Chronic Pain

How Chronic Pain in the Back is Diagnosed in Kids and Teens

When trying to determine what’s causing back pain in adolescents and teenagers, doctors typically look at where the pain is and where else it could be coming from. Typically, a thorough discussion of the patient’s symptoms, previous medical or surgical procedures, and family history is had with the patient’s parents or primary caretakers.

The doctor will perform a thorough physical examination and then suggest further testing, such as imaging and/or laboratory work, to make a definitive diagnosis.

causing back pain in adolescents

In this article, you will learn about the best chronic pain treatment, and understand pain signals, and their implications for mental health — not exclusively about using nonsteroidal anti-inflammatory drugs, but also with relaxation techniques, and other natural pain medicines.

The Results of Your Physical Body

When a kid or teenager complains of back discomfort, the doctor should first look around their back while they are standing.

It is standard practice for doctors to examine a child’s posture and spinal curvatures during a medical examination. If your spine isn’t aligned like it should be, see a doctor.

The doctor looks at the patients:

  • General stance, 
  • Spinal symmetry, asymmetry, and/or visual malalignment 
  • Flexibility in the neck and shoulders, and 
  • Range of motion in the hips and knees, as well as any pain associated with these motions

Evaluation of the child’s gait (including their capacity to walk on their toes and heels), leg length disparity, skin colour changes (such as café au lait patches or freckling), and the child’s ability to touch their toes are all important.

The doctor can assess the severity of local or systemic soreness in the back and/or pelvis by gently touching or palpating the area. You can also read about All You Need to Know About Chronic Pain in the Neck by visiting

Examinations in Humans

A complete motor and sensory examination is carried out, including an assessment of reflexes and the sensitivity of different parts of the body as well as the strength of individual muscles. Standard medical laboratory tests include:

The hyperextension test on a single leg. The presence of spondylolysis can be determined using this exam. The youngster is directed to stand on one leg and bend backwards to lengthen the spine. When the test is successful, the patient will feel discomfort in the area of their back that corresponds to the leg that was elevated.

The straight-leg-raise (SLR) test. Inflammation, irritation, and compression of the spinal nerve roots can be detected with this examination. As the youngster is laying on their back, one leg is lifted carefully without bending the knee. If you feel pain in your back or leg while taking this test, it’s a good sign.

pain in your back or leg

FABER test. The sacroiliac (SI) joint is evaluated with the flexion, abduction, and external rotation (also known as FABER) test. The patient lies on their back while the doctor has them lay one leg in a “figure 4” posture, where the knee is bent and the ankle rests on the knee on the other side.

When the test causes pain in the groyne, hip, or buttocks, it is considered positive. In addition, the doctor may feel the skin on your lower back and/or leg(s) to detect any tingling, numbness, or weakness that could indicate nerve root irritation.

Magnetic Resonance Imaging (MRI)

A magnetic resonance imaging (MRI) scan is superior to a computed tomography (CT) scan because it may detect minute abnormalities in the soft tissues that surround the spinal cord and the spinal column. In adolescents and teenagers, MRI is very helpful in identifying tumours, infections, and herniated discs.

Having a kid has an MRI typically necessitates the use of general anaesthesia.

Diagnostic Imaging and Radiography

A combination of the radiographic and imaging tests listed below may be conducted, with the specific combination depending on the degree of concern.

CT scan, or computed tomography

A computed tomography (CT) scan may be prescribed if the results of the x-ray examination are equivocal or if more imaging is required. CT scans are able to image particular diseases that cause back discomfort, such as a herniated disc, and give good bone detail through several views.

Check the bones with a CT scan

As an alternative to the more invasive MRI, bone scans can detect tumours and infections in bone and soft tissues.


An x-ray of the area should be taken if a bone fracture or misalignment is suspected. X-rays can only evaluate the bony components of the spine, thus soft tissue injuries like a muscle strain or a herniated disc will go undetected.

Tests of Blood

Complete blood count, erythrocyte sedimentation rate, and C-reactive protein measurement are some of the laboratory procedures that may be conducted if an inflammatory disorder, infection, or cancer is suspected.

After the root cause of back pain has been identified, a targeted treatment plan may be developed. Pain in the back is a common problem in children and teenagers, but nonsurgical therapies are typically effective. Rarely, surgery may be needed to treat medical crises including particular types of fractures, tumours, or spinal deformity concerns.

A Child’s Tethered Cord Syndrome

Tethered cord syndrome occurs when the spinal cord is abnormally attached to the tissues around it. Reduced mobility of the spinal cord and/or decreased blood supply to its end tissues are both consequences of the aberrant connection.

This back problem might be present from birth (congenital) or develop later in life as a result of an injury, infection, or tumour in the lumbar region.

Symptoms of tethered cord syndrome in children and adolescents

tethered cord syndrome

The lumbosacral junction is a common site for spinal cord tethering to develop (L5-S1 spinal segment). In most cases, the symptoms and indicators of a tethered chord vary with age and are influenced by the underlying aetiology of the condition.

Infants may experience spontaneous leg movement, aberrant reflexes, foot asymmetry, and loss of muscle mass in the leg (leg atrophy) (leg atrophy).

A toddler may have delayed walking development or an irregular gait.

In addition to musculoskeletal abnormalities like clubfoot and scoliosis, children of school age can also experience sensory deficiencies and weaken in the legs, painless foot burns (trophic ulcerations), and a lack of sensation in the feet.

Similar signs and symptoms, such as bowel and bladder problems and weakness, are seen in adolescents as they are in school-aged children with greater sensory deficiencies.

Birthmarks of a pink or crimson colour (port-wine stain), enlarged fatty nodules (cutaneous lipoma), and a deviated gluteal crease are other typical indications of tethered cord syndrome in the lower back.

Factors of a Psychosocial Nature

Depression, anxiety, behavioural disorders, and how one interprets pain might all have a role in the initiation, worsening, and/or progression of chronic back pain in children and adolescents. Back pain, as well as discomfort in the neck or elsewhere in the spine, may have a similar cause.

There is some evidence to show a connection between physical pain and psychological problems, namely via neurologic and chemical processes in the body. A person’s mood can be affected by the release of chemicals like serotonin and norepinephrine as a result of a physical injury.

When these substances aren’t working as they should or are out of whack, people might experience both mental and physical suffering.

Any complaint of back pain or related worrying symptoms in a child or adolescent should prompt a visit to a paediatrician or other trained healthcare provider because back discomfort is very uncommon in children and teenagers.


For more information on chronic pain management, acute pain, pain disorders, chronic pain resources, psychogenic pain, effective chronic pain treatment options for pain relief, or other physical therapy, you should book a consultation session with a specialist at Chronic Therapy today, to give you professional advice that will suit your personal experience.

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