Question
QUESTION: My 9 year old son has occasionally complained of back pain for several years. He is active  and mobile and does not seem to be hindered by pain. I have been concerned, but also suspicious that he has been copying the various adults  in his life who complain of back pain of their own.

It has been some time since he has complained of back pain, but today we went roller skating. Predictably we both did a bit of landing on our bums. He didn't seem to be suffering, but during one rest stop he asked me to rub a particular spot on his back. The place he directed me to was directly on his spine, below waist height. I was concerned to discover that I could not feel his vertebrae in this particular spot. There seems to be an area in which his spine is not where it should be. There is a small soft gap where I would expect the bony ridge of the spine to run all the way down. He accepted the light pressure I put on happily and without flinching. He says that this is not the usual area of pain, that it is normally higher or lower, which is as I remember it, but I have never noticed this soft area before. The testimony of a child, particularly when I'm not sure of my own facts and have no knowledge of correct spinal alignment, is hard to follow. I would be very grateful for any help or advice you can offer me. Doctors in the UK do not have a great reputation for their treatment of back pain, though obviously I will rush him straight there if that is your recommendation!

Many many thanks for your time.

ANSWER: Jen,

Kids are quite prone to painful spine conditions.  From what you describe, your son has back pain, and he might have what's called, "spondylolisthesis."   You should google this term.   He may have acquired this somewhere along the way where he was active in a sport or took a fall or spill.  Spondylolisthesis occurs in kids when there is a breaking away of the a part of the vertebral bone on each side - a part that connects the front of the vertebra to the back of the vertebra.  This breaking, called a "pars defect,"  is quite common in the pre-teen and early teen years.  The boney bridge, called the pars interarticularis, is still soft, developing part of the spine, and it can easily become irritated from repeated stress.   This will cause it to become inflammed and begin to crumble, a stress response.  Or, it can happen suddenly from something like a fall or, as in football, being hit from behind such that the spine forcefully is arched backwards.   The crumbling, or "lysis," is painful.  The acute break is painful.  When it all heals over, even if one bone is now slid forward off the other, "listhesis," the pain is often gone.   However, kids with joint dysfunction, muscle tightness with knots and tendon lesions, or with irritated joints, will also complain of pain whether they have a pars lysis or spondylolisthesis.   There are some good chiropractors in England.   You can start by contacting Joyce Miller, DC, at the Anglo-European College of Chiropractic in Bournmouth.   Tell her Dr. Scott Gillman said hello!  

'Hope this was helpful.

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Dear Dr Gilmore,

Many many thanks for sharing your expertise. I hope you won't mind me asking for clarification of a few minor points.

It is certainly possible that my son has damaged his spine. I had come across spondylolisthesis online before asking for your advice and worried that it might be his problem. Some early experimenting with breakdancing could be to blame, perhaps. If this were the case, can you give me some idea of the severity of the condition, possible treatment and expected prognosis?

Also, my mother has been an occasional patient of a McTimoney chiropractor for many years. I might be inclined to take my son to him because of that simple connection. Can you offer me any advice on the McTimoney method, or would you refer me once more to Dr Miller?

Once again, I am indebted to you for your time.

Jen

Answer
Jen,

I don't know anything about a McTimoney.   Dr. Miller is a good place to start.   I cannot comment on prognosis.  Your son is not my patient and this forum is not a means of examination, diagnosis, or prognosis.  Sorry...   Give a Dr. Miller a call and she can best direct you.

'Best,

Dr. Gillman