Low Back Pain in Adolecents and Teens - Imaging

From: American Academy of Pediatrics (AAP) 2011 National Conference and Exhibition; Abstract #14782. Presented October 14, 2011.
  
No Imaging Needed for Most Low Back Pain in Teens
Low back pain is common in adolescents and teens. Most cases of low back pain are diagnosed as "mechanical low back pain", which is a diagnosis of "exclusion", ruling out any serious pathologies.

Mechanical low back pain is common in the pediatric population, and recent studies have shown that undiagnosable mechanical low back pain accounts for up to 78% of cases in adolescents. The most common pathologic cause of back pain in this age group is spondylolysis and spondylolisthesis

Most cases of low back pain in children will get better with conservative management, such as Chiropractic and do not need to be diagnosed with radiographic studies, researchers said here at the American Academy of Pediatrics (AAP) 2011 National Conference and Exhibition.

Parents often worry as low back pain can appear to be very serious at it's initial onset. However, the routine use of X-rays, CT scans and bone scans can complicated matters as it can expose your child to relatively high doses of radiation.

This study followed 2846 children aged 10 to 19 years who were seen at their institution with low back pain between 2000 and 2008. Most (63%) were female, and the average age was 14 years.
In 79% of the patients (n = 2244), the cause of their low back pain went undiagnosed. Spondylolysis, which was diagnosed in 272 patients (9.6%), was found by plain radiography in 234 patients (86%), by bone scanning in 34 patients (12.5%), and by computed tomography (CT) in 4 patients (1.5%).

Dr. Dennis Drummond, MD, who headed the stated concluded: "Our message is try and treat the low back pain conservatively. If they are 50% to 60% improved when you see them in 6 weeks, you’re probably on the right track. If the pain is all gone at 3 months, get them ready to go back to sports or usual activities. If there is just as much pain at 6 weeks, go back to the old system of more investigation, but the majority will get better by then."

At Peninsula Spine & Sports Rehabilitation in San Mateo, Dr. Hindocha treats Pediatric patients with gentle Chiropractic therapy, soft tissue procedures and therapeutic exercises for rehabilitation. Dr. Hindocha does not routinely prescribe the use of X-rays on his patients, Pediatric or Adult, but does so when there is a need or clinical justification for use of these procedures. If your child has low back pain, please call us at (650) 347-2225 to schedule a consultation.