Children and Back Pain 

Back pain is common in Australian children, particularly during adolescence. Some causes of back pain in young people include poor posture, inappropriate forms of exercise and carrying heavy schoolbags. If pain is persistent, and felt in the same place, it should always be investigated by medical practitioner. Since children with back pain may become adults with chronic bad backs, it is important to encourage sensible back care in young people. See your doctor or chiropractor for professional advice. 

Back pain can be caused by a chain of events

A single incident, such as falling from a horse, can cause sudden spinal injury. However, cases of nagging, ongoing back pain seem to be caused by a range of factors working in combination. Relatively minor injuries as a result of normal sports and games may lead to muscle spasm, so that some back muscles may have to work harder than others. This can cause fatigue, pain and changes in posture. Poor posture can further contribute to back pain. A child with a sore back may shy away from sporting activities, and the lack of exercise may then cause further problems. 

A range of causes

Some of the many potential influences in the development of back pain in children include: 

• Gender, since back pain is more common in females.
• Age, since children at 12 years and over experience significantly more back pain than younger children.
• Obesity and poor posture.
• Heavy schoolbags carried on one shoulder or in one hand.
• Incorrectly packed backpacks.
• Sedentary lifestyle, such as watching a lot of television or sitting in front of the computer.
• Injuries caused by vigorous sports like football or horse riding, flexibility dependent sports such as gymnastics or dance, and power sports such as weightlifting or rowing.
• Soft tissue injuries, such as strains and sprains.
• Competitive sports that demand intense training - it is thought that tight thigh muscles can trigger lower back pain.

Medical conditions that can cause back pain in children

Always see your doctor for diagnosis if your child complains of back pain. Soft tissue injuries are the most likely cause but, in some cases, the pain is caused by medical conditions that require professional treatment. These can include: 

• Injuries to bones and joints - such as compression fractures and disc injuries.
• Fibromyalgia - although more common in adults, this nuisance chronic pain disorder does occur in adolescents, causing back and neck pain with associated muscle spasm and fatigue.
• Sciatica - pain radiating down the buttock and leg, caused by compression of the sciatic nerve.
• Scheuermann’s disease - a growth disorder of the vertebrae, which may produce a humpback curvature (kyphosis).
• Idiopathic scoliosis - sideways curvature of the spine with an unknown cause; it is usually not painful. Any persistent pain associated with a fixed curvature must be carefully evaluated.
• Spondylosis - a congenital structural defect in the vertebrae. Certain activities may increase the potential for pain - for example, in gymnastics, caused by hyperextending the spine.
• Spondylolisthesis - a condition characterised by unstable vertebrae as a consequence of a pre-existing spondylosis.
• Tumours or infection - the rarest, least likely cause of back pain in children. 

Prevention suggestions

Suggestions to reduce spinal stress include: 

• Reduce the risk of falls for younger children by always using safety straps in prams, strollers and change tables.
• Spread tanbark around home playground equipment to cushion falls.
• Give your child a backpack to carry schoolbooks. Make sure the backpack is worn correctly over both shoulders, and that the heavier items are packed close to the child’s back.
• Encourage regular ‘walking and stretching’ breaks when doing homework because sitting for long periods of time can fatigue back muscles.
• Limit television and computer time.
• Teach them how to sit properly in a chair - for example, instead of slouching, they should sit up straight with their bottom square on the seat.
• Consider buying them an ergonomic chair to improve their posture while doing homework.
• Make sure their lifestyle includes plenty of exercise.
• Encourage your child to warm up and cool down thoroughly when exercising to reduce the risk of injury.
• Use proper sporting techniques and appropriate safety equipment (such as helmets and padding).
• Suggest a regular program of gentle stretching to help prevent tight muscles.
• Make sure you look after your back too - children learn best by example.