Adolescent Pain & Musculoskeletal Care

Roughly one third of adolescents experience spinal pain each month. According to the World Health Organization (WHO), spinal pain and headaches are some of the leading causes of disability in people in the second decade of life.  They impact social and emotional development, school absenteeism, physical activity and sport performance, and overall quality of life. Experiencing spinal pain as an teenager also increases the likelihood of having persistent spinal pain as an adult.

This is a big deal!  Experiencing pain during such a critical time in development of the physical body, the brain, and the person (identity/sense-of-self) can have ripple effects, not just in how they interact with the world during their teen years, but also down the road in their future.

We care about our adolescent patients and want to ensure they are set up for success in all their bright future adventures. 

To this end, our office was part of an international research cooperation trying to better understand the impacts of that initial pain experience in adolescent patients. We were a clinical data collection site for the study and our own Dr Amanda Stevens worked as the study coordinator for cohorts in Canada, the US, and the UK.  

We are doing our part to help improve both the understanding of pain during adolescence and its impact on overall and future health, as well as experience of pain in the daily lives of our teen patents. 

How can a chiropractor help adolescents who are experiencing pain?

1. Pain Education

Learning about the science of pain actually changes our experience of pain. 

• On the one side, if we are in an acute injury situation, understanding the actual cause of our pain, the structures that are involved, and being able to name the insult can be helpful in both alleviating anxiety around the unknown and creating a plan for optimal recovery.  This is why we always do a thorough physical exam as part of our initial visit, to be able to properly diagnose the issue.  
• Sometimes pain experiences are a bit more complicated than contusions and acute injuries on the sports field. Sometimes pain persists even after an original injury is “healed”.   In these cases of complex or chronic pain, pain education and understanding the brain side of pain is even more important.  

2. Exercise Rehab & Home Care Instruction

The most well researched, evidence-based, and effective known treatment for most causes of musculoskeletal pain is movement. This is sometimes counter-intuitive, because we naturally want to protect an injured area.  However, doing specific exercises to strength weak areas or retrain a movement pattern tends to both help us recover from pain and to build a body that is more resilient to the next challenging moment.  Of course, you need to listen to your body and rest is also important, but in general, erring on the side of moving your body is better than bedrest. 

3. Manual Therapy

In most areas that it has been studied, pairing exercise with manual therapy outperforms either treatment in isolation.  This isn’t shocking.  Working with areas of body tension to improve range of motion can make the exercise homework easier and more comfortable (which also means you are more likely to do it).  Body work can also help to reduce pain, allowing your nervous system to operate in a mode more conducive to healing and learning new skills. 

4. Injury Prevention & Performance 

Once we recover from an initial episode of pain, we want to build a body that is more resilient in the future. It’s not just about getting out of pain. In many cases, especially with injuries like whiplash after a car accident or sprained ankles, we develop compensation strategies and body imbalances. Our tendency is often to move on as soon as the pain subsides, but these imbalances and movement dysfunctions should be assessed and retrained so that we are not vulnerable to future injuries and overload issues.  

At our office, we work with young athletes from a variety of sports. For these active bodies, we want to train integrity in their movement patterns and in their understanding of the demands they are putting on their body. This helps to build resilience in their growing bodies and helps to set them up for success as they continue their sport(s) over the years.  A lot of these preventative strategies come in the form of self-care routines and education (around overload/burnout, rest/periodization, nutrition, stress…). We also do movement screeners to assessment symmetry and ideal loading strategies to support performance goals. 

On the screening side of things, adolescence can be a time of rapid progression of scoliosis (abnormal curvatures in the spine). This is another thing that we can check in on during our physical exam. As are hypermobility syndromes and concussions. 

How we respond to, talk about, and treatment a teenager’s pain complaint matters.  Our experience of pain (present and future) is impact by our perceptions of self, social and cultural factors, and interactions with our support network. The relationship between pain, physical activity, and mental health is intertwined and important to address. We are here to help your adolescent (or you) along the journey of body healing and improved understanding of self. 

REFERENCES

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