Children from 7 years old experience back pain. They can have several origins, but psychosomatic causes are common.
One in a hundred children of 7 years old is affected by back pain. As soon as they start school, this figure increases: at 10 years old, they are 6%, and almost one in five are affected at 14-16 years old. The symptoms are sometimes significant and disabling: they affect their attendance in class, and their ability to participate in sporting activities. Yet barely 7% of these children consult, report researchers from the Nationwide Children’s Hospital in Columbus (Ohio, United States).
In a review of the scientific literature on the subject they have published this Monday in JAMA Pediatrics, they also remind us that back pain in childhood is a major risk factor for problems in adulthood. Most of the causes of this low back pain are however benign. And not necessarily linked to a satchel that is too heavy, believes Dr Chantal Job-Deslandre, rheumatologist at Necker-Enfants Malades hospital.
Dr Chantal Job-Deslandre, rheumatologist at Necker-Enfants Malades hospital: “The schoolbag is often a pretext”
Signs not always identified
“In children and adolescents, we often find Scheuermann’s disease, which also gives more back pain than lumbar, explains to Why actor Dr. Job-Deslandre. The diagnosis is easy to make, with clear signs on the radio. “
On the other hand, for other pain of inflammatory origin – more frequent in boys, especially between 10 and 12 years old – the diagnosis is more complicated. There is no sign of this pain on the X-ray, the inflammation is not always obvious to detect, and MRI is not a standard test for children.
Sometimes psychosomatic pain
The literature review published in JAMA Pediatrics disputes the idea that there are specific causes of lower back pain. They are not always symptomatic of a serious pathology. In most schoolchildren, they are due to trauma or excess musculoskeletal activity, often sports-related. According to the researchers, this pain would also be strongly correlated with the level of sports competition. Growth, psychosocial factors, pre-existing injuries and heredity of back pain also contribute to the risks. Girls are generally more exposed to it.
“Children who consult also have functional pain (without apparent injury, editor’s note), continues Dr. Job-Deslandre. The causes are often psychosomatic, and the diagnosis is more complicated. We see a lot of them in consultation, and these cases seem to be much more numerous today than 10 or 15 years ago. These functional pains, observed mainly in girls, are often correlated with school absenteeism.
Dr Chantal Job-Deslandre, rheumatologist at Necker-Enfants Malades hospital: “Functional pains are more complicated to diagnose”
No more hours of sport than the child’s age
If your child complains of back pain, don’t panic. “While certain conditions must be treated by a specialist, most pediatricians have a good understanding of the principles recalled in our study, and can help children and adolescents to prevent and manage lower back pain,” says Dr. James MacDonald, specialist in sports medicine at Nationwide Children’s Hospital, and lead author of the study. In most cases, pain without a specific cause responds well to rest and rehabilitation. “
Finally, researchers believe that before resuming sport at the start of the school year, and even in children and adolescents, a period of physical preparation and neuromuscular conditioning is necessary, as is planning of rest time. The intensive practice of sport among children and adolescents is not trivial and, for the youngest, it should not exceed the child’s age in weekly hours: at 10 years, no more than 10 hours of sport per week !
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