Any condition causing pain of the thoracic, lumbar, or sacral spine
- 12-month period prevalence: 10–20% of children
- Lifetime prevalence: 12–50%
- Dependent on underlying cause
- Until skeletal maturity, partially ossified posterior column and vertebral body are weak points.
- Hyperextension with rotational spinal loading in the case of pars defects (e.g., spondylolysis or spondylolisthesis)
- Autoimmune or autoinflammatory processes as with juvenile idiopathic arthritis (JIA) or juvenile ankylosing spondylitis
- Unidentified in 50% of cases
- 30% of chronic cases (back pain >3 years) without clear etiology despite workup
- Poor conditioning or high athletic performance
- Joint hypermobility
- Role of backpack weight and style of wear undetermined
- Role of overweight or obesity yet to be determined
- Back muscle strengthening and hamstring stretching exercises may be helpful.
- Maximum backpack load: 10–15% body weight
- Weight loss and increased physical activity in overweight or obese children
- 3 months off from sport per year, 1 day off from scheduled activity per week
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