Who is at Risk of Developmental Back Pain?

Not to be confused with developing back pain, developmental back pain is due to abnormalities that occur whilst the spine and its components are maturing. These disorders can begin during foetal development, or commence during adolescence.Treatments for developmental back problems tend to be conservative with surgery only being used to prevent symptoms from worsening.

There are three main types of developmental back pain; sacral agenesis, Scheuermann’s kyphosis and scoliosis.

Sacral Agenesis

This term is given to disorders of the lower back and pelvis. There are different types of sacral agenesis; partial formation of the sacrum unilaterally, partial formation bilaterally or a total absence of the sacrum altogether. It is a serious condition as sufferers usually lack some degree of motor function starting from below the last normally developed level of the spine. The causes for this condition are largely unknown, though there may be evidence to show that a lack of essential minerals available from the mother to the foetus, is a contributory factor. It affects both males and females equally with a prevalence of around 1 in every 25,000 of live births. The sacral area of spinal growth is usually complete by the 4th or 5th week of foetal development; therefore the condition is easily discovered at birth if it hasn’t been diagnosed by scan during the pregnancy.

Scheuermann’s Kyphosis

Commonly referred to as ‘hunchback’, this condition is thought to be due to abnormal vertebral formation where the anterior side grows at a different rate than the posterior aspect, causing the individual vertebrae to become wedge-shaped. This results in a noticeable rigid ‘kyphotic’ curve, most often seen from the seventh to the tenth thoracic vertebrae. This abnormal growth is thought to be due to a condition called osteochondrosis which essentially means that the blood supply to the growing part of the bone (epiphysis) is compromised. It is normally diagnosed in the teenage years and is more common in males. Along with the backache caused by this rigid curvature, sufferers, especially children, may also feel isolated and lack confidence. The degree of curvature generally seems to worsen with age, perhaps due to a weaker overall skeleton, and the pain experienced may increase.

It is not to be confused with postural kyphosis which can be corrected by the sufferer making a conscious effort to improve their posture.

Scoliosis

All spines have natural curves in them to aid with balance and support; scoliosis causes lateral curvature. It is estimated that about 1 in 10 people have some degree of scoliosis and of these around 2 in every 1,000 will require treatment.There are three types of scoliosis; congenital, idiopathic and neuromuscular.

Congenital Scoliosis

This disorder occurs when there are malformations of the vertebral components and can be divided into three groups- failure of formation, failure of segmentation or a combination of the two. Congenital scoliosis occurs during foetal development.

Idiopathic Scoliosis

Scientists are unsure of the actual biology of this condition, but it is generally regarded as being due to a considerable growth spurt in adolescence. Most idiopathic scoliosis is relatively painless, develops gradually and is usually seen as a lateral curve in the thoracic region. It is more prevalent in females than males.

Neuromuscular Scoliosis

This describes lateral curvature in children who also have a neurological disorder such as spina bifida, cerebral palsy or muscular dystrophy. It results in lower body weakness and progresses with age. The underlying neurological condition can cause sufferers to have very reduced mobility, even wheelchair confinement, so with scoliosis as well, comfort is not always achievable and quality of life may be seriously compromised.