Evaluation of back pain in children

Back pain in children is common, affecting around 25%. The incidence in adolescence is higher, with girls more commonly affected. Epidemiological studies demonstrate associations with weight of backpacks and access to school lockers. There is a strong association with psychosocial factors and disability. An algorithm for the evaluation of the disorder is described. Those individuals with ‘red flags’, i.e. night pain, constant pain of recent onset and constitutional upset, need further investigation. MRI scanning is the most valuable imaging tool. A definite cause for the pain is only found in 22%. Rehabilitation with physiotherapy and back education schools are the mainstay of treatment.