Children's Hospital Colorado

Back Pain

What is back pain in children?

Back pain is very common in children and adolescents and can be frustrating for kids and their families. Children and teens can experience back pain anywhere in their back, from their neck to their tailbone.

Where does back pain occur in kids?

Your child may experience back pain in one spot, or in many parts of their back. Children most commonly experience back pain in their lower back. It is also common for children with back pain to feel some associated "spread" or "tingling" in their back or buttocks.

How common is back pain?

Back pain is very common in kids and teenagers.

  • Approximately 50% of kids and teenagers experience back pain at some point.
  • Up to 10% of kids and teenagers who have back pain may have pain that is severe enough to keep them out of school or sports.

The good news is that almost all back pain in children and teenagers can be treated without medications or surgery.

What causes back pain in children?

There are many causes of back pain in children and teenagers, including:

  • Muscle weakness and stiffness (the most common causes of back pain in growing children and adolescents)
  • Tight hamstrings and weak core muscles
  • Being overweight or obese
  • Pain from overuse
  • Pain from sports, dance or other activities

What are the signs and symptoms of back pain?

Symptoms of back pain can be different for each child. Common symptoms include:

  • Increasing pain with bending or movement, including movement from sports
  • Increased pain with prolonged sitting or standing
  • Short periods of tingling in the buttocks and legs
  • Difficulty getting comfortable after activities

When to call the doctor because of your child's back pain

Please contact your child's doctor if your child has back pain lasting longer than a week, changes in bowel or bladder habits, pain routinely waking your child at night, fever, unexplained weight loss, weakness of arms or legs, persistent numbness, or tingling of arms or legs.

How is back pain diagnosed?

Back pain diagnosis and management should begin with your pediatrician or family doctor. After listening to your child's symptoms and examining them, your doctor may recommend treatments such as stretching and strengthening exercises, physical therapy, chiropractic care, and/or occasional use of over-the-counter medications.

At Children's Hospital Colorado, we do not recommend the use of narcotic pain medications and muscle relaxants for treatment of back pain in kids and teenagers.

If your doctor has concerns about your child's pain, they may refer your child to the Spine Program at Children's Colorado.

When does my child need an MRI for back pain?

Your doctor may recommend an magnetic resonance imaging (MRI) test if they're worried about a problem with your child's spinal cord or nerves. However, these problems are rare in kids and teenagers.

For most patients with back pain, an MRI is not helpful in developing a diagnosis or treatment plan. Our providers will only order MRI when it is required for diagnostic purposes.

If our specialists do order an MRI for your child, our pediatric radiology team and child life specialists will work hard to make it a positive experience. Our providers will frequently begin imaging of the spine with low-dose radiation to evaluate the bone structure and alignment of the spine.

If your child fails to improve after doing 2 to 3 months of a home exercise program and/or physical therapy, your child's orthopedic doctor may consider doing additional testing. These additional tests may include MRI, computed tomography (CT) scan and/or blood tests.

How is back pain in children treated?

Fortunately, it is very uncommon for a child to need orthopedic surgery for back pain.

Research shows that a daily exercise program can greatly reduce your child's back pain. However, if your child has unrelenting back pain, your doctor may refer you to the Pain Clinic at Children's Hospital Colorado where pain specialists will work together to help your child.

Can exercise improve back pain?

A commitment to a home exercise program focusing on stretching and core muscle strengthening is essential in the treatment of your child's back pain.

Home exercise tips:

  • It typically takes 6 to 8 weeks of consistent exercise for your child to begin to experience reduced back pain.
  • Activities such as Pilates, yoga, swimming, walking or bicycling are great ways for your child to strengthen their core muscles.
  • You may consider adding alternative treatments such as chiropractic care, massage and acupuncture as an enhancement to your child's home exercise program.

Exercises that support a healthy spine

Watch this video playlist and/or share it with your child to learn 20 exercises that can help you strengthen your child's core and protect their spine.

Physical therapy for back pain treatment in kids

Your child's provider will work with you to determine whether a home exercise program is sufficient to treat their back pain. They may also recommend a referral to a physical therapist for instruction if needed.

Physical therapy is only effective if the exercises are done at home daily. The time commitment for performing your exercises is 10 to 15 minutes per day at least five days a week.

Other things your child can do to help improve back pain include:

  • Avoid activities that cause your child back pain.
  • Have them keep doing activities they enjoy, including a variety of exercises.
  • Try to not let the back pain dominate your child's life. Help your child maintain a positive attitude, stay in school and not fall behind on academics.
  • Spend time with friends and family.
  • Encourage them to minimize stress and get proper sleep; teenagers should be sleeping a minimum of eight hours a night.
  • Help them maintain a healthy diet and body weight. If your child is struggling with being overweight, please discuss this with your pediatrician, family doctor or pediatric weight management specialist.

Why choose our Spine Program for your child's back pain?

The Spine Program at Children's Colorado evaluates and treats infants, children, adolescents and young adults with all types of spinal diseases, deformities and injuries, ranging from back pain to complex neuromuscular disease and trauma.

Our pediatric spine care team is among the most knowledgeable in the country. For the most basic to the most complex spinal conditions, our goal is to always provide the safest and most effective treatments.

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