Low back pain in school-aged children a common occurrence

January 30, 2017, Nationwide Children's Hospital

Low back pain in school-aged children is a common occurrence, and the prevalence of low back pain increases once children reach school age - one percent at age seven years; six percent at age 10 years; and 18 percent at ages 14-16 years. Yet only seven percent of adolescents with lower back pain will seek medical care. Diagnosis, pathophysiological findings, evaluation, treatment and prevention are outlined in a recent review of the literature published online today by the JAMA Pediatrics.

According to the literature review led by Nationwide Children's Hospital Sports Medicine, most causes of low back in this population are benign; however the effect of low back pain can be significant, affecting daily activities such as school attendance and participation in gym class or other athletic activities. Development of low back pain in adolescents is a substantial risk factor for the possibility of low back pain as an adult.

The literature review demonstrates that there is no single risk factor or factors for lower back pain as previously thought. For school-aged children, most cases are because of musculoskeletal overuse or trauma. One possible cause for the prevalence in adolescents is participation in athletic activities. Studies have shown there is a correlation between the level of competition and low back pain, as well as there being an increased risk of low back pain with both high and low levels of physical activity. Other possible risk factors include a quickening of growth, adverse psychosocial factors, increase in age, a previous back injury and family history of low back pain. Females are also at a greater risk for low back pain.

"Historically, pediatric training has emphasized that a specific factor or factors cause low back pain in children and adolescents, but recent studies have informed us that is not necessarily the case," said James P. MacDonald, MD, MPH, lead author of the review and sports medicine physician at Nationwide Children's. "It is important for physicians to have a firm understanding of the relevant spinal anatomy and the etiological factors of in children and adolescents."

While some lower back pain needs to be treated by a specialist, most pediatricians who have a good understanding of the principles outlined in our article can help children and adolescents prevent and manage lower back pain," said Dr. MacDonald, who is also an associate professor in the Department of Pediatrics and Family Medicine at The Ohio State University College of Medicine. "Most pain with no specific cause responds to rest, rehabilitation and identification of predisposing risk factors."

Although the causes of lower back pain in school-aged children are most often benign, according to the literature, a thorough evaluation performed by the primary care physician can help rule out a more serious condition. For example, obtaining a full clinical history, asking certain questions associated with an inflammatory cause of , examining the back for signs of deformities, performing neurologic workups and potentially ordering imaging tests if deemed necessary as a result of the overall evaluation.

Based on the review, because and ' musculoskeletal systems are still developing they are at an increased risk to trauma and explosive muscle contractions, especially during periods of rapid growth. For this reason, evidence suggests the importance of pre-season sports conditioning programs and neuromuscular training that will allow the athlete to gradually increase his or her training intensity and help reduce injuries. Additionally, rest should be incorporated into the training regimen, especially for athletes who perform repetitive motions, such as tumbling in gymnastics. Young athletes should not participate in more hours of sports in a week than their number of age in years.

Explore further: Surgery not the answer for most back pain, sports doctor says

More information: JAMA Pediatrics, DOI: 10.1001/jamapediatrics.2016.3334

Related Stories

Surgery not the answer for most back pain, sports doctor says

November 3, 2016
(HealthDay)—Back pain is a common problem, but most cases can be treated without surgery, a sports medicine specialist says.

Yoga may have health benefits for people with chronic non-specific lower back pain

January 12, 2017
A new systematic review, published in the Cochrane Library today, suggests that yoga may lead to a reduction in pain and functional ability in people with chronic non-specific lower back pain over the short term, compared ...

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

January 4, 2016
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 ...

Forward-thinking tips for back pain

January 19, 2017
(HealthDay)—Back pain is common but not inevitable, an orthopedist says.

Lumbopelvic stabilization training therapeutic for LBP

January 5, 2017
(HealthDay)—For patients with chronic nonspecific low back pain conditions, lumbopelvic stabilization training (LPST) has a therapeutic effect on pain modulation, according to a study published online Jan. 2 in Pain Practice.

Chronic pain in children and adolescents becoming more common

December 8, 2011
Children who suffer from persistent or recurring chronic pain may miss school, withdraw from social activities, and are at risk of developing internalizing symptoms such as anxiety, in response to their pain. In the first ...

Recommended for you

The inequalities of prenatal stress

August 14, 2018
Exposure to an acute stress in utero can have long-term consequences extending into childhood – but only among children in poor households, according to a new Stanford study that looked at the long-term impact of acute, ...

Promoting HPV vaccine doesn't prompt risky sex by teens: study

August 13, 2018
(HealthDay)—Controversial state laws that promote vaccinating kids against the human papillomavirus (HPV) do not increase the likelihood that teens will engage in risky sexual behavior, a new study contends.

Grip strength of children gives clues about their future health

August 13, 2018
While other studies have shown that muscle weakness as measured by grip strength is a predictor of unhealthy outcomes—including cardiovascular and metabolic diseases, disability and even early mortality—this is the first ...

Prenatal vitamin D pills won't boost babies' growth: study

August 9, 2018
(HealthDay)—For pregnant women who are vitamin D-deficient, vitamin supplements won't improve the growth of their fetus or infant, Canadian researchers report.

Giving kids plates with segments and pictures caused them to eat more vegetables

August 8, 2018
A pair of researchers at the University of Colorado has found that preschool kids ate more vegetables when presented with segmented plates with pictures of fruits and vegetables on them. In their paper published in JAMA Pediatrics, ...

Is too much screen time harming children's vision?

August 6, 2018
As children spend more time tethered to screens, there is increasing concern about potential harm to their visual development. Ophthalmologists—physicians who specialize in medical and surgical eye care—are seeing a marked ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.