Back Pain

Back pain in adolescents (and adults) is very common. Most back pain will resolve on its own and over several weeks. This type of back pain is likely due to muscle strain.

What are symptoms of atypical back pain?

Back pain that occurs in younger children that lasts for more than a few days should prompt further evaluation. This is more true if the pain is associated with symptoms of:

  • fever
  • weight loss
  • numbness
  • tingling
  • difficulty walking
  • pain that shoots down the legs
  • bowel/bladder disturbances
  • pain that prevents the child from sleeping

What should be expected at the Doctor’s visit?

The initial part of the exam will include a history of the child’s back pain and past medical history. While taking a history about the child’s back pain, the physician can begin to narrow down the causes. The physician may ask questions such as, when does the pain occur, how long does it last, what makes the pain worse, what makes the pain better, and does it interfere with activities.

The physical exam portion will include examination of the spine, muscles, and nerves. The Physician will look for any deformities or abnormalities of the spine, abnormal posture and walking. Nerves and reflexes will also be examined as well as the muscles of the back and legs.

Imaging may be required for further evaluation. Radiographs or X-Rays are the most common tool to evaluate the spine for any sources of problems or abnormalities such as fractures or displacements. In most cases, additional images are not required. A Bone Scan, Computed Tomography (CT), or a Magnetic Resonance Imaging (MRI) may be required for further evaluation if there are atypical findings on the X-rays.

Laboratory Studies may also be used to evaluate if the physician believes there may be an infection or systemic disease contributing to the back pain.

What are the causes of back pain?

In the general population, there are several causes to back pain. A specific motion such as lifting or bending can precipitate the pain. Over-activity, such as the first game in the season of softball or soccer is another common cause. Musculoskeletal strain is most often the cause of back pain in children and adolescents. Teenagers tend to have more persistent pain then younger children. Back pain in this age group tends to be more related to tight hamstrings and weak abdominal muscles.

Other possible causes of back pain

There are other causes of back pain that are not as common but are still possible, including:

  1. Rounded Back (Scheuermann’s Kyphosis) may cause middle back pain. The vertebrae are wedged shaped causing a curving or roundness to the back.
  2. Stress Fracture (Spondylolysis) may contribute to lower back pain. This may occur during repeating motion or hyperextension of the spine.
  3. Slipped Vertebra (Spondylolisthesis) is a shift io the vertebra forward.
  4. Infection or Diskitis is less common and affects more often younger children between 1 and 5 years of age. Children with diskitis may have other symptoms such as abdominal pain, stiffness, and limp.
  5. Tumor is less common but may also contribute to back pain. This kind of back pain typically presents differently with pain that is constant, becomes worse as time goes on, is unrelated to activity, and occurs at night.

What can help my child’s back pain?

Since the most common cause of back pain in children and adolescents is due to musculoskeletal strain, exercises that strengthen the muscles of the back and abdomen are utilized. Performing these exercises will help improve core muscle strength, posture, and body mechanics — all of this will improve back pain.

Back Pain Exercises

Ankle Pumps
Lie on your back. Move ankles up and down. Repeat 10 times.

Heel Slides
Lie on your back. Slowly bend an straighten knee. Repeat 10 times.

Abdominal Contraction
Lie on your back with knees bent and hands resting below ribs, Tighten abdominal muscles to squeeze ribs down toward back. Be sure not to hold breath. Hold for 5 seconds. Relax. Repeat 10 times.

Wall Squats
Stand with back leaning against wall. Walk feet 12 inches in front of body. Keep abdominal muscles tight while slowly bending both knees 45 degrees. Hold 5 seconds. Slowly return to upright position. Repeat 10 times.

Heel Raises
Stand with weight even on both feet. Slowly raise heels up and down. Repeat 10 times.

Straight Leg Raises
Lie on your back with one leg straight and one knee bent. Tighten abdominal muscles to stabilize low back. Slowly lift leg straight up about 6–12 inches and hold 1–5 seconds. Lower leg slowly. Repeat 10 times.

Single Knee to Chest Stretch
Lie on your back with both knees bent. Hold thigh behind knee and bring one knee up to chest. Hold 20 seconds. Relax. Repeat 5 times on each side.

Hamstring Stretch
Lie on your back with legs bent. Hold one thigh behind knee. Slowly straighten knee until a stretch is felt in back of thigh. Hold 20 seconds. Relax. Repeat 5 times on each side.