Conditions	Description
Strain/Sprain	Most common casue of back pain Common in children as the result of rough activity sports or heavy backpacks. This refers to overuse or stretch injury to one or more back muscles. Mild injury is associated with inflammation, whereas a more severe injury may be associated with physical muscle compromise.
Spondylolysis/ Spondylolisthesis	One of the most common causes of persistent back pain in children. Spondylolysis refers to a defect in a posterior boney element of vertebrae. Spondylolisthesis refers to slippage of one vertebra upon another. Spondylolysis predisposes one to the development of spondylolisthesis. Intially associated with positionally (mechanically) induced back pain. Can occur without symptoms. The primary cause is often developmental although it may occur as the result of trauma.
Scheuermann’s Disease	Characterized by an abnormal curve (kyphosis) in the mid back region. It involves a defect/abnormality in the endplates of the vertebrae. Second most common casue of back pain in children. Often not recognized unit after age 10. Strong genetic link.
Premature Disc Degeneration	Juvenile onset disc degeneration can predispose the disc to earlier failure and subsequent herniation. There is often abnormal water distribution within the involved disc.
Scoliosis	Characterized by abnormal curvature of the spine. The most common type is referred to as idiopathic (without a known cause). All types may be progressive
Spinal Cord Tumors	Uncommon but represent a serious cause of back pain. More common in the younger child. Often become associated with neurological complications such as numbness, tingling, muscle weakness, and incoordination. A tumor may be malignant or benign.
Spinal Bone Tumors	Rare cause of back pain. May be malignant or benign. Could be primary or metastatic. The most common form in children is osteoid sarcoma. May grow to compress spinal cord and/or spinal nerves.
Postural Muscle Fatique	Chronic poor posture leads to muscle weakness and abnormal stresses upon weight bearing elements of the spine. This can further lead to cumulative micro injury and adverse structural remodeling of tissues predisposing the child or young adult to injury and/or chronic inflammation.
Obesity and Core Deconditioning	Children are becoming more overweight. This is often associate with a lack of regular physical activity which resulting muscel weakness and deconditioning of “core muscles� which are required to maintain good posture. This results in destabilization of the low back during activity thus increasing the risk for low back injury and pain.
Infection	Children are prone to many different infections because of their immature immune status. An infection which spreads to involve the blood stream can result in infection within one or more tissues of the spine. It is often associated with antecedent illness and the presence of a fever. It can progress to include an abcess.
Hypoplasia	The term hypoplasia refers to underdevelopment of a tissue. With reference to the spine this may involve an interverbral disc, bone and/or ligaments. Weak tissue is more vulnerable to compromise under a load.

A child or adolescent should always be examined by a doctor if their back pain persists for more than several days or progressively worsens.