What could cause upper back pain and bony prominence in a 16-year-old male?
I am a 16-year-old male. I have had upper back pain for about 3–4 years, starting around age 12–13. The pain is located in the upper-middle back, around a noticeable bony prominence between my shoulder blades. Sitting for long periods, especially at school while studying, makes the pain worse. Sometimes the pain becomes strong enough that it affects my concentration and daily activities. I have noticed that my back does not look completely normal and there seems to be a visible prominence or asymmetry in the area where the pain occurs. I am concerned about possible kyphosis, scoliosis, or another spinal condition. I have attached photos of my back. I do not remember any major injury. The problem has gradually persisted over the years. Could you please advise what condition might cause these symptoms and whether I should have an X-ray or see a spine specialist?
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Doctors' responses
Your symptoms and concerns do point towards conditions like kyphosis or scoliosis. These involve abnormal curvatures or deformities of the spine that can develop during adolescence often leading to pain or visible back changes. The prominence you describe in your upper back area, combined with your pain, suggests it would be wise to explore these possibilities further. Getting a professional assessment is crucial here. Starting with an X-ray of your thoracic spine can provide valuable insights into the structural state of your spine; seeing as an X-ray will reveal any curvature or abnormalities like a scoliosis or kyphosis. Depending on the outcome of the X-ray, a referral to a specialist such as an orthopedic spine surgeon or a pediatric orthopedic specialist might be necessary. They can then conduct a comprehensive physical examination, evaluate the imaging results, and offer guidance on whether further imaging like an MRI is needed. Alongside structural issues, repetitive strain, poor posture during sitting for extensive periods could contribute to or exacerbate your symptoms. Regular breaks from prolonged sitting, posture correction, and targeted physical therapy are management strategies that could offer relief and are usually recommended by professionals in such cases. However, given the persistent nature of your symptoms and visual changes, medical evaluation should be prioritized to rule out or address any underlying conditions effectively.
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