Back Pain, Child

The usual adult back problems of slipped discs and arthritis are usually not the back problems found in children. However, preteens and adolescents most often have back pain due to the same issues that adults do. This includes strain and direct injury. Under age 10, it is unusual for a child to complain of back pain. It is important to take these complaints seriously and to schedule a visit with your child's caregiver. The most common problems of low back pain and muscle strain usually get better with rest.

CAUSES

Depending on the age of the child, some common causes of back pain include:

  • Strain from sports that involve a lot of back arching (gymnastics, diving) or impact (football, wrestling). Strain can also result from something as simple as a backpack that is too heavy.

  • Direct injury.

  • Birth defects in the spinal bones.

  • Infection in or near the spine.

  • Arthritis of the spinal joints.

  • Kidney infection or kidney stones.

  • Muscle aches due to a viral infection.

  • Pneumonia.

  • Abdominal organ problems.

  • Tumors.

DIAGNOSIS

Most back pain in children can be diagnosed by taking the child's history and a physical exam. Lab work and imaging tests (X-rays or MRIs)  may be done if the reason for the problem is not obvious.

HOME CARE INSTRUCTIONS

  • Avoid actions and activities that worsen pain. In children, the cause of back pain is often related to soft tissue injury, so avoiding activities that cause pain usually makes the pain go away. These activities can usually be resumed gradually without trouble.

  • Only give over-the-counter or prescription medicines as directed by your child's caregiver.

  • Make sure your child's backpack never weighs more than 10% to 20% of the child's weight.

  • Avoid soft mattresses.

  • Make sure your child exercises regularly. Activity helps protect the back by keeping muscles strong and flexible.

  • Make sure your child eats healthy foods and maintains a healthy weight. Excess weight puts extra stress on the back and makes it difficult to maintain good posture.

  • Make sure your child gets enough sleep. It is hard for children to sit up straight when they are overtired.

SEEK MEDICAL CARE IF:

  • Your child's pain is the result of an injury or athletic event.

  • Your child has pain that is not relieved with rest or medicine.

  • Your child has increasing pain going down into the legs or buttocks.

  • Your child has pain that does not improve in 1 week.

  • Your child has night pain.

  • Your child has weight loss.

  • Your child refuses to walk.

  • Your child has a fever or chills.

  • Your child has a cough.

  • Your child has abdominal pain.

  • Your child has new symptoms.

  • Your child misses sports, gym, or recess because of back pain.

  • Your child is leaning to one side because of pain.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child develops problems with walking.

  • Your child has weakness or numbness in the legs.

  • Your child has problems with bowel or bladder control.

  • Your child has blood in the urine or stools or pain with urination.

  • Your child develops warmth or redness over the spine.

  • Your child has a fever above 101° F (38.3° C).