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Back Pain in Teens – Self-Medicating and Secrecy

back pain in kids

Are your kids secretly self-medicating their back pain?

A recent report highlights the incidence of pain and the uncontrolled use of pain medications in teens, with back pain in children one of the reasons for often inappropriate use of such drugs. The report by Fouladbakhsh, et al, notes that sex and age appear to influence self-treatment of pain and that teens are often using pain medication without clear medical guidance and without knowledge of side-effects, interactions, or contraindications. In this study 90% of the school children surveyed had experienced pain in the previous two weeks, and many were dealing with this pain without appropriate guidance. Whilst most teens will not have back pain due to spinal stenosis it is possible that this early use of pain medications to mask back pain could store up problems throughout adult life.

Teens Have Poor Knowledge of Pain Pills

Rather alarmingly, it appears commonplace for teens and children to self-medicate, particularly with nonprescription analgesics. As children grow up they use more and more pain-relief products with a 150-200% increase in the use of such drugs with each grade. Fouladbakhsh, et al, found that whilst many of the children surveyed considered themselves knowledgeable about these drugs their actual level of knowledge was poor.

Teens in Pain

Oftentimes, teens are unaware that a single drug may have numerous names and some teens share pain medications with each other with little, if any, regard for side-effects, interactions, or contraindications even when the drugs are prescribed. When teens do ask for information on such drugs it is usually sought through parents, friends, the internet, and pain medications’ package inserts rather than from medical professionals.


Half of all Teens Suffer Back Pain

The research by Fouladbakhsh, et al, involved surveying a sample of nearly three hundred adolescents at an urban high school who reported that they had experienced pain in the preceding two weeks. The children completed a survey to assess demographics and factors such as physical activity. Most of the participants were white girls (75% and 70%, respectively) and most reported pain in a number of locations in the body. Head pain was most common for girls (66%) and there was a 50% incidence of back pain in teens during the previous two weeks.

Teens Secretly Taking Pain Meds

Teenage girls reported higher pain levels than the boys and were more likely to have experienced disrupted sleep and mood irregularities due to pain. As the girls’ activity levels rose so did the intensity of reported pain. Girls were also found to be three times more likely to seek help than boys with some 79% (vs 47%) asking their mothers for help coping with pain. Conversely, girls were two and a half times more likely to take pain medications without telling anyone.

Prescription Pain Medication Use Amongst Teens

Over the counter pain relief products were used by 90% of girls and 72% of boys, along with nonpharmacologic therapies such as heat or ice, massage, and relaxation, as well as complementary therapies for pain. Perhaps surprisingly more than half of the teens used prescription medication including:

  • Prescription-strength ibuprofen (36%)
  • Acetaminophen with codeine (30%)
  • Acetaminophen and hydrocodone (12%)
  • Propoxyphene and acetaminophen (withdrawn from the market in 2010) (8%)
  • Long-acting opioids (such as controlled-release morphine) (4%)

Chronic Pain in Teens

Students with multiple pain sites were increasingly likely to use pain medications and try to self-manage their condition, leading to questions over the help available for teens with fibromyalgia, Rheumatoid arthritis, or similar illnesses causing widespread pain. The idea that many teens are using prescription and nonprescription pain killers to mask the symptoms of chronic disease is disturbing, especially when considering that many of them are not discussing their use of such pain medications with health professionals or even an adult in many cases. Acute back injuries during phys.ed., chronic strain from overly heavy backpacks, hunched postures over school desks, and slouching on the sofa after school can all contribute to pain in kids, particularly back pain.

Looking Out for Kids with Back Pain

Chronic and acute pain, including back pain in adolescents is a serious concern as the pain itself and the use of pain medications can affect quality of life, physical and emotional health, academic performance and psychosocial function. Inappropriate use of pain medications could set teens up for a lifetime of misuse of pain medication, as well as masking pain from postural problems that then lead to arthritis and spinal stenosis in later life. School nurses could be made more aware of the potential use of pain medications amongst teens with back pain at their school and be alert to signs of drug misuse and undiagnosed serious illness being self-treated.

Reference

Fouladbakhsh JM; Vallerand AH; Jenuwine ES., Self-treatment of pain among adolescents in an urban community, Pain Manag Nurs. 2012; 13(2):80-93 (ISSN: 1532-8635).

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