Not Just Adults Complain of Backaches
Pain in kids can stem from a variety of sources

(HealthDay News) -- Back pain is usually considered an adult ailment, but children can be prone to back problems, too.

Low-back pain, in fact, is fairly prevalent among children. In a study of 287 Belgian kids 9 to 12 years of age, about 18 percent reported at least one episode of back pain in a two-year span, even though they were pain-free at the start of the study.

What's more, when children and teens seek medical care for back pain, it's highly likely that there's an underlying cause, according to a review published in the American Family Physician .

But contrary to popular belief, there's no definitive proof that backpacks are the culprit, noted the review's authors, Dr. Robert M. Bernstein, director of pediatric orthopedic surgery at Cedars-Sinai Medical Center in Los Angeles, and Dr. Harold Cozen, a retired family physician and former associate clinical professor of family practice at the Western University of Health Sciences in Pomona, Calif.

"There is controversy on whether the evidence truly supports the hypothesis that backpacks cause pain," Bernstein told HealthDay . "There are articles that support both views, and thus it remains unclear. Questioning a child while conducting a survey in which the child has not come to the doctor seeking care for a complaint of back pain may not be valid."

There's no data on the causes of back pain in children and teens who see their primary-care doctor, the co-authors noted. However, they added, when kids see a specialist, certain conditions commonly crop up. These include spondylolysis, a defect in the connection between the vertebra that can lead to stress fractures, and spondylolisthesis, a slip of one vertebra relative to another that causes low-back pain, they wrote. Herniated disk and scoliosis are also common.

Back pain isn't usually the reason kids to go to the emergency room, but when they do, it's often the result of trauma, muscle strain, nonspecific pain or a complication of sickle cell disease, according to the review.

The American Academy of Orthopaedic Surgeons says that muscle strain is the most common cause of back pain. But with rest, it usually goes away on its own.

Many teenagers have more persistent back pain, often related to tight hamstring muscles and weak abdominal muscles, the academy reports. These children seem to improve with a physical therapy program that stresses hamstring stretching and abdominal strengthening.

As for backpacks? Bernstein said he has rarely had a child attribute back pain to a heavy backpack.

"In addition, when questioned, most kids carry their pack out of the car, walk 50 yards, and drop it on the floor," he said. "They pick it up after class and walk another 25 yards to the next class, etcetera. They are not carrying the pack for 5 miles at a time over long distances."

Nevertheless, the American Academy of Pediatrics has guidelines on the safe use of backpacks, noting that improper use of these carry-alls can injure muscles and joints. "This can lead to severe back, neck and shoulder pain, as well as posture problems," it says.

To prevent injury, kids shouldn't wear backpacks that exceed 10 percent to 20 percent of their body weight, according to the pediatric group's guidelines. It also recommends using a pack with wide, padded straps worn on both shoulders.

Though Bernstein said the guidelines aren't based on specific data, he said he does provide the information to his patients.

On the Web

To learn more about back pain in children, visit the American Academy of Orthopaedic Surgeons.

SOURCES: HealthDay News ; Robert M. Bernstein, M.D., director of pediatric orthopedic surgery, Cedars-Sinai Medical Center, Los Angeles; Aug. 14, 2007, American Physical Therapy Association, news release; May 7, 2002, European Spine Journal ; Dec. 1, 2007, American Family Physician
Author: Karen Pallarito
Publication Date: July 31, 2008
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