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Back Pain in Older Children and Adolescents

Medically reviewed by Last updated on Nov 5, 2023.

What do I need to know about back pain in older children and adolescents?

Back pain may occur in your child's upper, middle, or lower back. Back pain may be caused by problems with muscles or bones, such as muscle strain or a herniated disc. Pain can also be caused by other conditions, such as swelling or an infection between spinal discs. The cause of your child's back pain may not be known.

What increases my child's risk for back pain?

  • Sports activities such as gymnastics, diving, and football
  • Family history of back pain
  • Physical stress on your child's back, such as from a heavy backpack

How is back pain diagnosed?

Your child's healthcare provider will ask about any medical conditions your child has or medicines he or she is taking. The provider will also ask about your child's back pain. Tell the provider when your child's pain started and if anything seems to make the pain worse or better. He or she may ask if your child was doing a certain activity or if he or she was injured when the pain started. Tell the provider if your child has any other symptoms. Your child may need any of the following:

  • A physical exam is used to check your child's spine. The provider may watch your child stand and walk, and check his or her range of motion. He or she will also check your child's nerves by asking him or her to raise his or her legs while lying face down and face up. He or she will also check the muscles in your child's back.
  • X-rays, a CT scan, bone scan, or MRI may be needed. These tests may show problems with your child's bones, tissues, or nerves. They can also show other problems such as an infection, inflammation, or a tumor. Your child may be given contrast liquid to help bones and tissues show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.
  • Blood tests may be done to check for signs of infection or inflammation.

How is back pain treated?

Treatment depends on the cause of your child's back pain. Your child's healthcare provider may recommend the following:

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from a healthcare provider.
  • Physical therapy may be used to teach your child exercises to help improve movement and strength, and to decrease pain.

How can I help my child manage back pain?

  • Limit activities that cause pain, such as sports, until his or her back pain gets better.
  • Apply ice for back pain caused by muscle strain for the first 3 days. Apply ice on your child's back for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover the bag with a towel before you apply it to your child's skin. Ice helps decrease swelling and pain.
  • Apply heat for muscle strain after 3 days. Apply heat on your child's back for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain and muscle spasms.

When should I seek immediate care?

  • Your child has trouble walking.
  • Your child has abdominal pain.
  • Your child has severe back pain that does not get better with medicine.
  • Your child has trouble urinating or having a bowel movement.
  • Your child has a fever, decreased appetite, or weight loss.

When should I call my child's doctor?

  • Your child's back pain gets worse or continues for longer than 3 weeks.
  • Your child has back pain that is worse at night or wakes him or her.
  • You notice a change in the shape of your child's spine.
  • Your child has pain that radiates down one or both of his or her legs.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.