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Myths About Back Pain in Children

Children can develop back pain with no apparent cause. There's been no injury or trauma. Parents and care givers are understandably concerned. They may turn to the Internet for information. But be careful because not all websites are alike. And not all websites offer complete, accurate information that presents the whole picture.

Take for example the idea that back pain in children is usually a serious problem. That's not exactly true. A better way to say this is that back pain in children can be caused by a serious underlying condition.

Back pain in a young child is more serious than back pain in an older child. Again, this statement can be true, but it's not always the case. Back pain caused by a serious disorder is often missed or diagnosed late. This does happen but in the majority of cases, children complaining of back pain or a backache get their parents' or caregiver's attention. If the symptoms don't go away in a few days, they are taken to see a doctor or to the health department.

Where does all this misinformation come from? Well, first, there is some truth and accuracy in each statement. But the bigger picture is that children can and do have their share of back pain. As with adults, the cause is often unknown. There's no fracture, no infection, no tumor. It just hurts. And often it hurts when they move. This type of back pain is called nonspecific or mechanical low back pain.

Only a small number of cases have an actual identifiable cause. And physicians usually diagnose these cases quickly based on the patient's history, clinical exam, and results of tests such as X-rays, MRIs, and lab values.

Many websites offering information base their facts on one study or a single news report. And they don't update their information. In some cases, information cited from studies in the 1990s is already out-of-date.

Physicians look to large-scale studies published recently in peer-reviewed (reliable) journals to help ensure the most accurate up-to-date information. When reading information on-line, look for dates when the information was published and posted. Look for reputable sources of that information. Unless presented by a well-known, reputable source, don't count the website as the content expert.

Today's evidence suggests that 1) back pain is common in children -- more common than we might expect, 2) most of the time, the cause remains unknown, and 3) physicians have a model or algorithm for evaluating and diagnosing back pain in children that will reveal more serious causes when they are present.

References: Traditional View of Back Pain Among Children. In The BackLetter. February 2009. Vol. 24. No. 2. Pp. 16-17.

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