Severe back pain in children and adolescents

If in adults the majority of diseases and disorders in the body, in particular all kinds of severe back pain, are mainly related to physical inactivity, then for mobility-born babies, this reason is irrelevant, especially until the moment when the child starts school. It is not surprising that children under 6 years old very rarely have spinal pains, except that their appearance is associated with spinal cord injury, as well as with hereditary or acquired pathologies:

• malformations of the skeleton due to which the load on the spine is incorrectly distributed or the nerve is pinched in the area of the birth defect,
• tumors in the spinal cord and bone and cartilage structures, as well as metastases of cancer affecting the internal organs,
• abnormalities in the development of internal organs, in which there may be reflected back pain,
• infections of bones and cartilage (for example, osteomyelitis or bone tuberculosis),
• inflammatory diseases of the kidneys and bladder radiating pain to the lumbosacral back,
• sickle cell anemia is a hereditary blood disease in which back pain occurs due to blockage of small vessels that feed the spinal cord, decrease bone density, joint damage,
• hereditary spherocytic anemia, which is characterized by: liver damage and enlargement of the spleen, accompanied by pressure on the nerve roots and the appearance of reflected back pain, as well as pathological increase in certain parts of the body.

The benefit of these and some other pathologies, one of the symptoms of which can be moderate and severe back pain, are rarely diagnosed at preschool age. Yes, and for the emergence of acute symptoms of the disease, some predisposing factors are needed: overcooling of the body, physical exertion, strong emotional distress, trauma.

Children of primary school age may complain of back pain associated with the need to sit at the desk for a long time. The spine of babies is not used to such a large static load and can react with rapid fatigue and pain. But what is their intensity is very difficult to assess, because the reluctance to sit at a desk for a long time pushes small fidgets to exaggerate the force of unpleasant sensations.

The most common cause of moderate and severe back pain at school age is scoliosis, which is in most cases triggered by a violation of the child’s posture, which is most noticeable during the period of active growth of the skeleton. No matter how much the teacher and parents watch how the child sits at the training table, starting to get tired, the children sometimes take on the most uncomfortable postures and, over time, their spine takes the form of an arc or a meandering line. A wrong position of the spine increases the load on the muscles and can provoke pinching of the nerve roots.

True, the disease can occur much earlier. Just his first symptoms become noticeable after a few years. In this case, the parents themselves cause problems with the baby’s back. Risk factors for the development of scoliosis at an early age, when the spine is still not quite strong, are:

• carrying a baby in one hand,
• parents' attempts to make the baby sit or walk ahead of time,
• driving with the same handle, etc.
• too soft bed, distorting the shape of the spine during sleep,
• limiting the mobility of a child (a preschooler can not sit still for more than 20 minutes, so you should not insist that he draw for hours or play board games).

But most often adolescents suffer from scoliosis, because it is during this period that the most intensive growth of the skeleton is observed, but children of this age do not really listen to the requirements for maintaining correct posture.

Many teenage boys and some teenage girls are active in sports. But not everyone treats training with sufficient caution. And as a result, there are complaints of severe back pain caused by muscle strain or injury, the risk of which during sports increases.

Not by chance is the age limit for weight lifting. A child can easily tear his back, lifting heavy objects both during sports activities and in everyday life. The result is a sharp cutting pain in the back and lower back.

Increased physical activity of children of different ages carries another danger. Active movements, especially when playing sports, are associated with intensive blood circulation and heating of muscles. But one has only to sit with a wet back and allow it to cool down, as the cold of the muscles with their subsequent inflammation (myositis) is guaranteed. Children think about it a little, and when there are no parents or mentors who would remind of the danger of such carelessness, they often face severe aching back pain that is characteristic of inflammation. Palpation reveals a painful, tense muscle, which is the source of perceptible discomfort.

Another extreme is the hobby of children and teenagers in computer games, online chatting, searching for forbidden sites and other Internet entertainment. This implies a long sitting in a sitting position at the computer, which is fraught with a large load on the spine and spasm of the back muscles.

Overweight children are at increased risk of spinal pain, even with sufficient physical activity. In this case, the child’s body weighs on the lower back and legs, which can lead to deformation of the vertebrae and intervertebral discs with the early development of such pathologies as a herniated disc, spondylolisthesis, etc.

Spinal fatigue during prolonged sitting in class in children and adolescents is associated with pain in the back of low intensity, while injuries to the spine and tailbone can be very painful. In children suspicious with an unstable psyche, acute pains in the upper back and shoulders can also occur, which have a psychogenic character and appear on the background of stress.

Pain syndrome in infectious and inflammatory pathologies of internal organs is mainly reflected aching pain. The nature of pain in various diseases of the spine depends on the stage of the process (exacerbation or remission) and which structures are damaged in the disease. If the pain arose after suffering a cold (typical of SARS and flu), which is not uncommon in childhood, then it has a pressing or dull, dull character, because it is provoked by inflammation of the back muscles. Severe piercing pains are manifested only when local spasmodic areas (trigger points) are formed in the muscles, with pressure on which the symptom increases many times.

It should be understood that it is difficult for a child to describe what kind of strength and character spinal pains have, therefore parents play a large role in understanding the problem. By carefully observing the behavior of the baby or teenager, you can get a more or less clear idea of when the pain appears, which contributes to its strengthening, and by feeling the back of the child, you can understand where the pain is most severe. This information, if reported to the pediatrician, will help the latter to correctly select the research methods and make an accurate diagnosis.

[1], [2], [3], [4], [5]