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The Child With Back Pain

A child (I will refer at all times to younger children and adolescents in general) may have back pain, although it is not as frequent as in adulthood. Today I’m going to talk about the causes that can be behind this child with pain.

1 – For the tranquility of the reader, the great majority of the pains in the child are musculoskeletal, mechanical without any significance. Moreover, many of them do not get to have any diagnosis because they are diseases without alterations of any type. Behind these ailments are the muscular pains related to the efforts, postures, and sports. There are many debates like the backpack of children although there is not much agreement as to the importance of these things. In these group psychological problems such as anxiety and depression should be included that will give pain without objective injuries.

The Child With Back PainSometimes there are lesions with more transcendence, as is the case of spondylolysis predisposing to a listesis (I speak of this extensively in the post of the link). This injury is a fracture of an area of the vertebrae that is weaker in children. It is an injury that can come after a major fall for example, or be more subtle in relation to intense sports. For this reason it is important to stop the sport when a child has low back pain, even if it is mild. If detected early, these lesions can heal and prevent future problems.

The Child With Back PainAnother treatable cause that can leave chronic pain is Scheüermann’s disease. As I comment more extensively on the link post, it gives back pains in the child and can be corrected with a corset. In some cases this correction will be necessary and may prevent back pain in adulthood.

The scoliosis is a very controversial of back pain cause. There are advocates who do not have to hurt more often than a non-deformed back. On the web I added a category with posts dedicated to it that you can find in the sidebar, and I will add more in the future. Scoliosis is a deformity of the spine in which there is a rotating component. This makes the muscles on one side of the curve more “loose” and the other side more “tense”. In my experience this asymmetry generates greater muscle contractures than normal, and this alone would justify having more pains. Muscle pains can be improved by sports that develop the dorsal musculature, as is the case of swimming.

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The herniated disc, so famous in adulthood, is rare to find in children although it can occur and be a cause of pain in the back.

2 – We have seen clearly the most frequent but there is another group of diseases that give back pain and have a different origin. I will comment on the different causes without the intention of creating alarmism since they are rare causes and often easier to diagnose because they are more serious.

– Malformations such as Arnold Chiari or neural tube defects such as hidden spinal bifida associated with problems such as syringomyelia, can all give problems of back pain and sometimes aggravate with neurological problems (in the links you can find more information).

The Child With Back Pain– Infections in the discs or vertebrae give striking symptoms of pain and limitation, as well as alterations in the analytic ones. It is a rare cause of back pain. In younger children, discitis (infection in the disc) is more typical. Young children have better defenses against this problem because during the growth still blood comes to the disk as there are blood vessels in this area. This often causes them to heal even without antibiotics. In adolescents osteomyelitis (infection of the bone) is more frequent. There are other areas of infection such as sacroiliac joints or localized infection in a muscle. There are infections outside the back that can give pain in the spine. An infection in the kidney or uterus, for example, can give lumbar pains.

– Rheumatic diseases: There are diseases in childhood that cause arthritis in the child. These types of ailments give what we call inflammatory pain. Typically they hurt in the morning and give mobility limitation that progressively improves as we get moving. It is important to detect them because they can respond very well to treatment by putting the case in the hands of a rheumatologist.

The Child With Back PainTumors: This possibility terrifies us all but fortunately they are very rare and most benign. The most common tumor in the child is a benign tumor called osteoid osteoma. The typical pain of this benign tumor is an increasing pain that is worse at night and is passed by taking an aspirin or an anti-inflammatory. The latter is especially characteristic of this tumor. With imaging tests such as CAT scan and MRI, we can avoid doubts and rule out the existence of a tumor.

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– Some diseases such as stones in the kidney or gall bladder and other visceral problems can give back pain. I mention it out of curiosity because it is most likely that back pain is not the predominant symptom and rarely confuses, although our doctor must always keep these possibilities in mind.

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