Back pain in kids

We’re used to thinking of back pain as something that happens when we get older, but it can also be a common problem in children and teens. As many as 70% of kids experience back pain by age 15, according to the Pediatric Orthopedic Society of North America. But even though back pain can be common, that doesn’t mean it’s something to ignore.

About back pain in kids

Pain is a signal from our body that something isn’t working the way it should. The back is a complex, hard-working area with a lot of moving, interconnected parts that can cause pain, including:

• Muscular back pain: Most back pain is muscular in nature. Injuries or everyday activities can strain muscles, tendons and ligaments.
• Spinal pain: The spine is made up of small, stacked bones called vertebrae separated by soft, shock-absorbing spinal discs. Herniated disks and stress fractures can cause back pain. Spondylolysis and spondylolisthesis are spinal injuries that can develop in children who participate in activities that require repeated backward extension of the spine, such as dance or gymnastics. Spinal infections, including osteomyelitis and meningitis, can also cause painful inflammation in the spine.
• Nerve pain: Sometimes nerves can get pinched by a disc, which can lead to sharp shooting pains, numbness and tingling. Sciatica is a common nerve problem that involves the sciatic nerve, which runs from the lower back to the back of the legs.

Experts in kids’ back pain

At the AIM Spine Center at Children’s Wisconsin, our pediatric spine experts work together to provide outstanding and compassionate care for even the most complex spinal disorders and spine trauma in infants, children and teens. If your child has already been diagnosed at another center, we invite you to get a second opinion for back pain at the AIM Spine Center.

What causes back pain in kids?

Getting to the root of that question is the first step to helping your child feel better. Your child’s everyday activities can cause back pain — because of poor posture, muscle weakness or stiffness, weak core muscles, overuse injuries from sports, extra weight/obesity, the strain of heavy backpacks and more. Even constipation can cause back aches. Most cases of back pain in kids are caused by muscles strains or overuse injuries.

Other times back pain can be a symptom of a spinal condition, such as a spinal infection, stress fracture, herniated disc, kyphosis or lordosis. When a child has a spinal abnormality, it can prevent the vertebrae from moving and functioning normally, which can cause pain and other problems over time.

Why is back pain in kids a concern?

Mild or occasional back pain is nothing to worry about. But if your child’s pain is persistent or severe, it’s time to get them checked out. Chronic pain can affect a child’s quality of life, disrupting sleep, school, sports and other activities. Plus, the pain could be a symptom of a larger spinal issue that needs to be addressed before it gets worse. Back pain in children under age 5 is rare and should be evaluated as soon as possible.

What are the symptoms of back pain in kids?

Back pain can affect kids at different times and in different ways. Your child might notice pain or discomfort:

• When bending or moving
• After long periods of sitting or standing
• During or after sports activities
• When it affects their ability to participate in the activities they enjoy the most

If your child’s pain persists for several weeks, is constant or waking them up at night, or is accompanied by a fever, numbness or tingling, or bladder/bowel problems, it’s time to see a doctor. 

How is back pain in kids diagnosed?

Your child’s doctor might be able to identify the source of the pain through physical examination. If needed, the doctor might use the following imaging tools to assess your child’s spine:

• EOS scanner – Children’s was one of the first pediatric hospitals in the nation to have this scanner, which provides detailed, 3D images and limits radiation exposure.
• CT scan – More detailed than an X-ray, a CT scan uses a combination of X-rays and computer technology to produce cross-sectional, detailed images of parts of the body, including the bones, muscles, fat and organs.
• MRI– Uses a magnet, radio waves and a computer to create very detailed, 3D still and moving images.

Chronic pain is a complex issue that can be affected by many factors. A psychologist might be part of your child’s assessment to get a holistic view.

Treatment for back pain in kids

Treatment will vary depending on the cause and severity of your child’s back pain. Our spinal specialists will recommend the best treatment for your child based on:

• Your child’s age, overall health and medical history
• Extent of the disease
• Your child’s tolerance for specific medications, procedures or therapies
• Expectations for the course of the disease
• Your opinion or preference

Treatment could include:

Rest – Your child could benefit from taking a break from athletics or other activities that worsen his or her discomfort. Ice and warm compresses can help during the recovery period.

Medical management – Anti-inflammatory medications can relieve children’s pain temporarily, though it’s important to address the cause of the pain.

Bracing – Your child’s doctor might recommend a brace if your child’s pain is caused by an abnormal spinal curvature or a stress fracture. 

Physical therapy – Physical therapy and home stretching programs can ease pain and increase range of motion. Our physical therapy program offers a rehabilitation space designed for spinal conditions including sports specific rehabilitation. 

Surgical repair – Surgery often isn’t required for back pain unless there’s a more serious underlying spinal disorder, and only after more conservative treatments haven’t brought relief. Your child’s spinal care team will advise you on the best options for your child.

Cognitive behavior therapy (CBT) – Behavioral health factors can affect everything from a child’s surgical recovery time to their ability to manage pain. Children with spinal concerns can also experience psychological issues like changes in mood and sleep disturbances. Our AIM Spine Center psychologists, Matthew P. Myrvik, PhD, and Nicholas D. Young, PhD, use CBT to help patients with spinal conditions reduce risk, manage problems and promote overall health and healing.

Long-term outlook for kids with back pain

Recovery from back pain can take time, but with proper treatment, your child should start feeling better and be able to resume regular activities soon. Depending on the cause of your child’s pain, it’s possible that your child’s pain might return. It’s important to follow your child’s doctor’s recommendations for any lifestyle changes (such as weight loss or regular stretching) for the best results. Be sure to tell your child’s pediatrician if you notice any new symptoms.