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BACKACHE IN ADOLESCENCE BLOCK 14

Learn about the extent of the problem, causes, and treatment options for back pain in adolescents. Recognize red flags and understand the importance of clinical assessments. Identify disease-specific causes and how to address them effectively.

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BACKACHE IN ADOLESCENCE BLOCK 14

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  1. BACKACHE IN ADOLESCENCE BLOCK 14

  2. WHAT’S SPECIAL

  3. Extent of the problem (Nachemson) • Affects 80% of people • Self – limiting disease • 70% clears spontaneously in 2-3 weeks • 90% clears with conservative treatment in 6-8 weeks • <5% will need surgery

  4. CAUSES • Mechanical • Pathological

  5. Causes of low backpain • Trauma - fractures(esp. pathological) - sprains • Infections –acute discitis - tuberculosis • Tumours -primary( myeloma) -secondary(breast , lung , thyroid , renal, prostate) • Degeneration -oa of the 3-joint complex -disc herniation • Refered from abdomen - pancreas ,kidneys ,aorta , uterus • Psychosocial factors

  6. TREATMENT

  7. Clinical assessment • History • Examination • Investigations

  8. Red Flags • Age <15; >50 • Duration >1mnth • History of cancer • Loss of weight • Rest pain • Night pain • Fever • Morning stiffness

  9. examination • Watch patient walk • Note ease of getting onto exam table • Assess abdomen • Is tenderness ellicited in abd same as the pain patient presents with • Examine the hips • Neurologic examination • Examination of the back

  10. Examination of the back • Deformity • Gibbus • Tenderness • Movement/ stiffness

  11. Red Flags • Any neurologic deficit -saddle numbness -urinary incontinence -urinary retention • Radicular pain • Stiff back

  12. TREATMENT • Disease specific

  13. Causes in adolescence • Infection - Acute discitis • - Tuberculosis • Tumours - osteoidosteoma • Trauma - spondylolysis • Scheurmann’sdiseases

  14. Pathology • Clinical examination • Investigation • Treatment

  15. Backache in children should always be regarded as pathological

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