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Back Pain Basics

If your child complains about back pain, it may not be for the same reasons you experience it. Sometimes, back pain may be a sign of a serious problem, especially in children younger than 10 years. However, most back pain is not serious and will resolve without treatment.

About half of all children and adolescents experience some sort of back pain by the time they are adults. Your child might feel it anywhere in the back and describe it as sharp and shooting, burning or aching.

The most common cause is muscle sprain and strain. This can occur because of a fall or from playing or carrying a heavy backpack. Less common reasons might include vertebrae (spinal bone) abnormalities, infections, arthritis and, rarely, cancer.

The Age Factor

Different age groups experience different causes for back pain.

Normally, infants and toddlers don’t experience muscle strains or sprains. It could be caused by severe constipation. Urinary tract infections (UTIs) are more likely in girls than in boys and might show up as a fever and back pain. Infants and toddlers are more likely to experience infections than older children because their immune systems aren’t fully developed yet. They might get infections between the bones—called discitis—that adults don’t get.

Meningitis can cause high fevers, headaches and neck pain. Infections can spread and cause abscesses on the spinal cord. A rare cause could be tumors that are leftover from the development of the neural system. You can tell if your infant or toddler is experiencing back pain if they hold their backs, don’t want to move, or cry when picked up. If your child experiences any of these symptoms, you should contact your child’s healthcare provider.

In general, school-aged children have different problems, although UTIs may be the cause. A common cause of low back pain in adolescent athletes is a stress fracture in one of the bones (vertebrae) that make up the spinal column. This is called spondylolysis and could be caused by genetics, overuse (from sports such as gymnastics or wrestling), or both. Boys also have back pain from tight hamstrings caused by rapid growth. Stretching can help ease the pain. While it’s rare, pain may be caused by leukemia or bone tumors.

Teenagers can experience many of the same symptoms as school-aged children. They are also more likely to experience back pain from backpacks—due to weight or carrying it on one shoulder. Obesity can also cause back pain because body fat can pull the spine forward. Additionally, teens are more likely to experience adult forms of back pain from muscle sprains and strains.

Watch for signs of a serious problem related to back pain. Contact your healthcare provider if your child has one or more of the following:

  • Back pain that is severe, occurs at night, wakes the child from sleep or worsens over time
  • Back pain accompanied by fever (temperature of 100.4o F or higher)
  • Back pain accompanied by weight loss
  • Back pain in a child under five years of age
  • Leg weakness, walking with a limp or refusing to walk
  • Back pain that developed after a recent injury
  • Change in bowel or bladder control (e.g., new accidents)
  • Back pain that prevents the child from participating in normal activities 

Treating Common Back Pain

If your child has back pain but none of the warning signs described above, you may want to treat at home first. If there’s no improvement, contact your child’s healthcare provider.

Home treatments that may help include non-prescription pain medications, such as acetaminophen (Tylenol® and others) or ibuprofen (for example, Advil®). You can also apply heat using a heating pad, hot water bottle or other hot pack. Your child can continue regular activities and light exercise that do not cause pain. Keeping active can also help relieve muscle spasms and prevent muscle weakening. High-impact activities (running, jumping or other activities that cause pain) should be avoided while your child is still experiencing back pain.

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