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Adolescent Back Pain

Metabolic-	Juvenile Osteoporosis
Inflammatory-	Ankylosing Spondylitis Sero-negative Arthritis
Neoplasm	Osteoid osteoma
Congenital	L5-S1 Facet Hypoplasia
Developmental	Lumbar Scheurmann's
Trauma	Pars interarticularis

Adolescent back pain has been reported to affect more than 50% of school age patients. Parents are often confounded by the severity of the complaints and yet their teenager continues in sports or other extracurricular activities. Muscular strains are also common, but typically resolve with time, stretching, and anti-inflammatory medications. After months of complaints and minimal relief of symptoms with anti-inflammatory drugs, the family will seek an evaluation.

The adolescent with lumbar back pain may have multiple reasons other than overuse or "growing pains" for the discomfort (Table 1).

The clinical examination provides information about the location of the pain, muscle spasm, lumbar spine range of motion, hamstring muscle tightness, muscle strength in the legs, reflexes, and sensation in the legs. X-ray studies may be beneficial in ruling out less the less common phenomena noted in table 1.

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