Encourage healthy lifestyles to treat teenagers with back pain

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More and more young people suffer from back pain but their quality of life is not strongly affected by it. Expensive therapies are not usually necessary. In many cases, sport and a healthy lifestyle could be enough of a treatment, say Spanish experts at the European Orthopaedics Congress (EFORT) in Madrid.

Back pain, a disease of modern civilisation, can also affect teenagers. However their situation is far better than that of older people with the same problem: “Their quality of life is much less restricted by it, and a healthy life style with regular sporting activities generally suffices as therapy,” said César Garcia-Fontecha (Hospital Val d’Hebron, Barcelona), who spoke at the 11th Congress of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) in Madrid. “These patients can be spared aggressive therapies, which are expensive, psychologically disadvantageous and a burden on the health system.”

Pain associated with the spine is one of the most widespread and expensive illnesses of our time. It is the most common cause of absence from work for men, and the second most common cause for women. For both men and women, it is the most common grounds for early retirement or invalidity. It has been estimated that over 80% of the adult population reports low back pain at some time in life, and for children the lifetime prevalence increases with age, reaching 70% in late adolescence.

A Spanish study has now demonstrated that adolescents with low back pain should not be grouped with middle aged or senior citizens as they in a completely different situation. “This leads us to think that young people should be offered different therapies” said Garcia-Fontecha: “We compared 76 teenage patients with an average age of 14.1 years, firstly with healthy teenagers, and then with others who suffered back pain but who had not yet sought medical advice for it. What surprised us was the quality of life of the teenage patients as measured by the so-called KIDSCREEN health parameters: in nine out of ten aspects of life as analysed by KIDSCREEN, the quality of life of teenage patients, despite their back pain, was actually higher than that of school pupils who were not in pain. Only in the area, physical health’ they did score worse than their peers from the general population.”

This contradiction could be related to the fact that school age patients generally do not seek medical advice on their own initiative, but at the behest of their parents; those who sought treatment may have had parents who paid more attention to them, and who took their remarks about pain seriously. “This is supported by the fact that the teenagers who were treated—which is also a result of our study—had a greater sense of well-being and significantly better relationships to parents and friends than those who were not treated, with or without back pain,”  said Garcia-Fontecha.

Advantages compared to adult patients
 
“Back pain limits the quality of life of teenagers only minimally. That is a striking difference to the situation of adult patients, many aspects of whose lives, such as their psychological and social well-being, may be affected by back pain,” he said.

From this, it follows that teenagers with back pain could need a quite different treatment regime than that of adults. Garcia-Fontecha said: “Aggressive physiotherapy combined with drugs and frequent doctor’s visits—entirely suitable for older patients—is not indicated for teenagers as a rule. In light of the low psychological strain, the side effects of many pain relief drugs and the high costs of frequent physiotherapy sessions and consultations, far outweigh the advantages in most cases. It is wiser and of greater long-term benefit to avoid risk factors related to back pain, such as excess weight and lack of exercise, through a healthy lifestyle, especially a balanced diet and regular sporting activities. Even when they already suffer pain, teenagers can rely on their own intact physical resources, and avoid medical over-treatment from the health system.”

Around 7,500 experts in orthopaedics and traumatology, from every continent gathered in the Spanish capital from 02–05 June.