Etiology, Risk Factors, and Diagnosis of Back Pain in Children and Adolescents: Evidence- and Consensus-Based Interdisciplinary Recommendations
Michael Frosch,
Maximilian D. Mauritz,
Stefan Bielack,
Susanne Blödt,
Uta Dirksen,
Michael Dobe,
Florian Geiger,
Renate Häfner,
Lea Höfel,
Bettina Hübner-Möhler,
Thekla von Kalle,
Burkhard Lawrenz,
Andreas Leutner,
Frauke Mecher,
Kiril Mladenov,
Heike Norda,
Lorin Stahlschmidt,
Marc Steinborn,
Ralf Stücker,
Ralf Trauzeddel,
Regina Trollmann,
Julia Wager,
Boris Zernikow
Affiliations
Michael Frosch
German Paediatric Pain Centre, Children′s and Adolescents′ Hospital, 45711 Datteln, Germany
Maximilian D. Mauritz
German Paediatric Pain Centre, Children′s and Adolescents′ Hospital, 45711 Datteln, Germany
Stefan Bielack
Klinikum Stuttgart, Olgahospital, Stuttgart Cancer Center, Center for Pediatric, Adolescent and Women’s Medicine, Pediatrics 5 (Oncology, Hematology, Immunology), 70174 Stuttgart, Germany
Susanne Blödt
Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften—Institut für Medizinisches Wissensmanagement (AWMF-IMWI), Philipps-Universität Marburg, 35043 Marburg, Germany
Uta Dirksen
Pediatrics III, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany
Michael Dobe
German Paediatric Pain Centre, Children′s and Adolescents′ Hospital, 45711 Datteln, Germany
Florian Geiger
Spine Center, Hessing Foundation, 86199 Augsburg, Germany
Renate Häfner
German Center for Pediatric and Adolescent Rheumatology and Center for Pain Therapy for Young People, 82467 Garmisch-Partenkirchen, Germany
Lea Höfel
German Center for Pediatric and Adolescent Rheumatology and Center for Pain Therapy for Young People, 82467 Garmisch-Partenkirchen, Germany
Bettina Hübner-Möhler
German Paediatric Pain Centre, Children′s and Adolescents′ Hospital, 45711 Datteln, Germany
Thekla von Kalle
Department of Pediatric Radiology, Olgahospital, Klinikum Stuttgart, 70174 Stuttgart, Germany
Burkhard Lawrenz
Private Practice for Paediatrics and Adolescent Medicine, 59821 Arnsberg, Germany
Andreas Leutner
Department of Pediatric Surgery, Medical Center Dortmund, 44137 Dortmund, Germany
Frauke Mecher
Physio Deutschland, German Federal Association for Physiotherapy, 50679 Cologne, Germany
Kiril Mladenov
Department of Pediatric Orthopaedic Surgery, Children’s Hospital Hamburg-Altona, University Medical Center Hamburg-Eppendorf, 22763 Hamburg, Germany
Using a structured approach and expert consensus, we developed an evidence-based guideline on the diagnosis of back pain and the treatment of non-specific back pain in children and adolescents. The first part comprises etiology, risk factors, and diagnosis. The second part, published in the same issue, includes treatment and prevention. A comprehensive and systematic literature search was conducted to identify relevant guidelines and studies. Based on the findings of this literature search, recommendations on risk factors and diagnosis were formulated and voted on by experts in a structured consensus-building process. Notable red flags for specific back pain and evidence-based risk factors for non-specific back pain in children and adolescents were identified. Only three evidence-based recommendations could be formulated for causes, red flags, and risk factors for back pain, while two recommendations are based on expert consensus. Regarding diagnostics, eight expert consensus recommendations and one evidence-based recommendation could be provided. Despite the importance of adequate diagnosis for the treatment of back pain in children and adolescents, results of this work confirm the deficit in research investment in this area.
