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Forum Name: Spinal problems and back pain

Question: lower back pain in children


 debisab - Wed Jan 26, 2005 8:28 pm

My 3 3/4 yr old has been complaining of lower back pain for almost a year. We have done an MRI, multiple x-rays, blood work (CBC, ESR, ANA) and sonograms of her tummy. All were normal. She had a TB test which was also normal. She continues to complain. The complaints are off and on. She will go weeks without complaining and then complain for a week or two. Then it will gradually go away for weeks then she complains again. It is not a sharp pain. It is very matter of fact: my back hurts. It is normally just as she is falling asleep. Sometimes in the car seat and less frequently at play. Are there other tests that I should be looking into? Also, as a note, she was adopted from an orphanage in Ukraine at 15 months.
Any advise as to what I should do next.....or do nothing???
 Dr. A. Saif - Fri Feb 04, 2005 11:16 am

User avatar Hi Debi,

Sorry about the delay...the day job itself is fairly hectic for me at present. Difficult to say what could be the cause...you seem to have been through most of the investigations necessary.

One can try Occam's razor way of trying to get some clues as to the cause...
If it is musculoskeletal then musculo-skeletal activity will worsen pain. Bending, stretching, will aggravate pain. If it is due to abdominal or pelvic pathology then these movements will not aggravate the pain, but things like associated nausea, bowel disturbance and a colicky nature might indicate a Gastro-Intestinal pathology. Urinary problems can also cause back pain, colicky pain occurs if the pain is ureteric (a cause of back pain in children is due to narrowing of the ureter in ceratin places). Non.colicky renal pain can be due to problems within the kidney substance itself, but such things (e.g. pyelonephritis) usually give clues in blood tests. Neuralgic pain usually follows a pattern that reflects the distribution of a nerve.

If we decide the problem is musculoskeletal, then the next step, if X-rays, MRI etc are all normal, perhaps may be a bone scan may be indicated...this gives a vague idea if we should be focusing on certain areas or not. It is difficult to advise without your daughter in front of me, but it seems you have already been through a fairly exhaustive battery of tests...

Regards

Saif

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