Is your child's achy back more than just growing pains?

According to a new literature review in the January issue of the Journal of the American Academy of Orthopaedic Surgeons, it's becoming more common for children and adolescents to seek medical care for back pain. Even with expensive, advanced tests like MRI scans, doctors may not be able to find the exact cause for the pain.

"If your history, physical exam or simple tests reveal a diagnosis or problem, this can be treated early and you will probably be able to return to your activities or sport," says lead study author and orthopaedic surgeon Suken A. Shah, MD, division chief at Nemours Spine and Scoliosis Center, Alfred I. duPont Hospital for Children. For nearly two thirds of adolescent patients, clinical physical examination and imaging may not produce clear cause for their back pain. "It could be from a muscle strain, poor posture, too much training in a single sport or multiple sports in the same season, or the opposite—too little activity and not enough exercise."

Pain that is dull and achy in the low back and not from any specific injury usually gets better with rest and anti-inflammatory medicine like ibuprofen. These instances may be less likely to recur with physical therapy and strengthening of core muscles near the abdomen, low back and hips. But, says Dr. Shah, "it is very important to know that if you are experiencing any weakness, numbness or pain that extends down your leg, pain that wakes you up from sleep, or pain that is getting worse over days, you need to seek medical attention quickly."

The most common "diagnosable" causes of back pain for children and adolescents are:

• stress fracture(s) in the low back (spondylolysis);
• instability or a forward shift of the lower spine above the tailbone (spondylolisthesis);
• poor posture like slouching forward or a rigid hump in the back from a spinal bone problem (kyphosis);
• overuse injuries from poor conditioning or overtraining;
• disk herniation; and,
• infection.

To help prevent or minimize back pain, Dr. Shah encourages patients to:

• maintain proper posture;
• maintain good core muscle strength, flexibility and aerobic conditioning;
• exercise regularly to avoid a sedentary lifestyle; and,
• avoid frequent use of heavy backpacks, and always wear both backpack straps to better distribute the weight of the load evenly.