Back Pain and Scoliosis

There is an increased likelihood of serious pathology in the under-20 year age group.

There are a number of red flags specific to paediatric back pain

Specific Red Flags in Paediatric Population

Children presenting with these red flags should be referred to the Acute Paediatrician Team, Tower Block, Treliske Hospital.

(See RCHT Care Pathway for the Physiotherapy Management of Paediatric Back Pain)

Children presenting with possible scoliosis or kyphosis and NO other red flags should have AP and lateral standing X-Rays arranged and X-Ray of left hand and wrist to determine bone age.

In all cases they should be simultaneously referred to The Paediatric Spinal Deformity Service, Princess Elizabeth Orthopaedic Centre, Exeter for their assessment to ensure appropriate management depending on curve magnitude shown on X-Ray. This may be surveillance, physiotherapy, spinal bracing or surgical management.

Children 0-18 years who have a diagnosis of scoliosis and require physiotherapy input should be referred to ‘Physiotherapy - Paediatric Orthopaedic Outpatient Service’ via maxims or ERS

The Paediatric Orthopaedic Physiotherapy team accepts referrals for paediatric back pain with the absence of red flags under the age of 10 years.

Children over 10 years of age with the absence of red flags should be referred to the MSK Physiotherapy service via eRS.

RCHT Referral of Children With Back Pain to Physiotherapy Services at RCHT and CFT Clinical Guideline, March 2023

Davis PJC, Williams HJ (2008) ‘The investigation and management of back pain in children’, Arch Dis Child Educ Pract Ed, vol 93, pp 73-83

Author:Dr S Burns, Dr R Hopkins

Contributors:Sarah Harvey, Paediatric Orthopaedic Physiotherapy Team Lead RCHT. Russel Hawkins, Consultant Orthopaedic Surgeon RCHT.

Date 9/6/23

Next Review Date: 9/6/24

Version No. 1.2