Is an MRI Necessary for My Son's Persistent Back Pain?
I have a 12-year-old son who has been suffering from persistent back pain, primarily located in the T12-L3 area, for the past 14 months. This daily discomfort is hindering his ability to engage in sports activities, and despite taking breaks from sports like running and Jiu jitsu, the pain continues unabated. Recently, he mentioned that the pain has begun to disturb his sleep, especially over the last couple of months, with relief only occurring when he first wakes up in the morning before he gets out of bed. Last winter, we sought physical therapy for four months, but it proved to be ineffective. More recently, I attempted chiropractic treatment for two months, which also failed to provide any relief. Over-the-counter NSAIDs have offered minimal help, and a trial of consistently taking them for a few weeks led to stomach discomfort. We have consulted with a pediatric orthopedist on two occasions, where he underwent X-rays each time. The doctor attributed the symptoms to growing pains and expressed no significant concern. During the examinations, the only notable finding was a mild two-degree scoliosis, along with typical issues like a rounded back and forward shoulders—common in many kids today likely due to excessive screen time. After expressing my frustrations as a parent, the chiropractor suggested we consider an MRI, prompting me to reach out to his pediatrician for a referral. My son also has autism and anxiety, meaning that any MRI will require sedation. I find myself wrestling with thoughts about whether his pain might stem from sensory issues, causing him to perceive discomfort more acutely, and perhaps this is not a serious concern after all. However, a few weeks ago, following a cross-country practice, he experienced significant pain for several days, forcing us to cancel some summer plans. Now, I am torn about whether to proceed with the MRI, given the associated stress it might impose on him. I seek opinions from medical professionals on whether this step is warranted now, or if my anxiety and frustration are leading me to overreact. He has not lost weight, there are no fevers or unusual bruising, and his measurements put him at approximately the 40th percentile for height and 60th for weight. Any guidance or reassurance would be greatly appreciated!
Answers (1)
6/25/2025, 4:50:40 AM
OpenHealth AI
It sounds like you're dealing with a challenging situation regarding your son's persistent back pain, and it's understandable to feel a bit overwhelmed. Let's break this down.
Main Points
Your son's ongoing back pain over the past 14 months is concerning, especially given its impact on his daily life, activities, and sleep. Although previous evaluations and treatments have not brought relief, an MRI may provide valuable information about the underlying cause of his discomfort. However, it's also crucial to weigh the necessity and implications of that MRI, especially considering your son's autism and anxiety.
Explanation
Back pain in children can be tricky to diagnose. The pediatric orthopedist noted growing pains and scoliosis, which are common but can sometimes mask more serious issues. Since the pain has persisted, worsened, and begun interfering with daily life, including sleep, it may be worth exploring further. The fact that rest initially alleviates his pain is notable, suggesting that certain activities might be exacerbating his condition.
Next Steps
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Evaluate the Need for an MRI:
- While the pediatric orthopedist felt confident about the diagnosis, your son's ongoing pain and the disruption it causes are valid reasons to reconsider. Discuss with your pediatrician the possibility of the MRI to rule out any structural or neurological issues that may not be evident through X-rays and physical exams.
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Consider Additional Professional Input:
- If you decide against the MRI right now, consider seeking a second opinion from another pediatric specialist, such as a pediatric rheumatologist or a pain specialist. They may have different insights or treatment options that could help manage your son’s discomfort more effectively.
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Explore Pain Management Techniques:
- In addition to any medical evaluations, consider non-invasive approaches to help manage your son's pain. Techniques such as gentle stretching exercises, core strengthening routines designed for children, or appropriate modifications to physical activities could potentially reduce discomfort. You might also look into mindfulness or relaxation strategies that can help with both his pain and anxiety.
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Monitor and Document Symptoms:
- Keep a detailed record of your son's pain, including what activities exacerbate it, any changes in severity, and how it impacts his day-to-day life. This information can be helpful for any medical professional you consult moving forward.
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Optimize Sleep Environment:
- Since sleep is being affected, try to create a calming bedtime routine. Ensure his sleeping area is comfortable, free from distractions, and conducive to relaxation.
Navigating this situation can be difficult, but you're taking the right steps by seeking guidance. Stay supportive of your son as you explore these options, acknowledging that pain perception can vary, especially for kids with autism. It's okay to seek further answers if you're not satisfied with the current outcomes.
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