- Disc herniation
- Other Causes of Back Pain in Teens: The causes for back pain in both younger and teenage children are:
- Infections: Such as osteomyelitis, pyelonephritis and retroperitoneal infections can cause back pain in teenagers and children.
- Cancer or Tumour of Spine and Bone: Commonly observed bone tumors are Ewing’s sarcoma, osteoblastoma, osteoma and ependymoma(spinal cord cancer).
- Systemic disease such as sickle cell anemia.
The severity of back pain in teens in the above mentioned cases varies and it may be sharp and shooting, burning, aching and felt anytime in the back.
Characteristics of Back Pain in Teens
Different causes have their own characteristic features which are as follows:
- Characteristics of Back Pain in teens Caused Due to Scheuermann’s Diseases: It is the second most common type of back pain in teenagers and children. It results due to problem with spine alignment. Scheuermann’s disease is a growth disorder of the vertebrae. It produces humpback curvature (rounded back/spine) which leads to middle back pain. The vertebrae become wedged causing a rounded appearance of the back. However, this condition does not limit one’s activity.
- Characteristics of Back Pain in Teens Caused Due to Spondylolisthesis: It is also called as slipped vertebra. It occurs when one vertebra shifts on the next one present directly below it. Spondylolisthesis occurs at the base of the spine. This condition progresses in adolescence and results in instability of the spine. The treatment for this type of back pain requires spinal fusion surgery.
- Characteristics of Back Pain in Teens Caused Due to Spondylolysis: It is an injury to the spine and is also called as a stress fracture of the vertebra. It occurs during hyperactivity of adolescents in activities such as sports including swimming, gymnastics, cricket and football. This type of spinal injury does not heal and affects adolescence too. The back pain is mild and radiates to buttocks and legs. However, the pain gets worse with intense activity. A child with spondylolysis may walk with stiff gait and take short steps.
- Scoliosis: It occurs due to problem with spine alignment. It is a lateral curvature in the normally straight vertical line of the spine leading to the S-shaped curve. A child with scoliosis shows uneven shoulders, a prominent shoulder blade, uneven waist and leans on one side.
- Infection: Infection in disc space (discitis) leads to back pain. It typically affects children between 1-5 years and is of great concern. It generally has vague symptoms of malaise, low grade fever, pain in lower back and child walks with a limp.
- Tumor: The child complains of night pain, there is generalized illness or weakness.
- Osteoid osteomas: These are small benign osteoblastic tumors which can occur anywhere and can involve single bone or several bones.
- Characteristics of Back Pain in Teens Caused Due to Disc Herniation: Occurs rarely in children. It is characterized by leg pain, numbness and tingling in the legs, weakness of the lower extremities, and difficulty bending or straightening the spine.
When to Worry for Back Pain in Teenagers & Children?
Back pain in teenagers and children becomes a warning when the following signs are noticed:
- The back pain occurs in child less than 5 years of age.
- The pain in the back wakes up the teenager or the children at night can be a reason to worry.
- There is a very high fever accompanied with chills and overall weight loss.
- Back pain radiating to legs and accompanied with numbness and weakness due to which the teenager or the child refuses to walk.
- Change in bowel or bladder control.
- Back pain that is accompanied by morning stiffness which lasts for more than 30 minutes.
These signs indicate of the immediate requirement for medical intervention for back pain in teens.
Diagnosis of Back Pain in Teens
Diagnosis of teenage back pain is done by taking the medical history, physical examination of the back, imaging and laboratory tests.
- Medical History to Diagnose Back Pain in Teens: Doctor will ask questions regarding the child’s overall health and specific questions regarding the back pain. It will also include questions to determine the cause behind this pain.
- Physical Examination to Diagnose Teenage Back Pain: During physical examination, the doctor carefully examines the child’s spine, muscles, bone and nerves. During check-up of the spine each vertebrae are examined for the deformity in alignment and mobility of the spine. This is important when there is increased curve of the back. If there is difficulty in walking or any other movement then it will be checked since this indicates problem with the spine. During examination of nerves of the back, the doctor performs particular test. Muscles in the back and legs are examined by feeling the tightness of back muscles or the hamstring muscles at the back of the thigh. The tenderness of muscle will indicate a strain. Further balance, flexibility and muscle strength will also be tested.
- Imaging Tests: Doctors may use one or several imaging tools to examine the body. These include use of X-ray, bone scans, MRI, CT scan and PET scan. The modern imaging scans gives in depth and reliable results about changes that have occurred in the spinal cord, nerve roots, disks and other soft tissues which cause the back pain.
- Laboratory Tests: The blood tests include performing the complete blood-cell count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). These biochemical parameters may be affected by the presence of inflammation or infection.
The results from all these diagnostic tests will allow the doctor to know the exact cause and extent of the back pain in the teenager or the child which will help in providing a proper treatment of the patient.
Treatment of Back Pain in Teens
The back pain in children occurs due to their sport activities. It generally gets treated with home based remedies and then it goes away.
- Medications to Treat Back Pain in Teens: Pain relieving medicines (analgesics) such as acetaminophen and ibuprofen may alleviate a child’s back pain caused due to excessive exercise or sports activity. In some special cases the treatment varies as:
- Treatment of Infections: Infections are treated with administration of antibiotics. In extremely rare cases, when the damage is caused due to spread of infection, surgery is considered.
- Treatment in Case of Spinal or Bone Tumor: Benign tumors may be treated with surgery. Malignant tumors of spine require a combination of treatments that may include chemotherapy (medications), surgery and radiation therapy.
- Heat Application to Treat Teenage Back Pain: Applying heat can help with back pain. It can be applied by means of a heating pad, hot water bottle or other hot pack.
- Remaining Active Can Help Prevent Back Pain in Teenagers and Children: Staying physically active helps to relieve the muscle spasms and prevents weakening of muscles. However, this activity should not be very strenuous instead light exercise must be done.
- Stretching and Strengthening Exercises for Teenage Back Pain: When pain starts improving specific stretching and strengthening exercises are recommended under the guidance of a physiotherapist.
Prevention of Back Pain in Teenagers & Children
- Teenagers and Children should be told the importance of good postures and should be encouraged to sit straight.
- The backpack should not be overloaded as they are one of the common causes of back pain in teens.
- Teenagers and children should be advised to take regular walks and perform stretching exercises since sitting for long hours can bring tiredness to back muscles.
- Parents should educate themselves regarding sports injuries. Children below 6 years of age should be always accompanied by parents and should not be left alone while playing. Children should be supervised when on swings, slides or other playground equipment.
- Teenagers and children should be told the importance of safety when they take up sports such as skiing and skating. They should take lessons to learn good techniques.
Back pain is becoming common among teenagers and children. In majority of the cases, it is caused by muscular sprain and strain and gets treated with some variations in daily activities. Due to advent of medical technology, today, teenage back pain can be managed very well so that they can live a better life in the future.
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