Back pain

Back pain

Children report back pain less frequently than adults, although >50% will have had one episode by late adolescence. Back pain in a child is a ‘red flag’ for serious spinal pathology; however, if it is mild, intermittent or occurring only on strenuous activity , it is usually self-limiting. Many adolescents do su ff er posture- related discomfort. Physiotherapy to improve core strength and stability reduces symptoms if exercises are performed regularly . Summary box 44.17 ‘Red flag’ symptoms and signs for spinal pathology /uni25CF /uni25CF /uni25CF /uni25CF All ‘red flag’ signs require urgent investigation with a full blood count (FBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plain radiograph and MRI or other - imaging. Other causes of back pain include intra-abdominal, renal and systemic pathology . Summary box 44.18 - Other spinal conditions /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Systemic illness, fever or weight loss Progressive neurological de /f_i cit Unrelenting or night pain Spinal deformity Excessive kyphosis may be due to Scheuermann’s disease Spondylolisthesis is a forward slip of one vertebra on another; it may cause mechanical and, rarely, neurological symptoms Torticollis may be congenital and usually responds to stretching of the sternocleidomastoid muscle Acquired torticollis may be due to one of several signi /f_i cant pathologies Back pain with red /f_l ag symptoms and signs requires urgent investigation

Back pain

Children report back pain less frequently than adults, although >50% will have had one episode by late adolescence. Back pain in a child is a ‘red flag’ for serious spinal pathology; however, if it is mild, intermittent or occurring only on strenuous activity , it is usually self-limiting. Many adolescents do su ff er posture- related discomfort. Physiotherapy to improve core strength and stability reduces symptoms if exercises are performed regularly . Summary box 44.17 ‘Red flag’ symptoms and signs for spinal pathology /uni25CF /uni25CF /uni25CF /uni25CF All ‘red flag’ signs require urgent investigation with a full blood count (FBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plain radiograph and MRI or other - imaging. Other causes of back pain include intra-abdominal, renal and systemic pathology . Summary box 44.18 - Other spinal conditions /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Systemic illness, fever or weight loss Progressive neurological de /f_i cit Unrelenting or night pain Spinal deformity Excessive kyphosis may be due to Scheuermann’s disease Spondylolisthesis is a forward slip of one vertebra on another; it may cause mechanical and, rarely, neurological symptoms Torticollis may be congenital and usually responds to stretching of the sternocleidomastoid muscle Acquired torticollis may be due to one of several signi /f_i cant pathologies Back pain with red /f_l ag symptoms and signs requires urgent investigation

Back pain

Children report back pain less frequently than adults, although >50% will have had one episode by late adolescence. Back pain in a child is a ‘red flag’ for serious spinal pathology; however, if it is mild, intermittent or occurring only on strenuous activity , it is usually self-limiting. Many adolescents do su ff er posture- related discomfort. Physiotherapy to improve core strength and stability reduces symptoms if exercises are performed regularly . Summary box 44.17 ‘Red flag’ symptoms and signs for spinal pathology /uni25CF /uni25CF /uni25CF /uni25CF All ‘red flag’ signs require urgent investigation with a full blood count (FBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plain radiograph and MRI or other - imaging. Other causes of back pain include intra-abdominal, renal and systemic pathology . Summary box 44.18 - Other spinal conditions /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Systemic illness, fever or weight loss Progressive neurological de /f_i cit Unrelenting or night pain Spinal deformity Excessive kyphosis may be due to Scheuermann’s disease Spondylolisthesis is a forward slip of one vertebra on another; it may cause mechanical and, rarely, neurological symptoms Torticollis may be congenital and usually responds to stretching of the sternocleidomastoid muscle Acquired torticollis may be due to one of several signi /f_i cant pathologies Back pain with red /f_l ag symptoms and signs requires urgent investigation