What to Do for a Child with Lower Back Pain
No reason to panic and no reason to think the worse; if your child is experiencing low back pain, just take a deep breath and read. And contrary to popular belief, low back pain in children is usually not caused from a backpack full of books. No, a majority of back pain seen between the ages of 10-18 years of age is related to sports. Children who are involved in football, gymnastics, wrestling, diving, volleyball, or racket sports tend to be the most likely kids who will experience back pain. Fortunately, these aches and pains usually go away with good conservative care because they rarely represent a dire problem.
Although dire problems like infections and tumors do rarely occur; thus, a child with low back pain should see a doctor just to be sure. A doctor will ask a lot of questions about what makes the pain worse or better, general health, and other feelings of numbness, pain or weakness. After these questions have been answered, the doctor will test the reflexes, strength and sensation. Your doctor will especially want to look for scoliosis or other abnormal postures. Most of the time, a simple doctor visit is all that is necessary to rule out serious problems. Experts in the field say that “pediatric back pain frequently does not carry a definitive diagnosis and that exhaustive diagnostic protocols may not be necessary for this problem”. So, do not expect an entire litany of tests and imaging studies. Resist the urge to be like many parents who insist on MRI’s, x-rays, lab tests, and the whole nine yards for little Billy or Jane. Without just cause for the specialized tests, much time and money can be wasted.
When is it necessary for a child with low back pain to have a special test? If other joints are painful or fevers are involved, some laboratory tests can look for signs of infection or arthritic conditions. If the child is an athlete or was involved in an accident or has persistent pain, some imaging may be needed. In particular, a SPECT is very helpful to look for fractures in the bone. If there are signs of nervous system involvement, an MRI is probably needed. All of these specific problems are rare; in turn, special tests are rarely needed.
What is needed is: rest, a little physical therapy, and a whole lot of reassurance. Yes, the season might be over for your child athlete. But without proper care now, the risk of low back pain in the future is high. In fact, this may be a wonderful opportunity to improve your child’s general health and fitness level by teaching him/her better ways to take care of the body including the spine. With only one spine to live with, proper spine care should begin early in life, starting with the first episode of low back pain.
So do not panic or think the worst when your child complains of low back pain. With a pinch of medical care, a dash of rest, and enough reassurance added to taste, everything will be okay.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.