Potential Causes of Back Pain in Children

Elisabeth Bablin

Back pain in children and young adults is a common phenomena with a myriad of causes that vary in seriousness. Compared to back pain in adults, back pain in children is understudied, even though it is almost equally prevalent (7). The least serious cases arise from play or physical exertion. Often, these cases resolve themselves with time and do not require additional medical attention (1).

Unrelenting back pain may be rooted in a child’s lifestyle. Spending long periods of time playing video games may lead to pain if the child has poor posture, hunching over or bending to see the screen. Interestingly, the same study found that watching television did not contribute to back pain, likely because the activity does not require any interaction and the child is free to lay down in a more comfortable position (4).

The way a child carries a book bag, as well as the weight of the bag may be another contributing factor to ongoing back pain. Two separate studies conducted on students found a strong relationship between carrying backpacks and back pain. Both suggest that children would benefit from a reduced backpack load (6, 7). However, a third study found no relationship between backpacks and back pain in children. Interestingly, the same study found back pain in children more common when the child identified at least one parent who experienced the same affliction. This could indicate that children needed previous exposure to the condition to identify it in themselves (4).

 There are a few factors that could account for the backpack discrepancy such as different backpack styles, qualities, and weights. Additionally, these studies were conducted in different countries, so a variety of cultural factors may impact this data.

More severe cases may be caused by scoliosis, spondylolysis and spondylolisthesis, disk herniation, Schuermann disease, sickle cell disease and cancer of the spinal cord (1). If back pain lingers, parents should consider seeking medical attention to have additional testing and imaging done.

Treatment for back pain in children is varied. The pain may recede with time or require lifestyle changes such as taking breaks while playing video games or reducing backpack weight. In serious cases, surgery may be necessary (5). An experimental approach tried in a 2018 study, found a combination of spinal manipulation and exercise therapy to be an effective and non-invasive treatment, with no negative side effects. It centers around educating the child on proper posture, creating a “strengthening” exercise program, and undergoing spinal manipulation with the assistance of a chiropractor (3).

Back pain in children is a serious issue that unfortunately, receives less attention then back pain in adults. If child back pain is left untreated it can lead to sleep issues, drug use, and increased aggression (2). Causes of back pain in children are varied and can be serious. Medical attention may be required if the pain does not subside in a few days. Luckily, there are several treatment options for dealing with back pain that can improve the quality of life in children.

This article has been approved and reviewed by the Scientific Writing Team Lead of Esurgi : Ishtiak Ahmed Chowdhury

Sources:

1. Afshani, E., & Kuhn, J. P. (1991). Common causes of low back pain in children. Radiographics : a review publication of the Radiological Society of North America, Inc, 11(2), 269–291. https://doi.org/10.1148/radiographics.11.2.1827529

2. Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. Journal of research in health sciences, 19(1), e00440.

3. Evans, R., Haas, M., Schulz, C., Leininger, B., Hanson, L., & Bronfort, G. (2018). Spinal manipulation and exercise for low back pain in adolescents: a randomized trial. Pain, 159(7), 1297–1307. https://doi.org/10.1097/j.pain.0000000000001211

4. Gunzburg, R., Balagué, F., Nordin, M. et al. Low back pain in a population of school children. E Spine J 8, 439–443 (1999). https://doi.org/10.1007/s005860050202

5. Illeez, O. G., Akpinar, P., Bahadir Ulger, F. E., Ozkan, F. U., & Aktas, I. (2020). Low back pain in children and adolescents: Real life experience of 106 patients. Northern clinics of Istanbul, 7(6), 603–608. https://doi.org/10.14744/nci.2020.93824

6. Rodríguez-Oviedo, P., Ruano-Ravina, A., Pérez-Ríos, M., García, F. B., Gómez-Fernández, D., Fernández-Alonso, A., Carreira-Núñez, I., García-Pacios, P., & Turiso, J. (2012). School children’s backpacks, back pain and back pathologies. Archives of disease in childhood, 97(8), 730–732. https://doi.org/10.1136/archdischild-2011-301253

7. Skaggs, D. L., Early, S. D., D’Ambra, P., Tolo, V. T., & Kay, R. M. (2006). Back pain and backpacks in school children. Journal of pediatric orthopedics, 26(3), 358–363. https://doi.org/10.1097/01.bpo.0000217723.14631.6e