Although children and early adolescents are much less likely to experience back pain than their adult counterparts, this younger population does occasionally experience spine problems. Margaret Magin, RN, the Nurse Coordinator of the Spine Clinic at Children’s Hospital Boston, cites the two most frequent children’s back conditions as scoliosis and kyphosis, followed by spondylolysis and spondylolisthesis.Scoliosis, which affects approximately one in ten children, is a condition of abnormal spine alignment. From a side view, a healthy spine mimics a shallow S shape, but appears perfectly straight from the back or front. When scoliosis is present however, the back or front view will reveal a curve in the spine. Usually painless, scoliosis is most prevalent in children ages 10 – 18 in its idiopathic form, meaning there is no identified cause. The high proportion of idiopathic cases during the adolescent years has encouraged many states to implement school scoliosis-screening programs. Depending on the extent of the deviation, bracing may be employed to correct the spinal malformation, thereby avoiding the need for more invasive, surgical correction.
Kyphosis is yet another back condition occurring in children, and is referred to as Scheuermann’s Disease when occurring in adolescents. With the onset of Scheuermann’s, several adjacent vertebrae wedge together, yielding a curved or bowed back. Similarly to idiopathic scoliosis, it is unknown why Scheuermann’s disease develops in certain children. It is often accompanied by mild back pain, fatigue, tenderness and stiffness in the spine, and in extreme cases, difficulty breathing. A program of bracing and physical therapy is usually employed to correct the condition, although in extreme cases surgery may be necessary to correct the deformity. If the problem goes untreated, a rounded or hunchback shape will result.
Although much less common than scoliosis or kyphosis, children also occasionally suffer from spondylolysis. More common in girls than boys, spondylolysis consists of a stress fracture in the spine, usually the result of repeated twisting or hyperextension of the spine. It is often seen in children who participate in sports like gymnastics, diving or football, and the resulting lower back pain is usually mild, often radiating down from the spine through the pelvis and legs. A 4-6 week respite from athletic activities, non-steroidal anti-inflammatory drugs, exercises designed to strengthen back and abdominal muscles, bracing, and surgery may all be prescribed to help heal the fracture and/or reduce the accompanying pain.
Along similar lines, spondylolisthesis occurs when one of the lower vertebrae slips forward against the vertebrae below. In children this is often the result of a physical deformity in the spine, but the condition also may develop from a stress fracture (usually associated with hyperextension of the spine), and very rarely, bone disease. Possible symptoms include lower back pain, muscle tightness, tenderness in the "slipped" region, and, if the vertebrae are impeding nerves, pain radiating down the legs. Spondylolisthesis is also often associated with lordosis (swayback) and kyphosis. To treat the condition, physicians may prescribe strengthening and stretching exercises, a reduction in physical activity, or braces. In severe cases (e.g. a pronounced slip or significant neurological damage), spinal fusion may be employed to stabilize the spine.
References
American Academy of Orthopaedic Surgeons. "Back pain in children." December 2001. http://orthoinfo.aaos.org
Huang, Julian. Potential causes of back pain in children and teens. http://www.spine-health.com July 10, 2002
Chen, Andrew L. Spondylolisthesis. U.S. National Library of Medicine and the National Institutes of Health. November, 2002. http://www.nlm.nih.gov/medlineplus
Cohen, Ezra. Kyphosis. U.S. National Library of Medicine and the National Institutes of Health. February, 2003. http://www.nlm.nih.gov/medlineplus
National Scoliosis Foundation. “Information and Support.” http://www.scoliosis.org
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