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Back Pain in Older Children and Adolescents


What should I 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 the muscles or bones in his back. These problems include muscle strain, herniated disc, or a stress fracture. It can also be caused by other conditions, such as swelling or an infection between the discs in his spine. The cause of your child's back pain may be unknown.

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 is taking. He will also ask questions about your child's back pain. He may ask if he was doing a certain activity or if he injured himself at the time the pain started. Tell him when your child's pain started and what part of his back hurts most. Tell the healthcare provider if there is anything that seems to make his pain worse or better. Tell him if your child has any other symptoms. Your child may need any of the following:

  • A physical exam will be done. Your child's healthcare provider will check his spine. He may watch your child stand and walk, and check his range of motion. He will also check his nerves by asking him to raise his legs while lying face down and on his back. He will also check the muscles in his 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 his bones and tissues show up better. 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 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 help decrease swelling, pain, and fever. This medicine is available 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 your healthcare provider if NSAIDs are safe for him. Always read the medicine label and follow directions.
  • Physical therapy may be recommended for your child. A physical therapist teaches your child exercises to help improve movement and strength, improve posture, and to decrease pain.

How can I help my child manage back pain?

  • Limit activities that cause pain. Your child may need to limit activities, such as sports, until his 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 it with a towel. Ice helps prevent tissue damage and decreases 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 contact my child's healthcare provider?

  • 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 from sleep.
  • You notice a change in the shape of your child's spine.
  • Your child has pain that radiates down one or both of his 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.

© Copyright IBM Corporation 2019 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

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

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