Back Pain in an Adolescent

Ernest M. Weitz, MD
JAMA. 1980;244(15):1673. doi:10.1001/jama.1980.03310150013010.
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To the Editor.—  I have read the letter from F. K. Peterson, Jr, MD (243:1188, 1980), regarding a 15-year-old boy with back pain after exercise. Peterson states the pain was in the right side of the lower back without radiation to the buttock, although there was tenderness opposite the L-4 spinous process on the right and positive straight leg-raising at 70° on the right, with pain referred to the right buttock. The kick on the right side was likewise restricted.I believe findings such as these probably represent irritation of the nerve root on the right, possibly caused by lateral disk protrusion. Irwin M. Siegel, MD, answered that this is due to "low-back strain." I fail to comprehend how an alleged low-back strain can impair straight leg raising and cause the pain to be referred to the buttock. I am in complete agreement with his treatment program. I think, however,


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