Back Pain in Children


Back pain is more common in children than one might expect. In fact, by age 15, 30-50 percent of all children have had at least one episode of back pain.

At Gillette Children’s Specialty Healthcare, our team of internationally-recognized orthopedic experts work closely with many pediatric patients each year, helping them identify and treat their unexplained back pain.

“We see lots of patients experiencing back pain, with and without structural abnormalities of their spine,” explains Walter Truong, MD, a pediatric orthopedic surgeon. “It can be challenging to determine what is contributing to the pain, so it is important to complete a thorough evaluation to isolate the cause.” 

Read on to learn what can cause back pain, what red flags to watch out for, and how Gillette can answer your questions and provide treatment plans.  

Top Causes of Back Pain in Children: 

“Back pain in children is often wrongly associated with underlying spine issues like scoliosis,” explains Heather Rich, PA-C, MSPAS, who specializes in orthopedics, “Most back pain, however, is actually caused by the muscles surrounding and supporting the spine, and not the spine itself. Just like adults, kids with a curve in their back get back pain sometimes, but so do kids with a perfectly straight spine.” 

Most cases of back pain in children are caused by: 

  • Too much activity, especially when starting a new activity or sport.
  • Too little activity (e.g. sitting too long in school). 
  • Stress reaction in the bone from repetitive motion, also known as spondylolysis. Especially common from activities that require a lot of back bending or arching of the back, like hockey, gymnastics, volleyball, jumping in track and field, lacrosse, swimming, etc. 
  • Familial conditions that affect the shape of backbones and discs, i.e. Scheuermann’s kyphosis.  
  • Intervertebral disc herniation (compression of the discs that separate the back bones). Can occur from repetitive stress to the back, or an acute injury.
  • Compression fracture of vertebra after an acute fall or impact. Common when landing hard on backside or feet, or sustaining a high impact in sports. 

Less commonly, back pain in children can be caused by: 

  • Infections.
  • Rheumatologic or inflammatory conditions.
  • Neural axis: abnormalities in the brain stem and spinal cord.
  • Tumors or blood and bone marrow abnormalities.

Back Pain Red Flags 

Most back pain should resolve within a week or be relieved with changing positions or stretching. Talk to your doctor right away if you notice any of the following:  

  • Pain that lasts several weeks
  • Pain that prevents participation in activities  
  • Night pain 
  • Weight loss 
  • Numbness or tingling in extremities 
  • Changes in walking pattern or coordination 
  • Severe constipation or loss of control over bowel/bladder  

Gillette Can Help Answer Questions 

Gillette is home to nationally and internationally recognized leaders in pediatric orthopedics. Our team of expert spine surgeons and advanced practice providers are happy to help identify the cause and develop a plan to manage back pain. A visit to Gillette for back pain will often include:

  • Learning your health history. This includes better understanding the nature of your back pain, the character, location, and timing (when it started, how frequently it occurs, what time of day, etc.) as well as factors that make the pain worse or better. 
  • A physical examination to isolate the location and mechanics that might contribute to pain and to check range of motion, nerve, and muscle function.  
  • An X-ray to examine overall alignment and identify abnormalities in the shape of the bones. 
  • An MRI to examine soft tissue in the back and look for inflammatory changes.

Common treatment plans often include the following:

  • Period of rest or change in activity
  • Physical therapy 
  • Bracing  
  • Medication (anti-inflammatory) 
  • Referral to a Gillette specialist in rheumatology or neurologic services 

Keeping a pain journal before your visit can be helpful for providers to understand the causes of chronic pain. In more acute cases, or a sudden onset of pain, always consider an evaluation at an emergency room or urgent care, especially if there are changes in sensation, motor function or mental status.  

Above all, if you have questions or concerns related to your child’s back pain, Gillette can provide answers. Schedule an appointment with one of our experts today. 

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