< Back to All

Treatment of Low Back Pain in Adolescents

Mar 31, 2021

     When most of us think of low back pain we don’t picture young, adolescent kids.  There are however, growing trends that show a significant portion of this population are, in fact, experiencing low back pain on a regular basis.  What’s even worse is that if you have chronic pain as an adolescent, it’s a high likelihood or correlative to experiencing low back pain as you get older.  
There are many ways to treat back pain however I think most of us would agree that a more conservative treatment route would be best to start with.  Especially when it comes to our children.  Would it surprise you then that approximately 20-40% of adolescents receive opioids for their chronic pain?  There has to be a better way!


Spinal Manipulation And Exercise For Low Back Pain In Adolescents.  Evans R, Haas M, Schulz C, Leininger B, Hanson L, Bronfort G. Spinal manipulation and exercise for low back pain in adolescents: a randomized trial. Pain. 2018;159(7):1297-1307. doi:10.1097/j.pain.0000000000001211


     This study looks at the effectiveness of spinal manipulation (adjustments) and exercise for low back pain in adolescents.  The main objective is to evaluate the patient’s low back pain at 12 weeks, 26 weeks, and 52 weeks after receiving exercise only as treatment or exercise plus manipulation (adjustment) as treatment.  The secondary objective is to measure the patient’s disability, quality of life, medication, improvement, and satisfaction.  

Child Back Pain

“20-40% of adolescents receive opioids for their chronic pain”

The group of participants were chosen based off symptoms that demonstrated they were dealing with chronic pain and would be difficult to get positive results:

-Duration of back pain had lasted over 1 year in 70% of the participants

-The average severity of pain was rated as a 5.3 on a 0-10 scale

-11% had pain traveling down the leg

-More than 50% had tried treatment for low back pain in the past



Based on the 0-10 pain scale there was an advantage of half a point in reduction in pain for spinal manipulative therapy plus exercise vs. exercise alone at 12 weeks, by over a point at 26 weeks, and by just about a point at 52 weeks.  A point in the positive direction would indicate approximately a 10% reduction.

On average, the difference in reduction of low back pain severity favored manipulation plus exercise over exercise alone by approximately 7% at 12 weeks, 17% at 26 weeks, and 10% at 52 weeks.

When spinal manipulation was added beyond exercise alone that created an average of over a 10% reduction or improvement in pain.   

The spinal manipulation and exercise group experienced significantly greater satisfaction than exercise alone at all time frames (12, 26, and 52 weeks) and most important both groups reported eighty percent reduction in use of medication at end of treatment which was sustained during the entire follow up period.   

The patient rated improvement and satisfaction favored the manipulation plus exercise group and was statistically significant at week 52.  



Spinal manipulation (adjustment) combined with exercise was more effective than exercise alone, in reducing pain, over a 1 year period.  The largest differences occurring at 6 months.  Manipulation plus exercise also produced higher levels of patient satisfaction and improvement over a 1 year period. 

In short, exercise for low back pain is good, exercise plus chiropractic for low back pain is better!


My personal experience has been that kids respond great to chiropractic care!  It is not uncommon for them to be out of pain and back to their normal selves within a few treatments.  We always make an effort to not only provide chiropractic treatment, but also educate kids on how to take care of their bodies with proper exercise.  If you have questions about your child’s condition please give us a call.

– Dr. Eric Mersch

Contact Us

720 Elm Street
Wilmington, OH 45177

504 E Business Way
Cincinnati, OH 45241