Back Pain in Children: How it Happens and How to Help

A 2020 study suggests a third of kids experience back pain. Here’s how it happens, and how parents can help prevent back pain in children.

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When you think of back pain, you might think of a little old man or lady, hunched over and grimacing. However, back pain in children and adolescents is relatively common. According to an August 2020study published in Spine, nearly 34 percent of children have reported feeling back pain in the past year, with almost 9 percent of those reportedly experiencing severe back pain. 

back pain kidsYes, children can get back pain too. If your child complains of back pain, listen.

By the age of 15, anywhere from 20 to 70% of children will have experienced back pain at some point in their lives. The likelihood of developing back pain increases with age, and is significantly more common in girls.

The study found that when treatment is sought out, physical therapy is most commonly prescribed, with fewer than 2%of patients requiring more invasive treatments, such as injections and surgery. 

Knowing that pain can have a major impact on the life of a child, the prevention and treatment of back pain in this population is important to help restore their overall health and wellness.

What are the Signs and Symptoms of Back Pain in Children? 

Symptoms of back pain in kids can vary, with the most common being: 

  • Increased pain with movement, such as bending 
  • Increased pain after prolonged sitting or standing
  • Tender/sore muscles near the spine
  • Tight muscles or muscle spasms

Although most back pain in children is mild, there are some instances where your child will require medical attention. “Your child should see a doctor if their back pain persists for more than two to three days, is accompanied by a fever, or they’re experiencing any numbness or weakness in their arms and legs,” says Los Angeles-based neurosurgeon Khawar Siddique, MD

What are Some Common Causes of Back Pain in Children?

“Like in adults, muscular strains are the most common cause of back pain in kids,” says Dr. Siddique. “These strains are more common in the low back (lumbar spine) than the neck (cervical spine) or mid-back (thoracic spine), and typically happen from overuse injuries, poor exercise technique, or falls.” 

In addition to injury-related muscular strain, other common causes of back pain in kids include: 

  • Weak core muscles
  • Poor posture
  • Extra weight/obesity
  • Muscle weakness and stiffness (common in growing children and adolescents)
  • Carrying a heavy backpack incorrectly or for prolonged periods
  • Sedentary lifestyle (e.g., watching television or sitting in front of the computer for hours at a time)

Back pain kids backpackHeavy backpacks are often the culprit in back pain in kids. What Back Pain Conditions are More Likely to Affect Children?

Although injuries that children sustain in recreational activities are the most common cause of back pain, some may be due to underlying health or spine-related conditions. “Around one third of adolescents with low back pain may have a diagnosable condition of their spine,” says orthopedics specialist Saad Chaudhary, MD, of Mount Sinai in New York City. The most common conditions include: 

Idiopathic Scoliosis: an abnormal curvature of the spine. Though often not painful, some curvatures are severe enough to cause pain and require medical attention. “Scoliosis can involve the mid/low spine or the entire spine and is most common in adolescents (ages 11-17),” says Dr. Siddique. “Signs to look for include tilted shoulders, uneven hip bones, and/or one side of the rib cage is more prominent than the other.”

Scheuermann’s kyphosis: a growth disorder of the vertebrae that occurs when the front of the spine doesn’t grow as fast as the back of the spine, which may produce a humpback-like curvature. “This occurs when spine is bent forward so that the child cannot stand up straight,” says Dr. Siddique. “It typically occurs during periods of accelerated growth.” 

Spondylolysis and pars fractures: The pars is a bony connection of the vertebrae that can break in kids who do repetitive exercises that involve bending and twisting. “Kids who engage in sports such as gymnastics and football are at risk for spondylolysis. This is most common in the lumbar spine and presents with persistent low back pain,” explains Dr. Siddique. “It is most often treated with rest.” 

Other causes of low back pain in children and adolescents include spinal cord tumors, systemic disease such as sickle cell anemia, or infection. “Tumors and infections are very uncommon in kids,” says Dr. Siddique, “they most often present with persistent pain or fever. If the nerves are pinched, kids can develop numbness, tingling, weakness in the extremities.”

What Back Pain Treatments are Most Commonly Used for Children and Adolescents?

“The most common treatments are geared towards symptomatic relief,” explains Dr. Chaudhary. Back pain in children is usually short-lived and can be treated through the use of ice, rest, and over-the-counter medications such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to alleviate their pain. Research suggests that a daily exercise program can play a role in reducing your child’s back pain. “Sometimes activity modification or a brace may be utilized,” says Dr. Chaudhary.

If your child is experiencing unrelenting back pain, they may be referred to a specialist — such as a physical therapist — who can provide advice on any exercises and lifestyle changes that will help reduce the pain. Complementary therapies such as massage, chiropractic care, and acupuncture may enhance your child’s healing process and help eliminate the pain faster, too.

Tips for Parents on Preventing Back Pain in Kids

“Stop slouching!” is more than just a parental nag — it’s sound advice that can prevent back pain. Because children and adolescents' musculoskeletal systems are still developing, it’s important to ensure they sit, stand and lift properly, and avoid activities that put repeated strain on the spine (i.e., overexertion during sports).

Here are some tips for keeping your kids back-pain free: 

  • Ensure proper backpack wearing: carried on two shoulders instead of one
  • Avoid activities that cause repeated strain on the same muscles (e.g., gymnastics)
  • Encourage stretch breaks when sitting for long periods of time 
  • Limit sedentary activities
  • Teach them proper posture: no slouching, sitting up straight
  • Make your home a stress-free environment (as much as possible)
  • Help them maintain a healthy weight and diet by providing balanced meals and snacks

“Parents should also promote overall mental and physical health,” says Dr. Chaudhary. “Studies show that kids who are stressed or depressed have a higher incidence of more severe back pain. Encourage your kids to keep active on a regular basis, exercise, get proper sleep, recover, and rest.”

If your child is experiencing back pain, take heart: with the right treatment program and lifestyle changes, your child will be on the path to being back-pain free and able to return to their favorite activities in time.

Updated on: 09/22/20
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Pain in the Back: Your Child's Backpack May Not be the Cause
Vincent C. Traynelis, MD
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