What is the cause for back pain?

Q: My daughter is 16 years old and for the last 2 years she has been on and off suffering from back pain at the tip of her spine. When we consulted our doctor he said it was a spasm and there was nothing to worry. But the pain occurs on and off regularly, specially when she does any physical exercise. She is not on any medication. The doctor said it will disappear naturally over time but is it a matter of concern? Will you please advise me regarding this.

A:There can be many reasons for such pain including spasm, stress fracture or soft tissue inflammation. Since the doctor has already examined her, it should be fine. There are very few things that can be done for such pain; since pain is very subjective and not always due to an identifiable cause. The treatment should be directed to symptoms rather than the cause. If physical therapy increases or causes the pain, then it should be avoided. If hot fomentation or postural changes help, then it should be used. if the pain does not resolve, further imaging studies may be required to diagnose the cause.