Ask the Doctors
Q: My 16-year-old son is a volleyball player and has been having lower-back pain for three weeks. He's pretty sore and has to lie in bed after a long practice. Our friend's son was diagnosed with a back tumour at age 14 and we have a family history of cancer. Does my son have cancer?
A: Although anything is possible, the likelihood of this diagnosis is minimal. The most common cause of lower-back pain in a young athlete is a stress fracture, which usually hurts when the athlete extends the back.
Musculoskeletal issues are by far the most likely causes of the majority of back pain. One characteristic of musculoskeletal pain is that it's usually related to physical activity.
Manoeuvres that stress the back typically hurt, and rest usually makes things better. Symptoms of concern for more ominous causes of back pain would be pain at rest or at night. The description of the pain is often deep, boring, throbbing pain. The pain may not be related to exercise.
Cancer pain associated with a bone tumour may have pressure features, since it is expanding in the bone, similar to toothache-type pain. The pain can be worse when you are lying down, since more blood flow may be directed towards the tumour.
If there are any other symptoms, such as fever, fatigue or weight loss, or if the pain is persistent despite even a week of rest, it's good to let your physician know.
Fortunately, most complaints of back pain with young people will be musculoskeletal, and are rarely due to a cancer.
Dr Anthony Luke is a professor of clinical orthopaedic surgery at the University of California, San Francisco. Reprinted with permission of the American College of Sports Medicine's ACSM Fit Society Page