“A 12 year old with lower back pain?”
My 12 year old son has lower back pain and he doesn't play sports. What would cause this?
4 Answers
Back pain can be musculoskeletal (muscle related) or joint related. I encourage you to take him to his primary care physician for further evaluation.
Most back pain in children or adolescents is related to either structural changes or trauma. More serious causes could include inflammatory arthritis or back problems, infections and less common tumors. The evaluation should include a complete history for activity, family history, and duration of symptoms. A thorough physical examination and possibly X-rays as indicated. Most causes of back pain can be self-limiting.
Please take him as soon as possible to your primary care doctor.
Back Pain:
The back is supported by a bony structure call the vertebral column. The vertabral column is made of 33 bones stuctures. The first 24 vertabrae are separated by a discs (cushions) that prevents friction or crashingn and alows flexibility of the bones. The last 9 vertabrae (sacrum and coccyx) are fused with out a disc. The spinal vertebrae houses the spinal nerve (spinal cord) and spinal fliud that baths the these nerves.
The back bone (vertebrae) supports the the body above the hips. Any process that would affect this supporting stracture may cuase pain.
Back pain is a very common phenomenon. Most back pain are self limitted. Over 50% of children age 10-18 years will have back pain at verious times. Most of these complaints are not serious. And most of the back pain are self limited though they may reoccur from time to time.
The most common cause of back pain in children and adolescents are due to muscle strain or sprain of ligaments, most likely due to injury, over use or carrying heavy backpack. Inactivity, poor conditioning and excessive weight gain may contribute to back pain as well.
Causes of back pain are;
1. Muscle strain or ligament sprain (non specific) mostly from injuries or stress.
2. spondylosis (bone fracture, spur formation, disc degeneration, disc herniation etc) from injury or stress. These may lead to nerve compression.
3. Spondylolisthesis ( a vertebrae slips forward in to the bone below)
4. Alignment or Postural imbalance (anomalis) such as scoliosis and kyphosis.
5. stenosis of vertebral canal. This restricts nerve and causes nerve pain.
6. Ankylosis or anchilosing spondylitis ( fusion of vertebrae from inflamation such as arthritis.
7. Various cancers or tumors that either originate or spread to the spinal vertebrae.
8. Congenital or hematologis disorders.
Most back pain are not serious. They will improve with;
1. Application of heat
2. pain killers
3. Streching and strengthening excercise.
4. By remaining active such as swiming, walking, bicycling etc.
5. Bed rest is not a solution unless there is a serious back pain such as fractures
6. Always movement is the solution
Signs of serious back pain
1.Persistent and prolonged back pain
2. Night pain that awakens you from sleep
3. persistent back pain in very young children
4.Generalized sickness
5. Fever, chills or malaise
6. Unexplained weight loss.
7. Weakness
8. Leg pain, tingling sensation or extremity numbness.
The above symptoms should be considered serious and a medical help should be sought proptly. A bed rest is recommended on these instances until a medical professional determines the best treatment options.
There are few ways or tests to determine the seriousness of the pain or the cause of the pain.
1. Adams forward bending test: The child is standing with his feet together and his knees are straight, and the person bend forward. If the spinal column are curved or the rib cage is asymmetry the test will be cosidered positive.
2. Straight leg raise test: The child will be in a supine position (laying on his back) and the leg is raised will the knee is striaght. Raising the leg while the hip is flexed between 30-70% pain will be felt on the back for the test to be positive.
3. Faber test; lying on supin position the knee if flexed at 90 degree and the hip is pushed and externaly rotated while the pelvic is stabilized with the other hand. The test will be positive if pain is felt buttock, groin or pelvic joint.
4.Trendelenburg test: The child will stand on one legm and the pelvis position is observed. A positive test cosistent with a droping of the other side of the pelvic.
Generally in children the majority of pack pain are from musle strain due to injury of stress or postural imbalance. they can be managed as discussed above. Few cases may need medical attention if they show some of the above mentioned worning signs.
Going back to your son:
Your son is not physically active. That in itself may cause back pain. If he is not active he may be overweight which can cause back pain. It is also possible that your son may be carrying a heavy backpack. These things can contribute to back pain. In the majority of children back pain is not serious and is due to mascle stain or ligamnet sprain due to fall or stress from repetetive activity. These conditions can be managed conservatively with proper physical activity with streching and strengthening activities, pain killers, warm compressors etc. Inactivity is not good to any child. Inactivity can predispose to frequent back pain. Over weight and carrying large backpacks may also cause back pain. Your son should participate in a structured physical activity on regular basis. The recommendation is atleast over an hour a day for 6 days a week of moderate to vigorous physical activity with 10-20 minutes of balance or strength training with each activity. He should maintain healthy weight appropraite for his age and gender. He should not carry large backpack for a prolonged time when he does not have a meaningful sports activity.
You should also make sure that he does not have the warning signs of serious back pain such as prologed back pain, fever, unxplained weight loss, leg pain, numbness, tingling senssation or extremity weakness. If he has any of the above warning signs, you should seek immediate medical help.
Please discuss these issues with his primary care doctor and get more advice on these issues.
Good Luck.
The back is supported by a bony structure call the vertebral column. The vertabral column is made of 33 bones stuctures. The first 24 vertabrae are separated by a discs (cushions) that prevents friction or crashingn and alows flexibility of the bones. The last 9 vertabrae (sacrum and coccyx) are fused with out a disc. The spinal vertebrae houses the spinal nerve (spinal cord) and spinal fliud that baths the these nerves.
The back bone (vertebrae) supports the the body above the hips. Any process that would affect this supporting stracture may cuase pain.
Back pain is a very common phenomenon. Most back pain are self limitted. Over 50% of children age 10-18 years will have back pain at verious times. Most of these complaints are not serious. And most of the back pain are self limited though they may reoccur from time to time.
The most common cause of back pain in children and adolescents are due to muscle strain or sprain of ligaments, most likely due to injury, over use or carrying heavy backpack. Inactivity, poor conditioning and excessive weight gain may contribute to back pain as well.
Causes of back pain are;
1. Muscle strain or ligament sprain (non specific) mostly from injuries or stress.
2. spondylosis (bone fracture, spur formation, disc degeneration, disc herniation etc) from injury or stress. These may lead to nerve compression.
3. Spondylolisthesis ( a vertebrae slips forward in to the bone below)
4. Alignment or Postural imbalance (anomalis) such as scoliosis and kyphosis.
5. stenosis of vertebral canal. This restricts nerve and causes nerve pain.
6. Ankylosis or anchilosing spondylitis ( fusion of vertebrae from inflamation such as arthritis.
7. Various cancers or tumors that either originate or spread to the spinal vertebrae.
8. Congenital or hematologis disorders.
Most back pain are not serious. They will improve with;
1. Application of heat
2. pain killers
3. Streching and strengthening excercise.
4. By remaining active such as swiming, walking, bicycling etc.
5. Bed rest is not a solution unless there is a serious back pain such as fractures
6. Always movement is the solution
Signs of serious back pain
1.Persistent and prolonged back pain
2. Night pain that awakens you from sleep
3. persistent back pain in very young children
4.Generalized sickness
5. Fever, chills or malaise
6. Unexplained weight loss.
7. Weakness
8. Leg pain, tingling sensation or extremity numbness.
The above symptoms should be considered serious and a medical help should be sought proptly. A bed rest is recommended on these instances until a medical professional determines the best treatment options.
There are few ways or tests to determine the seriousness of the pain or the cause of the pain.
1. Adams forward bending test: The child is standing with his feet together and his knees are straight, and the person bend forward. If the spinal column are curved or the rib cage is asymmetry the test will be cosidered positive.
2. Straight leg raise test: The child will be in a supine position (laying on his back) and the leg is raised will the knee is striaght. Raising the leg while the hip is flexed between 30-70% pain will be felt on the back for the test to be positive.
3. Faber test; lying on supin position the knee if flexed at 90 degree and the hip is pushed and externaly rotated while the pelvic is stabilized with the other hand. The test will be positive if pain is felt buttock, groin or pelvic joint.
4.Trendelenburg test: The child will stand on one legm and the pelvis position is observed. A positive test cosistent with a droping of the other side of the pelvic.
Generally in children the majority of pack pain are from musle strain due to injury of stress or postural imbalance. they can be managed as discussed above. Few cases may need medical attention if they show some of the above mentioned worning signs.
Going back to your son:
Your son is not physically active. That in itself may cause back pain. If he is not active he may be overweight which can cause back pain. It is also possible that your son may be carrying a heavy backpack. These things can contribute to back pain. In the majority of children back pain is not serious and is due to mascle stain or ligamnet sprain due to fall or stress from repetetive activity. These conditions can be managed conservatively with proper physical activity with streching and strengthening activities, pain killers, warm compressors etc. Inactivity is not good to any child. Inactivity can predispose to frequent back pain. Over weight and carrying large backpacks may also cause back pain. Your son should participate in a structured physical activity on regular basis. The recommendation is atleast over an hour a day for 6 days a week of moderate to vigorous physical activity with 10-20 minutes of balance or strength training with each activity. He should maintain healthy weight appropraite for his age and gender. He should not carry large backpack for a prolonged time when he does not have a meaningful sports activity.
You should also make sure that he does not have the warning signs of serious back pain such as prologed back pain, fever, unxplained weight loss, leg pain, numbness, tingling senssation or extremity weakness. If he has any of the above warning signs, you should seek immediate medical help.
Please discuss these issues with his primary care doctor and get more advice on these issues.
Good Luck.
