Child Back Pain and Treatments
Child Back Pain – Conditions and Treatments
Back pain in children, particularly lower back pain, is much less common than back pain in adults. Unless it has been caused by an obvious strain or period of overuse, child back pain can point to a more serious underlying condition. Diagnosing and treating any potential child back condition is recommended promptly.
Our orthopaedic podiatrist, Chris Parish, is highly experienced in treating child back pain, and lower back pain in children and teenagers of all ages.
To discuss your child’s back condition or to make an appointment, please contact us by phone or send us a message
Contents
- Spondylolysis
- Treatment of Spondylolysis
- Spondylolisthesis
- Treatment of Spondylolisthesis
- Scheuermann’s Disease (Sherman’s Disease/Juvenile Kyphosis)
- Treatment of Scheuermann’s Disease (Sherman’s Disease/Juvenile Kyphosis)
- Scoliosis
- Treatment of Scoliosis
- Juvenile Rheumatoid Arthritis
- Oligoarticular (or Pauciarticular) Juvenile Rheumatoid Arthritis
- Polyarticular Juvenile Rheumatoid Arthritis
- Systemic Juvenile Rheumatoid Arthritis
- Treatment of Juvenile Rheumatoid Arthritis
Spondylolysis
Spondylolysis is a stress fracture in one of the vertebrae (bones of the spine), usually in the lower back. It is one of the most common causes of back pain in children, particularly adolescents, and is generally caused by overuse, especially during a growth spurt.
It is most common in children who engage in sports that involve arching the back, such as gymnastics, football and ballet dancing. Spondylolysis can also be hereditary.
As far as symptoms are concerned, your child may complain of an aching lower back but many children can have spondylolysis without experiencing any pain.
Treatment of Spondylolysis
If treatment is necessary, this usually includes rest, possibly with a back brace or support, and exercises to help strengthen the lower back.
In most cases activities can be resumed gradually. Surgery is rarely needed.
Spondylolisthesis
Spondylolisthesis happens when one vertebra (bone of the spine) slips forward over another vertebra. It usually affects the lower back and is most commonly caused by spondylolysis.
Spondylolysis is a stress fracture in one of the vertebrae of the lower back, usually the fifth lumbar (the last bone of the spine). If the fracture weakens the bone so much that it is unable to maintain its proper position, the vertebra can slip out of place. Too much slippage can cause the bones to press against nerves.
Symptoms can include pain in the lower back and legs, muscle spasms and weakness although some children are symptom-free. Spondylolisthesis can also be hereditary.
Treatment of Spondylolisthesis
If treatment is needed, it may be enough to restrict your child from activities that make the condition worse, typically those that involve arching the back, such as gymnastics, football and ballet.
If not, complete rest may be necessary, possibly with the support of a back brace. Exercises to help strengthen the lower back can also help.
An Orthopaedic Podiatrist will be able to advise on correct treatment, rehabilitation and prevention.
Surgery may be needed if back pain progressively worsens.
Scheuermann’s Disease (Sherman’s Disease/Juvenile Kyphosis)
Scheuermann’s disease, also known as Sherman’s disease and juvenile kyphosis, is a deformity of the spine that mainly affects teenage boys. It is caused by a problem with bone growth in the vertebrae (bones of the spine), which results in increased curvature (kyphosis) of the upper back. It makes the back more rounded than it should be, which makes children appear shorter and fatter than they actually are.
Symptoms include poor posture and hunching of the shoulders, pain in the upper back which can also be tender to touch, stiffness and fatigue. In some children there may also be increased curvature of the lower back (in the opposite direction) to compensate for curvature of the upper part of the spine.
Scheuermann’s disease is rare and tends to run in families, but it may also result from injury or overuse.
Treatment of Scheuermann’s Disease (Sherman’s Disease/Juvenile Kyphosis)
An x-ray will confirm whether your child has Scheuermann’s disease. The normal curvature of the upper back is 20-40 degrees. If the curvature is greater than 45 degrees it is considered to be excessive.
Initial treatment is usually conservative. An Orthopaedic Podiatrist can give advice on correct posture and back stretching exercises to help prevent further curvature of the spine.
While these measures do not reduce the excessive curve they can help to improve flexibility and reduce pain in the back.
In severe cases a back brace may be prescribed.
Scoliosis
Scoliosis is a sideways curving of the spine, defined as a curve of more than 10 degrees. The curvature can be C-shaped or S-shaped and the spine may also be twisted.
Some children are born with scoliosis (scoliosis is congenital); others develop the condition while they grow (scoliosis is acquired or idiopathic).
There are two types of scoliosis: non-structural or postural scoliosis and structural scoliosis.
Non-structural scoliosis is usually caused by a condition outside of the spine, such as one leg being shorter, and can usually be corrected.
Structural scoliosis is a fixed curvature in the spine and is harder to correct.
Scoliosis is not always obvious to detect; a slight sideways curvature of the spine is perfectly normal.
You may first notice something is wrong if clothes start to hang unevenly or there is a change in your child’s posture: one shoulder may be raised higher than the other; he or she may have a more prominent shoulder blade on one side or they may be leaning to one side, their head not centred directly over their pelvis as it should be.
Children can develop scoliosis through carrying heavy bags incorrectly (on one shoulder and not spreading the weight across the back) all day at school.
Scoliosis can also cause mild back pain.
Treatment of Scoliosis
If scoliosis is suspected your child’s spine will be x-rayed. If confirmed, treatment will vary according to the severity of the condition.
Mild cases are usually left untreated but monitored closely (especially in adolescents who are still growing). Sometimes growth alone can correct the problem.
If scoliosis is non-structural, an Orthopaedic Podiatrist can give advice on correct posture and help to correct muscular or mechanical imbalances.
Moderate or severe cases may be treated with back braces to stop the curvature from getting worse; these are usually worn for up to 23 hours a day.
In the most severe of cases spinal fusion surgery may be necessary.
Juvenile Rheumatoid Arthritis
Juvenile rheumatoid arthritis, also referred to as juvenile idiopathic arthritis, is an autoimmune disease (where the immune system attacks the body’s own tissues), which can cause back pain, joint pain, heat and swelling in the joints, a rash and fever. There are three main types of junior rheumatoid artritis: oligoarticular (or pauciarticular), polyarticular and systemic juvenile rheumatoid arthritis.
Oligoarticular (or Pauciarticular) Juvenile Rheumatoid Arthritis
Oligoarticular (or pauciarticular) juvenile rheumatoid arthritis is the most common form, affecting about half of all children with arthritis and mainly girls under the age of eight. It is usually present in four joints or fewer and normally the larger joints such as the knees, ankles or wrists. After the age of eight, boys are more likely to develop this type of arthritis.
Polyarticular Juvenile Rheumatoid Arthritis
The polyarticular form affects about a third of children with juvenile rheumatoid arthritis and can occur at any age. It is a condition that affects five or more joints and especially the fingers and toes.
Systemic Juvenile Rheumatoid Arthritis
Systemic juvenile rheumatoid arthritis (also known as Still’s disease) is the least common form of the condition, affecting approximately 20% of children. It may develop at any age and in addition to joint pain, initial symptoms can also include a rash, fever, swollen glands, tiredness and lack of energy and/or weight loss, leading you to believe your child may have an infection.
In all types of juvenile rheumatoid arthritis, symptoms may last into adult life or they may disappear as your child grows up.
Treatment of Juvenile Rheumatoid Arthritis
While there is no cure for juvenile rheumatoid arthritis, treatment can help to reduce symptoms and prevent long term problems.
Anti-inflammatory medication is also used to help control pain and manage inflammation.
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