FEATURED IN JOURNAL OF PHYSIOTHERAPY They say prevention is better than a cure. This certainly rings true when it comes to low back pain. Despite most low back pain resolving in 6 weeks this costly condition still causes huge amounts of lost time at work, healthcare costs and unnecessary suffering. Research data has found that only 1% of 7 year olds have experienced low back pain. However only a few years later and a huge 40-70% of our children aged 12-15 say they have experienced low back pain. Over a lifetime 80% of the population will experience low back pain. The most significant risk factor for developing low back pain is having had previous low back pain, ie. if you’ve had low back pain before, you are likely to get it again. This is why it’s so important to prevent low back pain in childhood. If we can avoid low back pain in our kids now, it will greatly reduce their risk of having ongoing or recurrent low back pain as an adult. A recent review of the research by Monash University in Melbourne identified several possible risk factors for low back pain in children and adolescents. These included spine asymmetry, poor endurance in the lower back muscles, playing sport more than 6 hours per week, having a part time job, frequent abdominal pain and psychosocial difficulties. While more research is still needed it makes sense that if we can modify any of these risk factors we are going to help prevent low back pain in our kids. Spine asymmetry, also known as scoliosis, can very enormously in severity. Mild scoliosis may cause no problems, while moderate may need physiotherapy and exercises. Severe scoliosis occasionally requires bracing or even surgery. If your child appears to have a sideways curve in their spine the best option is to have them assessed by your physio or doctor who will determine the severity and what if any treatment is required. Poor endurance in the lower back muscles was found to contribute to low back pain. Studies in adults have also found that poor strength in the deeper core muscles of the lower back occurs with low back pain and increases the risk of future low back pain. The best way to make sure your child’s spine stays strong and healthy is to ensure they participate in regular exercise. Australian national physical activity guidelines recommend that children participate in a minimum of 60 minutes of moderate to vigorous intensity exercise each day. This exercise can be accumulated over the day and does not have to involve formal sport. Playing tag in the backyard, walking the dog, throwing a Frisbee and skipping are just some ideas. On the other side of the coin playing too much sport has also been identified as a possible risk factor for low back pain in children. A research study of 1000 school children found that greater than 18 sessions of at least 20 minutes of sport per week (equivalent to 6hrs/week) was associated with a higher risk of low back pain in 11-14 year olds. However given the well documented health benefits of regular exercise the best advice would be to avoid long hours playing sport known to have a higher risk for low back pain such as gymnastics, dancing and bowling in cricket. Importantly the study did not find playing competitive sport increased the risk for low back pain. While having a part time job was found to be a significant risk factor for developing low back pain, the type of work (heavy vs. light) made no difference. It is important when your child starts working that they are taught correct bending and lifting techniques, as well as optimal ergonomic set up for chairs, desks and computers. Frequent abdominal pain may be a difficult risk factor to modify however if your child has ongoing stomach problems it is even more important to ensure their other risk factors such as maintaining strong spinal muscles are improved and maintained. It is now known that there is a strong interrelationship between mental health problems such as depression and low back pain. In children psychosocial difficulties such as poor attention, antisocial behaviour and emotional problems have been found to increase the risk of low back pain. As parents, being on alert for difficulties in these areas, having them assessed and managed, and striving to create a happy enriched environment for children at home will assist to minimise psychosocial difficulties and thus reduce the risk of low back pain. The main finding from this review is that leading a healthy and active lifestyle is one of the best ways for your kids to avoid low back pain. If we can help our kids avoid back pain through into their adolescence then the risk of future problems can be significantly reduced. This is becoming more and more important given the increasing time many children and teenagers are spending at desks studying, playing or socialising on computers. For any more information please contact your local physio or call Precision on 9280 2322.