The problem of children and adolescents with low-back pain (LBP) is important among pediatric and chiropractic professionals. The prevalence of young people with LBP has been growing, and the reason for this is not clear. As children get older and into their teen years, their chances of having LBP increase significantly, and former research has shown that about 12% of teens have at least some degree of pain in the low-back. Another study’s results showed that 24% of schoolchildren in England aged 11-14 had LBP for at least one month.
Scientists and doctors have debated about risk factors. Some say that school furniture is not ergonomically configured; others say that today’s kids carry too many school books in their backpacks; still others blame the amount of strenuous physical activity that children and teens are exposed to. In addition, there has been some evidence that suggests that psychological and pyschosocial factors may also contribute to the increase in LBP in young people.
Another possible source of LBP in children and adolescents is herniation in the intervertebral disc joint. Although this is a rare condition among young people, it can be quite painful and difficult to treat.
In a recent case study, researchers followed the treatment of a 13-year-old boy with chronic LBP. The young patient had a four-month history of pain localized in his right low-back. He described his pain as “achy and annoying,” preventing him from sitting for long periods and resulting in him missing a significant amount of school and most physical activities. He had tried taking non-steroidal anti-inflammatory drugs, and he had also been treated with chiropractic high velocity low amplitude and low force spinal manipulation, but had not experienced any lasting relief.
The researchers determined that the boy’s pain was a result of a intervertebral discogenic hernia, likely from a bicycling fall he had endured shortly before the pain started. They concluded that in cases of chronic LBP in young people, especially when chiropractic manual therapy is not helping, providers should consider the possibility of discogenic causes, from annular tears, a hernia, or vertebral endplate injury. They also concluded that MRI can be a useful tool in diagnosing such problems. They highlighted the importance of resolving lumbopelvic function among young patients, to avoid negative effects on their growing spines and improve their quality of life.
The study authors also agreed that more research is needed about the long-term implications of these types of disc injuries among young patients, and how to manage them as non-invasively as possible.
Previous research has shown that chiropractic manual therapy combined with exercise is the best treatment for most back pain in teens.
King S, Chambers CT, Huguet A, et al. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain 2011; 152: 2729-2738.
Calvo-Munoz I, Gomez-Conesa A, Sanchez-Meca J. Prevalence of low back pain in children and adolescents: a meta-analysis. BMC Pediatrics 2013; 13: 14.
Carter C, Amorin-Woods L, Doss A. Early adolescent lumbar intervertebral disc injury: a case study. Chiropractic & Manual Therapies 2013; 12:13. doi: 10.1186/2045-709X-21-13.