Study: Back Pain May Start in Childhood

Dec. 2, 2003 -- Degenerative disc disease — an illness commonly seen in adults and often leading to low back pain — may start as early as childhood, new research shows.

The study examined 154 children in Scotland who had no symptoms of back pain. Each of the 11-year-olds underwent spinal MRIs and 14 were found to have an abnormal disc in the lower back. The discs either showed signs of disc breakdown or bulging.

The affected children denied any back pain. Only three had previously experienced a brief episode of back pain related to a fall, but this had been short-lived.

Experts say the unexpected finding means children should protect their backs and engage in early preventive measures. For adults, back pain is the second most common cause of lost work in the United States, according to the American Academy of Physical Medicine.

But others questioned the testing of patients who do not have symptoms, since degenerative changes on an MRI do not always predict whether someone will develop low back pain later.

"Most people with disc herniation on a scan don't necessarily have any symptoms, said Dr. Scott Boden, director of the Emory Spine Center and professor of orthopaedic surgery at Emory University School of Medicine in Atlanta. "It's important to remember that you need to treat symptoms. … We should treat patients, not X-rays."

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Is MRI a Guide for Back Care?

Still, results of the research are surprising, and even the study's authors were puzzled about the cause of the spine abnormalities.

"Perhaps something happened so early in life for which we can find no predisposing factors," said Dr. Francis W. Smith, the study's lead author and a radiologist and sports medicine physician at the Woodend Hospital in Aberdeen, Scotland. "We usually blame smoking, but clearly these kids have not smoked at all or long enough. Sedentary factors such as playing video games for too long or maybe heavy backpacks are to blame. There is quite possible a hereditary factor."