Zdravstveni dom Koper, Koper, Slovenija
Oddelek otroške ortopedske kirurgije Ortopedska klinika Univerzitetni klinični center Ljubljana Zaloška cesta 9, 1000 Ljubljana, Slovenija
Back pain is a common complaint, but an uncommon reason for visit in pediatric primary health care. Most children who complain of back pain have mild, self-resolving symptoms of limited duration. Symptoms of severe or persistent back pain, as well as any abnormal findings on physical examination, mandate a thorough evaluation. Clear etiologies are not always identified, particularly in older children and adolescents without other associated symptoms. Etiology for the pain is very diverse and it is crucial to take good patient history and thorough clinical examination. Patients history should include information of recent trauma, when and how did the symptoms begin, where is the exact location of the pain and how would the patient describe it. It is important to know if the pain radiates in extremities, if the patient experienced any gait problems, vertigo, nausea, tingling sensations, incontinence or signs of systemic illness (fever, fatigue, anorexia, eczema or indigestion). It is also mandatory to find out if the pain wakes the patient up at night and what worsens or alleviates the pain. Clinical examination should include full somatic, musculoskeletal and neurological examination. X-ray and magnetic resonance imaging are two common radiological evaluations in primary care. In case of systemic symptoms, laboratory evaluation should be taken. Minor trauma can be taken care of in primary care, while urgent cases should be transported in the nearby hospital with proper analgesia and immobilisation.
Key words: neck pain, back pain, child