What Works When Treating Children and Adolescents With Low Back Pain?

BACKGROUND: Low back pain is a common health condition for all ages. One quarter to a third of children report persistent pain, including low back pain. CLINICAL QUESTION: The aim of this Clinical Commentary is to provide an overview of evidence-based treatment approaches for children and adolescents with low back pain. KEY RESULTS: Physical, psychological, and pharmacological interventions are effective in reducing pain intensity and disability. Inter-disciplinary and patient- and family-centered treatment approaches are the gold standard for persistent pain in children and adolescents. Communication between health professionals. children, and parents is a key part of a therapeutic alliance. The use of holistic and complementary therapies is not supported by compelling evidence. CLINICAL APPLICATION: Physical interventions can be delivered alone or as a component of other interventions. The interventions are delivered over 8 to 12 weeks. Psychological therapies are mostly delivered as a component of a multidisciplinary treatment program: cognitive behavioral therapy is most often used, and interventions usually run from 4 to 10 weeks. Pharmacological interventions should be delivered in combination with physical and psychological interventions. Tailor family-centered interventions to personal aspects, such as age, gender, and family structure. When communicating with children and adolescents, use simple language that is clear and direct. Aim to support trust between health professionals and parents to facilitate family decision making.