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Low back pain in children and adolescents: Real life experience of 106 children

children and back pain

The goal of this study?

The objective of this study 1 examined the causes and risk factors for lower back pain (LBP) in children and adolescents who accessed a specific clinic.

Why are they doing this study?

LBP is common in children and adolescents, with existing research showing the prevalence of LBP ranging from 9%-69%, increasing significantly between 12 and 18. While research shows that LBP causes in children are as diverse as adults, there is much less information on LBP in children and adolescents. 

Who was involved?

The research looked at patients under 18 who came to the researcher’s clinic to address LBP between May 2014 and May 2018.

 

  • A total of 106 children and adolescents, aged between 8 and 17:
  • 55 girls (51.8%) & 51 boys (48.1%)

 

Those excluded included:

  • Anyone with referred pain, infections or anyone with emotional or mental stressors that are causing pain.

What was done?

The researchers used a retrospective study for their design, meaning that all of the patients were already experiencing LBP, and they look back in time to determine why.

 

The researchers looked at a variety of patient data, including:

    • demographic information (age, gender, ethnicity, etc.), 
    • pain severity, which was measured using a visual analog scale (VAS)
    • physical examinations
    • laboratory tests
  • Imaging using X-ray and MRI 
  • Family history
  • Lifestyle, including how much sitting per day, sporting activity
  • Examination for hypermobility and hamstring flexibility

 

Statistical analysis of all the data was done using SPSS (which is stat software) to determine…

What did they find?

The researchers found six different etiologies (causes) for LBP in children and adolescents. Overall, they found that LBP was more common in their adolescent patients than younger children. 

 

The vast majority of patients in this study, 62 (58.4%), had non-specific LBP. These patients had various risk factors, including obesity, poor posture, tight hamstring muscles, hypermobility, family history and immobility. All patients in this group had their symptoms resolved either independently or through the use of rest and analgesic medication. Additionally, all patients in this group were given a home exercise program.

 

The second most common cause was lumbar disc herniation, with 24 patients (22.6%). The causes of this were mostly related to trauma and family history. Treatment for these patients varied from steroid injections, analgesic medication, physiotherapy and three patients with uncontrolled pain required surgery.

 

Inflammatory LBP was the third most common findings, with 6 patients (5.6%). All of these patients were treated with non-steroidal anti-inflammatory drugs, exercise and referred to a pediatric rheumatologist.

 

Among the remaining patients, 5 had spondylolysis-listhesis (a crack or stress fracture in one of the vertebrae, the small bones that make up the spinal column), 5 had scoliosis, and 4 had Scheuermann disease (a childhood disorder where the vertebrae grow unevenly and can result in a humpback). Patients in these categories were treated with various approaches, including analgesics, rest, physiotherapy and exercise.

Why do these findings matter?

Determining the cause of LBP in children and adolescents is important to address pain and mobility issues for young people and because it is a significant risk factor for adulthood. If not diagnosed and treated appropriately, it may become chronic and cause disability in adulthood. 

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