What is the most common cause of back pain in children and adolescents?

The most common cause of back pain in children and adolescents is spondylolysis. This condition involves a defect in the bony arch of the spine, often due to stress fractures, and it is particularly prevalent among this age group, especially in athletes engaged in activities that involve repetitive extension of the spine, such as gymnastics or football.

Spondylolysis typically presents with low back pain that may worsen with activity and improves with rest. Diagnosis can often be confirmed with imaging studies, such as X-rays or MRI, which may reveal the bony defect.

While other conditions like a herniated disc, degenerative disc disease, and spinal stenosis can cause back pain, they are less frequently observed in the pediatric and adolescent populations. Herniated discs are more common in adults, and degenerative disc disease typically pertains to older individuals. Spinal stenosis, which involves narrowing of the spinal canal, is also more prevalent in older adults and is rare in children. Thus, spondylolysis stands out as the most common etiology for back pain in younger individuals.