Back pain

Nearly 40% of Youth have Back Pain

How prevalent is back pain among school-aged youth? To find out, researchers surveyed 481 children, aged 8 to 10 years, and 325 adolescents, aged 14 to 16 years. All subjects were students in Denmark.

Findings showed that "The 1-month prevalence of back pain was 39%. Thoracic pain is most common in childhood, whereas thoracic pain and lumbar pain are equally common in adolescence. Neck pain and pain in more than one area of the spine are rare in both age groups. No gender differences were found."

In addition to obesity, children who watched Tv for longer hours had an increased risk of headache, back pain, eye symptoms and sleep problems were found to be more often among children who watched television longer.

Wedderkopp N, Leboeuf-Yde C, Andersen LB, Froberg K, Hansen HS   Back pain reporting pattern in a Danish population-based sample of children and adolescents   Spine 2001 (Sep 1);   26 (17):   1879-1883

In-School Posture Awareness Classes Prevent Back Pain

Teaching children about proper posture may keep them free of future backache, according to a report by researchers in Spain.   As part of the experiment, 106 third-grade students participated in 11 sessions of either a posture awareness program or no intervention.

Results revealed that "The level of knowledge and motor skills in the experimental group showed a significant increase immediately after the intervention finished, and at 6- and 12-month intervals . . . In an independent health check carried out by the local school health services 4 years after application of the postural hygiene program, the results tended slightly to favor the experimental condition over the control conditions (placebo + no intervention). A significantly greater number of the control subjects " required medical treatment for low-back pain."

Mendez FJ, Gomez-Conesa A.   Postural hygiene program to prevent low back pain   Spine. 2001 (Jun 1);   26 (11):   1280-1286

Intensive Sports Training may Provoke Back Pain in Children

Thoracic hyperkyphosis is linked with an increased risk of back pain.  Because sports activities during childhood are thought to provoke thoracic hyperkyphosis, researchers looked at 407 girls and 1,863 boys, aged 8 to 18 years. Mid-sagittal curves were evaluated and subjects were also asked about the number of hours they spent engaged in sports activities.

Cumulative training time was positively correlated with larger thoracic kyphosis and lumbar lordosis. These curves were most pronounced in gymnasts. In contrast, youngsters who did not engage in sports had the smallest curves. Age and gender were not related to spinal curvature, according to the report.

Wojtys EM, Ashton-Miller JA, Huston LJ, Moga PJ.   The association between athletic training time and the sagittal curvature of the immature spine   Am J Sports Med. 2000 (Jul-Aug);   28 (4):   490-498

Disc Degeneration Predispose Children to Low Back Pain

A 9-year study highlights the long-term effects of lumbar intervertebral disc disease in children and adolescents. Investigators surveyed 1,503 14-year-olds. In total, 7.8% of subjects reported recurrent low back pain (LBP). Scientists then compared a subgroup of 40 children with recurrent LBP with 40 pain-free controls. The children underwent magnetic resonance imaging (MRI) at 15 and 18 years of age and were questioned about the existence of LBP at ages 15, 18 and 22.

Participants who showed signs of disc degeneration at age 15 were 16 times more likely to report LBP at age 23. The study concluded that, "individuals with disc degeneration soon after the phase of rapid physical growth not only have an increased risk of recurrent low back pain at this age, but also a long-term risk of recurrent pain up to early adulthood."

Salminen JJ, Erkintalo MO, Pentti J, Oksanen A, Kormano MJ   Recurrent low back pain and early disc degeneration in the young   Spine. 1999 (Jul 1);   24 (13):   1316-1321

Study Compares X-Ray Changes With Pain Symptoms

To determine a link between x-ray signs of vertebral  deterioration and pain symptoms, investigators tracked 159 adults, aged 20 to 65 years. At the study's initiation, all of the patients were asymptomatic. The subjects underwent lateral cervical radiographs at the study's onset and again 10 years later.

Results showed that "With age, there is an increase in the number of subluxations and the incidence and severity of  degenerative changes. Pain is more likely to develop in persons with degenerative changes at C6-C7."

Gore DR   Roentgenographic findings in the cervical spine in asymptomatic persons: a ten-year follow-up   Spine. 2001 (Nov 15);   26 (22):   2463-2466

Back Pain in Children Progresses to Adult Years

This report was based on a 25-year prospective cohort study and designed as a self-administered questionnaire with low back pain as the main topic. OBJECTIVE. To identify whether radiologic changes in the thoracic and lumbar spine and a history of low back pain in the adolescent period represent risk factors for low back pain in adults. Six-hundred-forty 14-year-old school children were examined with x-rays of the thoracic and lumbar spine and registered by the school doctor regarding a history of low back pain. Eleven percent of the cohort had a history of low back pain in adolescence, and the results showed an 84% lifetime prevalence of low back pain in these subjects as adults and an increased frequency of low back pain the last month and week before they answered the questionnaire, compared with the rest of the cohort.

This study suggests that low back pain in the growth period is "a real problem," with a trend toward aggravation as time passes. Thus, implementing preventive measures in schools may be very important.

Harreby M, Neergaard K, Hesselsoe G, Kjer J   Are radiologic changes in the thoracic and lumbar spine of adolescents risk factors for low back pain in adults? A 25-year prospective cohort study of 640 school children   Spine 1995 (Nov 1);   20 (21):   2298-2302

Back Pain and Degenerative Changes in the Spine

Using MRI (Magnetic Resonance Imaging) this study investigated the frequency, pattern, and sequence of early degenerative changes in the lumbar spine. The frequency of disk degeneration at follow-up was greater in the patients with LBP (increased from 42% to 58%) than among the asymptomatic subjects (from 19% to 26%)
Degenerative changes emerge rapidly after the adolescent growth spurt. The MR imaging appearance of the degenerative processes is similar regardless of symptoms, although these processes are more common in symptomatic adolescents and develop at an earlier age. There appears to be a positive correlation between degenerative lumbar disk disease and LBP in adolescence.

Erkintalo MO, Salminen JJ, Alanen AM, Paajanen HE, Kormano MJ   Development of degenerative changes in the lumbar intervertebral disk: results of a prospective MR imaging study in adolescents with and without low-back pain   Radiology 1995 (Aug);   196 (2):   529-533

Additional articles on the adverse effects of heavy back packs on our children:

The Backpack Page @ Chiro.Org

Bookbags: What Every Parent Should Know

Carrying the Back Pack Issue Into the Schools

Back Packs: Your Child's Spine is at Risk

Children and Back Pain