Dr. Tiji Mathew Thomas

Over the years of adulthood, a combination of bad posture along with wear and tear means that a significant amount of the adult population is affected by back pain. But is this normal for children, as well? Well, in most cases, the answer is a 'No'.

Children and adolescents have a greater degree of flexibility than adults, that is they do not complain of back pain as much as adults do. So when should a parent be worried if their child complains of acute back pain?

If a child is very active, then this could be a cause for concern when it comes to injury to the back. Due to the rough nature of the sort of activity that he or she is engaged in, stress fractures are possible. These injuries are generally explained by overuse. What a parent needs to keep an eye out for is, if the child complains of pain when certain actions are performed. So, back pain which occurs, say, during butterfly stroke when the child swims could mean that the child has a case of spondylolysis or a stress fracture.

If the back pain is so bad that the sleep of the child is disturbed and he or she wakes up on account of it, the parent should take this seriously. The reason for this is that the pain could be caused by a tumour to the spine or an infection. A possibility apart from these two could also be arthritis.

A parent should also be worried when the back pain is not the only thing that the child complains of. That is, if there are other things such as a fever and weakness, as well as pain extending down either or both legs, it could be a sign that the trouble is more than just superficial. In a similar way, when there is trouble walking or there are problems related to the functioning of either the bowel or the bladder, a doctor is to be consulted.

One of the most common cases of back pain in children happens to be Scheuermann’s disease, which is also known as Scheuermann’s kyphosis. What this means is that the spine is rounded in the middle. While this causes pain, it is usually not debilitating enough to hinder normal movement. But, after all, who would want their child to go untreated and suffer as a result?

Backache-1

Backache is the oldest agony that the mankind suffers from. In the prehistoric era, even the angels must have suffered from it. Though in the ancient Indian literature, no direct mention of this disease is made, it can be safely assumed that in the epic period of Mahabharata, Bhishma Pitamaha must have had some backache when he was lying on the bed of thorns.

Whatever be the exact aetiology of backache, it is for the medical scientist and the Pundits in the field to determine. Human back is a big Pandora box. Causes for backache are many. They range from a thorn prick in the foot to prolapsed intervertebral disc in the spine. Even, a trauma to human pride can cause backache. It will be no exaggeration to compare the backache with an elephant that the six blind men wanted to know about. One of them called it a pillar, other called it a wall, third called it a rope, fourth it a flap of leather, and so on. Similarly many scientists have approached the problem of backache from different angles and have ascribed as many reasons as its causes and suggested remedies for the same; depending on their own concept of human back - its structure and functions.

In last few decades, much scientific work has been done; data compiled and analysed to determine the exact cause of backache. It is estimated that at one point or other in their lives, eight out of every ten people on earth suffer from this universal affliction. It can strike almost everyone, the young and the old, male and female, people of all classes 7 and profession. Biggest leaders of the world have suffered from backache. President John F Kennedy spent hours in the soothing comforts of White House rocking chair, only to nurse his backache,

This was his wartime injury.

The largest group of people who suffer from this are the young housewives who have small children and are fully occupied at home. They have no outside job. When they have backache, a double burden is imposed on the family. If the person affected is the chief bread earner, then the situation becomes all the more worse.

Backache is not a killing disease, but it certainly cripples the individual for the time being. No one except the victim can truly understand the complete sense of helplessness and despair that overcomes, once an energetic adult who is suddenly struck down by the devastating, usually temporary ailment. The victim's world quickly shrinks, often limited at the onset to bed or couch. Work and household rituals are totally ignored due to pain. Dressing becomes torturous, a visit to toilet is a major expedition, sitting in chair for reading or eating can be an agony. Sex becomes virtually impossible. Even after the pain subsides, the sufferer wonders, almost at every turn, whether it will strike again.

Beyond the personal grief, back pain exerts a staggering socio-economic cost. Million and millions of work days are lost each year because of a backache. It is the single largest cause of worker absenteeism in all the countries of the world.

The remedies are simple and effective in most of cases. The most important being 'not to get tense and nervous'. An objective personal assessment of the disability with a relaxed mind and a wilful relaxation of the whole body coupled with a few pills and postures ( remedial exercises) is perhaps the secret of success in getting rid of this man's oldest agony. But in some cases even surgery or psychotherapy may be needed.

In the present series, I have attempted, step by step, how to modify the style of daily living so that this 'devastating though temporary ailment' can be prevented.

Pain Management for Chronic Back Pain