Pediatric Back Pain

• Back Pain in PrePubertal Children is rare and often due to serious underlying disorder
  • Infection (diskitis or osteomyelitis)
  • Malignancy
    • Osteoma, Osteoblastoma
    • Histiocytosis X
    • Lymphoma, Leukemia
    • Ewing Sarcoma
    • Neuroblastoma, Spinal Cord Glioma
• Back Pain in adolescent children is more likely to be due to muscular skeletal injury (as with adults)
  • Classified as chronic back pain (greater than 4 weeks duration) in up to 13%

 

• Red Flags for Serious Underlying Disorders
  • <4yrs of age
  • Back Pain causing functional disability (child not willing to play)
  • Fever
  • Neurologic Abnormality (get the child undressed and do a good neuro exam).