By Dr Neha Narula
Children and teenagers can end up with chronic back pain for a number of reasons including injuries from sports or stressing flexible joints. In rare cases, they may be born with spinal problems. For instance, the world’s fastest man Usain Bolt is born with a curvature in his spine (scoliosis). Hollywood’s empress of entertainment Elizabeth Taylor, too, was born with scoliosis, a medical condition in which a person’s spine has a sideways curve.
Our spine is an engineering marvel. It consists of a series of vertebrae extending from the skull to the small of the back, enclosing the spinal cord and providing support for the thorax and abdomen. It comprises basic structures such as vertebrae, disc, muscles and nerves and is divided into the cervical spine, thoracic spine, lumbar spine and coccyx, all held erect in a delicate balance.
Adding perspective to adolescent back pain, is a recent study in the Journal of Public Health, connecting substance abuse and back pain. Adolescents who experience back pain more frequently are also more likely to smoke cigarettes, drink alcohol, and report mental health conditions like anxiety and depression. For example, 14-15 year olds that experienced pain more than once a week were two to three times more likely to have drunk alcohol or smoked tobacco in the past month than those who rarely or never had pain. The combination of back pain and unhealthy habits persists into adulthood. In addition, the developing brain is susceptible to the negative influences of toxic substances, and use in early adolescence may increase the risk of substance abuse and mental health problems in later life, adds the study.
Chronically poor posture during adolescence could also, in rare cases affect the ligaments, stretch the muscles and give rise to a curved or slightly humped back, a condition called kyphosis. In a few cases, back pain can also be a sign of a problem unrelated to the spine. Kidney problems can cause low back pain, on either side of the spine. In very rare cases, back pain may be caused by a tumour.
The Lancet has famously recommended a drug free approach to the management of back pain.
Here are 10 ways for parents to contribute to keeping their children’s back healthy.
1. Don’t ask your child to sit down for continuous hours. Sitting is not necessarily good behaviour. Let them move around as much as they want to.
2. You are the biggest role model for your kids. Don’t slouch and don’t adopt a sedentary lifestyle. Remind yourself and your kids to sit up straight.
3. Make sure your child’s backpack isn’t overloaded.
4. If back pain is keeping your child up at night, waking them from sleep, or interfering with daily activities, see a doctor.
5. Educate yourself about sports injuries so you know how to manage them.
6. Supervise your child when she’s playing on swings or other playground equipment. Teach her not to walk or run in front or back of the swings — or stand on them.
7. Insist on safety when your child takes up a new sport. For example, a child who begins cricket or football should take lessons to learn good technique, including the proper way to play.
8. Insist on the right gear. Children riding bicycles or riding scooters or skating should always wear helmets, mouth guards, wrist guards and knee guards, as required.
9. Seat-belts and child safety seats are the best protection for children riding in cars. Babies and small children should have their own child safety seats.
10. Your adolescent will feel shy about movement, during and immediately post puberty. Encourage them to feel comfortable about themselves. Help them maintain an active lifestyle.
Self-diagnosis in the case of back pain is common. Most parents tend to ignore back or neck pain in children and teenagers as they believe it is due to growth spurts that their children experience. Identifying the problem and treating the pain is the most important thing to avoid it from getting worse. Always consult a spine specialist if you suspect back problems in teenagers or adolescents.
(The writer is Senior Spine Specialist, QI Spine Clinic.)