There has been a high prevalence of back pain in adolescents demonstrated in a number of epidemiological studies.
Adolescent back pain predominantly falls into three general categories as muscular, bone related and discogenic.
Muscle related pain.
Most common causes of back pain in adolescents.
Muscle related pain tends to be localized to paraspinal muscles of the thoracic or lumbar area rather than over the spine itself.
This type of pain is most commonly related to overuse, but there may be a history of acute injury.
Other relevent contributing factors are carrying a heavy rucksack,incorrect sports equipment,psychosocial distress,depression and anxiety.
Bone related pain.
Bone-related pain tends to occur at the cetre of the spine and usually increased by spinal extension(backward bending].
Common causes of bone related back pain in adolescents include spondylolysis, Adolescent idiopathic scoliosis[AIS],sheurmann’s disease.
Spondylolysis.
Describes a unilateral/bilateral defect[separation] in the vertebral parts usually the lower lumbar vertebrae.
Scoliosis.
️ It is an abnormal lateral curvature of the spine.It can be idiopathic or result from congenital spinal anomalies,muscular spasm or paralysis,infection,tumor.AIS is the most common form of idiopathic scoliosis,accounting for 80-85% of cases.AIS also noted as the most common spinal deformity.
Scheuermann’s disease.
️ It is the abnormal growth typically of the thoracolumbar region of the spine leading to increasing spinal curvature
Disc related pain.
️ Disc related pain is generally increased by trunk flexion and may radiate to other parts .
️ Approximately 10% of persistent back pain in adolescents is disc related.
Disc herniation.
️ It is a common disorder among adults with degenerated intervertebral discs with a lifetime occurrence as high as 40%.
️ Risk factors for disc herniation include Acute trauma,scheuermann’s disease,family history of disc herniation,obesity,sporting activities[eg:weight lifting,wrestling,gymnastic].
Symptoms.
️ Night time pain with Fever.
️ Acute pain which is a Radicular pain.
️ Chronic pain due to sacroilliac joint tenderness.
️ Pain with spinal forward flexion.
️ Pain with spinal extension.
️ Pain with recent onset scoliosis.
️ Risk factors for Adolescent back pain.
️ Early teenagers are more prone in getting
️ Excess body weight puts an extra stress on your back.
️ Sitting for long periods in improper postures.
️ Working with computers at a stretch.
️ psychological factors.
️ Improper lifting of heavy loads.
Prevention of low back pain.
Preventative treatments have been carried out over the last 3 decades,including physical therapy exercises,postural hygiene and promotion of physical activity
The best prevention of backpain is early detection
Preventative measures can include proper technique[eg:in lifting sports and limiting excessive lumbar lordosis,participating in core-strengthening exercises and stretches for tight hamstrings and hip flexors.
Physiotherapy Treatment.
Treatment of adolescents can be difficult and must be approached differently,with a good understanding of spinal develpoment.
Exercise is an effective treatment strategy to encourage motion of the lumbar spine to reduce joint stiffness ,provide muscle endurance of lumbar stabilisers and help encourage appropriate motor control of muscles associated with spine.
References.
https://www.aafp.org/afp/2007/1201/p1669.html#:~:text=When%20children%20or%20adolescents%20seek,%2C%20scoliosis%2C%20and%20Scheuermann's%20kyphosis
By:Mahesha Dilrukshi
