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Back Pain, Pediatric

Kate Berz, DO and Kelsey Logan, MD, MPH Reviewed 10/2018
 


BASICS

DESCRIPTION

Any condition causing pain of the thoracic, lumbar, or sacral spine 

EPIDEMIOLOGY

  • 12-month period prevalence: 10–20% of children

  • Lifetime prevalence: 12–50%

PATHOPHYSIOLOGY

  • Dependent on u...

DIAGNOSIS

HISTORY

  • History to elucidate most likely cause

  • Musculoskeletal/trauma

    • Direct trauma

    • Worsening pain after activity

    • Repetitive movements causing microtrauma

  • Inflammatory

    • Morning stiffness (variable p...

TREATMENT

GENERAL MEASURES

  • If no warning signs, conservative management with nonsteroidal anti-inflammatory drugs (NSAIDs) and relative rest (avoiding activities that cause or increase pain)

  • Supervised ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patients managed conservatively should be reevaluated within 2 weeks and then visits spaced further out as their pain improves.

  • If symptoms not improving with cons...

ADDITIONAL READING

  • Agabegi SS, Kazemi N, Sturm PF, et al. Natural history of adolescent idiopathic scoliosis in skeletally mature patients: a critical review. J Am Acad Orthop Surg.  2015;23(12):...

CODES

ICD9

  • 724.5 Backache, unspecified

  • 724.1 Pain in thoracic spine

  • 724.2 Lumbago

  • 724.6 Disorders of sacrum

  • 847.9 Sprain of unspecified site of back

  • 720.0 Ankylosing spondylitis

ICD10

  • M54.9 Dorsalgia, unspeci...

FAQ

  • Q: Which children with back pain should have activity restriction?

  • A: Activities should be able to be performed with normal mechanics (no limping or adjustment of skills due to pain). Resting is in...

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