We just went through a bout of low back pain caused by a herniated disc in our 13-year-old daughter. The specialist who diagnosed her said that disc problems are rare in children. He said that the most common age group affected are girls under the age of 16. Why is that?

Although rare, serious causes of back pain such as tumors, infection, and disc herniations must be considered in children. Girls younger than 16 years old are more likely than boys of any age to develop disc herniations. This may have to do with sudden growth spurts in girls that occur earlier than in boys.

Risk factors include heavy lifting, previous back injuries, and repetitive motions. Falls associated with athletic and sports activities are additional risk factors. For other patients, sudden increases in training, poor conditioning, or decreased spine range-of-motion increase the risk of disc herniation. It’s possible that congenital defects (present at birth) contribute to disc herniations but this hasn’t been proven directly.

Motions that put stress on the disc and increase pressure within the disc itself are more likely to lead to injury of the disc. For example, repeated flexion (bending) of the lumbar spine (low back), compression down through the spine, and spinal rotation or twisting can tear the outer covering of the disc. This area is called the annulus fibrosis.

Activities girls are more likely to be involved in (e.g., gymnastics, ballet, cheerleading) often require repetitive bending, extension, and twisting. If there is a family history of disc herniation, the soft tissues and connective tissue may be weak and more susceptible to damage and injury than in the general population.

There may be other reasons girls younger than 16 have more disc herniations than other age groups. Further research and discovery are needed to uncover all the potential risk factors. The important thing is to get your daughter the treatment she needs in order to have a full recovery.

Prognosis is excellent. More than 90 per cent of the children receiving conservative care recover fully. Pain relief is immediate and long-lasting. Only a small portion of children with disc herniations actually end up needing surgery. And only a few of the surgical cases (estimated at approximately one per cent of all children with disc herniations) need further surgery in the short-term (first 12 months).