Condition | Typical age group/risk groups | Clinical features |
Nonspecific musculoskeletal pain and muscle strain |
Nonspecific musculoskeletal pain (common) | - Older age
- Sports participation
- Soft mattress
- Large breasts (in females)
- Depression, anxiety, or psychosocial distress
- Comorbid medical disorders
| |
Muscle strain (common) | | - Acute pain
- Pain during and after activity
- Pain with twisting or lifting
- Muscle tenderness without radiation
|
Thoracic spine pain |
Scheuermann (juvenile) kyphosis (common) | - Early adolescence
- More common in males than females
- Tall males
| - Subacute/chronic or intermittent/recurrent pain
- Pain worse with activity and improves with rest
- Thoracic tenderness
- Increased pain with flexion
- Rigid thoracic kyphosis
- Hamstring tightening
|
Thoracic or lumbar spine pain |
Adolescent idiopathic scoliosis (without activity-limiting pain) (common) | - Adolescents (≥10 years of age)
| |
Intervertebral disc calcification (rare) | - Preadolescents
- Alkaptonuria
- May be associated with trauma
| |
Lumbar or lumbosacral spine pain |
Hyperlordotic low back pain (common) (Also called mechanical back pain) | | - Gradual onset
- Increased lumbar lordosis
|
Lumbosacral transitional vertebra (Bertolotti syndrome) | | - Gradual onset
- Poorly localized low back pain
|
Referred pain |
UPJ obstruction (uncommon) | - More common in males than females
| - Intermittent flank pain
- Pain worse with diuresis
- Abnormal urinalysis (hematuria)
|
Cholecystitis (uncommon) | - May be associated with hemoglobinopathies
| - RUQ or epigastric pain that radiates to right shoulder or back
- Pain precipitated by ingestion of fatty food
|
Widespread pain (not limited to back) |
Pain amplification/chronic pain syndromes (eg, fibromyalgia) | | - Chronic pain
- Discordance between reported symptoms and physical findings
- Frequent school absences
|