What was once an uncommon condition in children and adolescents, recent reports now suggest that the rate of back pain in younger age groups is increasing. By the age of 15 years, 20 to 70 percent of children will report some form of back pain. Although most back pain is not due to an underlying serious problem, this is not always the case, especially in children under 5 years.

The most common causes of back pain include:

  • Muscular strain, injury, or overuse
  • Repetitive running, jumping, and conditioning
  • Sedentary lifestyle – lack of exercise
  • Core muscle imbalance or weakness

Less common causes include:

  • Infection
  • Tumor
  • Trauma
  • Various deformities such as scoliosis, kyphosis, spondylolysis, spondylolisthesis

Symptoms

It is important to check with a doctor if your child reports severe or progressively worsening back pain. If your child’s pain lasts more than several days, or is associated with the warning signs below, contact your doctor.

  • Fever
  • Weight loss
  • Night pain or pain at rest
  • Trouble walking
  • Weakness
  • Numbness or decreased feeling in the leg or foot
  • Pain that goes down one or both legs
  • Bowel or bladder problems

Examination

When your child sees a doctor for back pain, the doctor will begin with a history and a physical exam. Reviewing common questions before your appointment that may be asked by your doctor will help prepare you for your visit.

Common questions:

  • How is the child’s overall health?
  • When did the pain begin?
  • Did it start with a specific injury or activity?
  • Is it getting better or worse?
  • Where is the pain located?
  • When does it seem worse?
  • What makes it better?
  • Are there any other associated complaints such as fever, weight loss, pain going down the leg, bowel or bladder changes?

Treatment

Treatment of back pain will depend on the underlying conditions. Because of the difficulty in finding the source of pain in up to half of children/adolescents, your doctor may recommend rest or therapy after initial evaluation and x-rays.

 

FAQs

Q: Do children get back pain as much as adults?

A: No, but the rate of back pain has been increasing with 20-70 percent of children reporting back pain by the age of fifteen.

Q: Is back pain in children always a sign of some underlying problem?

A: No. The most common causes of back pain in children and adolescents are muscular strain, injury, or overuse combined with core muscle imbalance. Conditions such as infection, tumor, deformity, and other disease processes are much less common. Evaluation by your doctor is warranted if pain has been severe or lasting more than several days.

Q: Will my child need physical therapy?

A: Maybe. Many children will have decreased back pain if they do exercises to stretch their leg muscles and increase core and abdominal strength. Many of these exercises can be done at home, but it may be helpful to learn them from a physical therapist. Regular low impact, aerobic exercise such as a walking program often will improve symptoms.

Q: Will my child need an MRI?

A: Usually not. Most back pain will resolve with a specific exercise. MRI’s can be useful in certain situations. MRI’s are safe but they require that your child remain still for a long period of time. This may be difficult for young children and may even require sedation. Your doctor will only request an MRI if he or she thinks it is necessary.

Q: Will exercise make my child’s back pain worse?

A: Usually no. Most back pain can be improved with core muscle strengthening and endurance exercises. Low impact aerobic exercise on a regular basis will also help. It is important to stretch before and after exercise to decrease the risk of injury.

Q: Will my child’s back pain improve?

A: This depends on the cause of the back pain. Most pain is caused by muscular strain or overuse. In these cases, pain usually improves with anti-inflammatory medications, rest, and exercises to stretch and strengthen muscles.