• Miller JE
• Mathews SL

• Exercise Therapy / methods
• Joint Instability / complications
• Joint Instability / therapy
• Low Back Pain / therapy

Objective: Adolescent back pain is becoming increasingly prevalent with levels approaching those of adults by late teens.  Joint hypermobility syndrome (JHS) is a common cause of musculoskeletal symptoms in childhood, including back pain.  These two facts combined suggest that the pediatric patient with JHS is likely to be a common presentation to the chiropractor's clinic.  Failure to identify the condition could result in inappropriate care.  This case report presents an appropriate management plan for hypermobile adolescents with back pain.

Clinical Features: A 15-year-old school girl with a history of childhood scoliosis and a year-long history of anterior rib pain presented to our clinic complaining of low back pain radiating to the lower ribs following an awkward movement 9 days earlier.

Intervention and Outcome: The patient was treated with gentle mobilization therapy and post-isometric relaxation to the quadratus lumborum, the external obliques, and the upper trapezius alongside daily proprioceptive exercises and early-stage core isometric strengthening exercises within neutral posture.  Overall there was a reduction in pain from 8/10 to 4/10 as of treatment number 5 accompanied by a 28-point reduction on the Bournemouth Questionnaire.

Conclusions: This case report showed the possible beneficial effects of a multimodal treatment approach combining chiropractic treatment with proprioceptive exercises in a patient with generalized joint hypermobility syndrome.

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