Childern And Back Pain
It is differnet with childern who have back pain then it is with adults who have back pain. If a child, especially a young one has back pain there could be a serious underlying problem. This is especially true if the child with the back pain also is experiencing any of the following.
* Fever or weight loss
* Weakness, numbness, trouble walking or pain that radiates down one or both legs
* Bowel or bladder dysfunction
* Pain that interferes with sleep
Muscle strain in the middle or lower back will get better on its own with rest. Many teenagers may have "mechanical low back pain." This is often related to tight hamstrings and weak abdominal muscles. These individuals seem to do well with a exercise program that stresses hamstring stretching and abdominal strengthening.
More serious causes of back pain need early identification and treatment or they may become worse. Always see a doctor if your child's back pain lasts for more than several days or progressively worsens.
If your child is experiencing back pain then a doctor will need to examine the child to determine what exactly the problem is. Here are some simple tips for when you bring your child to the doctors.
* Give the complete medical history- How is the child's overall health? Does he or she have any diseases or medical conditions? Is there any family history of disease? Has the child been in an accident?
* Describe the back pain and any other medical problems- What is the exact location of pain? Does it extend into the legs? Is there any numbness, tingling or weakness? Trouble with urination or bowel movements?
* Describe when and how the pain began- Was it sudden, or did it develop slowly over time? When does it hurt, all the time or only with movement? Does it hurt at night? What makes the pain better or worse?
* Tell the doctor if the child is involved in sports or other activities- If so tell them what sports. Also the doctor will need to know how often they train and what type of playing surfaces they train and play on.
Next will come the physical exam. The doctor will carefully examine the child's musculoskeletal and nervous (neurological) systems. This may include checking:
* Alignment and mobility of the spine- If nessesary the doctor feels each vertebra and looks for deformities.
* Posture- How the child walks and whether he or she can bend over to touch the toes, extend, and bend to the right and left. Poor posture is a very big problem with childern and adults.
* Nerves in the back- With the child lying face up, the doctor will raise the legs straight up. The doctor may also raise the legs with the child lying face down.
* Size and tightness of muscles (i.e., hamstrings).
* Balance, flexibility, coordination and muscle strength.
* Muscle spasm and areas of tenderness.
* Reflexes and reactions to pain and light touch.
The doctor may use one or several diagnostic imaging tools to see inside the body. The doctor may take several X-ray pictures of the spine and pelvis from various angles. More sensitive than X-rays, bone scans use a substance the doctor injects into a vein to detect infections, tumors and fractures with a special camera. Specialized X-rays that show a three-dimensional image, computed tomography (CT) scans let the doctor see bone injuries more clearly. Magnetic resonance imaging (MRI) scans use radio waves to let the doctor see the spinal cord, nerve roots, disks or other soft tissues.
Laboratory tests may also be done to check the white and red blood cells count and to look for for system-wide inflammation.
Most often, musculoskeletal strain is responsible for childhood and adolescent back discomfort. The pain frequently responds to rest, anti-inflammatory medications and an exercise program. Other more serious diagnoses must always be given consideration. Rounded back (Scheuermann's kyphosis), stress fracture of the spine (spondylolysis), slipped vertebrae (spondylolisthesis), infection and tumor are among these.
Scheuermann's kyphosis is a common cause of middle (thoracic) back pain in adolescents. Vertebrae become wedged, causing a rounded or hunched back. The curve may ache, and pain may get worse with activity. Boys get Scheuermann's kyphosis more often than girls do, usually around ages 14 to 17. Treatment is usually nonsurgical and include
Using a brace as the child grows may improve the curve.
If the curve is rigid, the child may need a series of casts.
Exercises to stretch and strengthen muscles may ease pain, but will not change the rounded back.
Similar symptoms in the lower back may indicate another disorder, lumbar Scheuermann's disease. This may feel like a chronic backache. It most often affects boys ages 15-17 who take part in sports like weightlifting and football and those who do heavy labor.
Stress fracture of the spine, may cause lower back pain in adolescents. Stress fractures may occur during adolescent growth spurts or in sports that repeatedly twist and hyperextend the spine (i.e., gymnastics, diving and football). Pain is usually mild and may radiate to the buttocks and legs. It feels worse with activity and better with rest. A child with a stress fracture may have a stiff-legged walk with short stride length. Girls are more likely to get stress fractures.
Treatments include:
Rest from activities that caused the stress fracture
Nonsteroidal, anti-inflammatory drugs (NSAIDS)
Strengthening exercises for back and abdominal muscles to help control symptoms
Bracing for several months and follow-up doctor appointments with X-rays to watch for changes
Surgery to treat painful spondylolysis that does not get better with conservative management
In young children, infection in a disk space (diskitis) can lead to back pain. Diskitis typically affects children aged 1-5, although older children and teenagers can also be affected. A child with diskitis may have pain in the lower back or abdomen and limited range of motion of the spine, limp or refuse to walk. and squat with a straight spine to reach a toy on the floor, rather than bend over.
To treat diskitis, the child may need several days of bed rest and antibiotics taken through the blood stream (intravenous or IV) or in tablets. In some cases, older children may need casting or bracing to immobilize the spine (for comfort) if infection narrows the disk space. Rarely is surgical drainage of infection needed.
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Childern And Back Pain
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