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Evaluating low back pain in adolescents.

Sarah J Garvick1, Candice Creecy, Megan Miller

  • 1Sarah J. Garvick is associate program director of the PA program at the Boone, N.C., campus of Wake Forest School of Medicine. Candice Creecy, Megan Miller, Lorae Schafer, Alex Spooner, and Ann Wallace Tazewell were students in the PA program at Wake Forest School of Medicine in Winston-Salem, N.C., when this article was written. Tanya Gregory is an assistant professor and director of student services in the PA program at Wake Forest School of Medicine in Winston-Salem. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|November 13, 2019
PubMed
Summary

Adolescent low back pain affects 40% of youth, impacting well-being and adult pain. A thorough history and physical exam are crucial for early detection and accurate diagnosis in primary care settings.

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Area of Science:

  • Pediatric Primary Care
  • Adolescent Musculoskeletal Health

Background:

  • Low back pain (LBP) is prevalent in adolescents, affecting up to 40% of this population.
  • Adolescent LBP is associated with increased healthcare utilization, future adult back pain, and diminished overall well-being.
  • Early identification and management are critical to mitigate long-term consequences.

Purpose of the Study:

  • To highlight the importance of comprehensive history taking and physical examination for diagnosing adolescent low back pain.
  • To guide clinicians in the appropriate diagnostic workup for pediatric patients presenting with back pain.
  • To emphasize the early detection and accurate diagnosis of serious underlying pathologies, though rare.

Main Methods:

  • Review of clinical guidelines and literature on adolescent low back pain diagnosis.
  • Emphasis on clinical assessment through detailed patient history and physical examination.
  • Discussion of red flags necessitating urgent evaluation.

Main Results:

  • A thorough history and physical examination are effective in guiding the diagnostic process for adolescent LBP.
  • Judicious use of diagnostic modalities can be achieved by relying on clinical assessment.
  • Early detection of serious conditions is enhanced through systematic clinical evaluation.

Conclusions:

  • Clinical assessment, including history and physical examination, is paramount for the initial diagnosis of adolescent low back pain.
  • Recognizing specific red flags is essential for timely intervention in cases of serious pathology.
  • Effective management strategies begin with accurate diagnosis facilitated by a comprehensive clinical approach.