Back pain or backache is defined as pain or discomfort felt in the upper, middle and lower back, arising from structures in the back like muscles, nerves, bones or ligament.
Back is divided into three major parts – upper, middle and lower. Depending upon the location, back pain is classified as Upper Back Pain (affecting the area of cervical and thoracic spine), Middle Back Pain (affecting the area of dorsal spine), and Lower Back Pain or Lumbago (affecting the area of lumbo-sacral spine).
Until recently, a complaint of back pain in children was considered uncommon. It was usually associated with certain medical conditions such as spine curvature, tumor, infection etc. however, more recently, reports of back pain is much more common among children.
Specific conditions which can be associated with back pain in children
Scoliosis is an abnormal curvature of the spine with rotation of the vertebrae. This curvature often results in one shoulder appearing higher than the other or the hips appearing uneven. Since the curvature occurs with growth. Once detected, it should be carefully evaluated and followed. Scoliosis is usually painless and detected only on examination. Pain suggests that the scoliosis has been present for a prolonged period with secondary mechanical problems.
Spondylolisthesis – is the slippage of one vertebra over another. Most often this occurs at the junction of the lumber and sacral spine. Some cases may be due to a congenital weakness, while other cases may be due to poor healing after an injury. Spondylolisthesis results when this weakness allows one bone segment to slide forward over another.
Although mild degrees of spondylolisthesis may be asymptomatic, more severe involvement characteristically leads to low back pain that may radiate down the back of the thigh.
Kyphosis – some children have kyphosis, excessive curvature of the spine in which the spine is bent forward. If you look at the child from the side, you will see that the upper part of the back angles forward. This abnormal forward curvature may be the result of abnormalities in the bone resulting from fractures or infection. In severe cases the child may appear to have a hunchback.
Infections – there are variety of infections that may damage the spine. Fortunately, none of them is common in childhood. Staphylococcal bacteria are common causes of infections that may affect the bones of the spine. Bacterial infections of the spine are usually very painful.
Discitis – is a confusing cause of back pain in younger children. Typically, it affects children under the age of ten. These children may have initial symptoms of a cold or flu like illness. They then develop severe back pain. The key to recognize this illness in very young children is that they suddenly refuse to sit up or walk.
Spondylolysis – this is a stress fracture of the pars interverticularis. It is often the result of excessive stress on the low back from dancing, running, or other activities. Female children in gymnastics are prone to this injury. Children with this type of pain should be carefully questioned about pain in other joints or stiffness when they arise in the morning. As the symptoms may indicate arthritis.
Disc herniation – usually the result of an excessive stress put on the spine with the result of rupture of the cushioning material in one of the intervertebral discs. This condition is quite rare in children, though you can check for this by having the child lie on his or her back and raise one leg while keeping it straight. A child who has pain during this maneuver may have significant disc herniation and should be promptly evaluated.
Spondyloarthropathies – a key indication is that children spondyloarthropathies almost never can bend over and touch their toes.
Tumor – another major cause of back pain in children can be a tumor in the spine. Although back pain back pain caused by tumor is a very rare occurrence.
Diagnosis of back pain
- Physical examination – Includes posture, gait, movement, extension of the pain, modalities of the pain, and examination of the related joints like sacroiliac joint.
- Blood test, urine culture
- X-ray spine
- CT scan-spine, MRI– To detect nerve compression. It can be done in the condition of long continued pain.
- Montoux test – To diagnose tuberculosis as it can cause back pain.
- Bone scan – To detect developing malignant diseases.
Homeopathic treatment of back pain in children
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which a patient is suffering. The aim of homeopathy is not only to treat pain in back, but to address its underlying cause and individual susceptibility of the patient. For this patient’s current symptoms, past medical history and family history are taken into account. There are many homeopathic remedies which cover the symptoms of back pain and lumbago and can be selected on the basis of cause, location, sensation, modalities and extension of the pain. For individualized remedy selection and treatment of back pain, the patient should consult a qualified homeopathic doctor in person. Some important homeopathic remedies for the treatment of back pain in children are given below:
- Rhus Tox. – Muscular pain, when pain is relieved by walking and worse at rest or at first motion. There is marked stiffness and warm application gives relief.
- Brynoia Alba. – When the pain is worse on every movement and better by absolute rest and pressure.
- Hypericum – Excellent remedy for nerve pain especially after surgery or injury.
- Colocynthis- Pain in the back is so severe that makes patient unable to walk or stand which finally settles down on the upper part of the thigh and buttock. Bending forward often ameliorates.
- Kali Carb. – Lumbosacral backache, pain goes down the back to the legs. Pains, stitching, darting, worse during rest and lying on affected side.
- Nux Vomica – Backache due to chill, which aggravate in the morning and better from heat. Especially suited to people working for long hours in an air-conditioned office and sitting in a chair for long periods. Irritability is often increased.
- Arnica Mont. – Acute pain after an injury along with sore bruised feeling. Slight touch aggravates.
- Actea Racemosa – Pain in the muscles with intense restlessness and sleeplessness. It is particularly applicable in rheumatism affecting the bellies of the muscles. Another use of this remedy is in the condition known as spinal irritation, it is indicated when upper and lower cervical vertebrae, particularly latter, are sensitive to pressure
- Gnaphalium. – Sharp cutting pain in anterior cervical nerve, aggravation on lying down and relieved when sitting.
- Aesculus Hip. – For persons with haemorrhoidal tendencies, and who suffer with gastric, bilious or catarrhal troubles. Severe dull backache in lumbo-sacral articulation; more or less constant; affecting sacrum and hips.