Pediatrics Common Questions, Quick Answers

Low Back Pain in Children

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: June 2002
Last Revision Date: June 2002

• Why is the lower back important?
• What causes low back pain?
• Who can get it?
• What are the signs and symptoms?
• How is it treated?
• How long does it last?
• Can it be prevented?
• When should I call the doctor?

Why is the lower back important?

• The lower back connects the upper body to the lower body (the pelvis and legs).
• It helps the body move, twist, turn, and bend.
• It gives the body strength for lifting, standing, and walking.
• The lower back is used in almost every activity of daily living.

What causes it?

• Sometimes the cause is not known.
• It can be caused by injury. A sudden movement or jerk commonly causes the injury.
• Lifting heavy objects can cause back pain. Children can have back pain from carrying heavy backpacks.
• Overworking the lower back muscles can lead to back pain.
• Obesity can lead to back pain.
• Smoking can lead to back pain.
• Injuries of the spine can lead to back pain.
• The following conditions or illnesses also can cause low back pain:
  • Arthritis
  • Viral infection
  • Menstruation or PMS
  • Scoliosis
  • Bladder infection

Who can get it?

• Smokers are more likely to have low back pain.
• Children who are overweight or out of shape are more likely to have low back pain.

What are the signs and symptoms?

• Lower back pain is described as aching, soreness, stiffness, or spasms in the small of the back.
• The pain may begin immediately after an injury or hours later.

How is it treated?

• Most cases of low back pain are not serious.
• Take your child to the doctor if he has low back pain.
• The doctor might recommend he see a special doctor, called an orthopaedist.
• The doctor will examine your child's spine and legs and ask about recent activities or injuries.
• Your child may be asked to take a break from activities that could be causing the pain or making it worse.
• Medicine can't heal a back injury, but ibuprofen can be used to relieve pain.
• Heating or icing the lower back may help relieve pain. Do not put ice directly on the skin. Cover with a towel.
• Rest and some light activity are usually recommended for a time. Ask your doctor for suggestions and limits.
• The doctor may ask your child to do exercises or stretching.
• If your child is overweight, he may need to lose weight.
• If the pain does not go away after simple treatment, the doctor may take X-rays to see what the problem is.
• Usually only severe cases need surgery.

How long does it last?

• How long the pain will last depends on its cause. Severe injuries will take longer to heal than minor strains.
• Rest and some light physical activity may speed recovery.

Can it be prevented?

• Avoid smoking.
• Lift with your legs instead of your back. Ask someone for help if the object is heavy or awkward.
• Children should not carry backpacks that are too heavy. Encourage them to carry only what they need.
• Backpacks should be less than 10% of their body weight. For example, an 80-pound child should not carry more than an 8-pound backpack.
• Make sure your child wears both straps over his shoulders. Wide straps are best. A waist belt will help take some of the pressure off his back.
• Exercise to keep the back strong.
• Use good posture (stand and sit up straight).
• Be careful while a back injury is healing to prevent further injury.
• Sleep on a firm mattress (with a board under the mattress) or sleep on a waterbed or the floor.
• Sleep with a towel folded up under the lower back or put a pillow between the legs.

When should I call the doctor?

• Call the doctor if your child's back pain lasts more than a week.
• Call the doctor if your child has both a fever and back pain.
• Call if the back or spine is swollen or red.
• Call if pain begins in the back and stretches down to the legs or knees.
• Call if a major fall or hit causes the back pain.
• Call if your child's legs are very weak or numb.
• Call if you have questions or concerns about your child's treatment or condition.

Quick Answers

• The lower back gives the body strength and helps it move.
• Back pain can be caused by injury, illness, or muscle strain.
• People who smoke or who are overweight are more likely to have back pain.
• Lower back pain is described as aching, soreness, stiffness, or spasms in the small of the back.
• Your child may have to take a break from activities that could be causing the pain.
• How long the pain will last depends on its cause.
• To prevent back pain, children should avoid lifting and carrying heavy objects, such as backpacks that are weighted down with too many books.
• Call the doctor if a major fall or hit causes the back pain.

References

• American Academy of Orthopaedic Surgeons. Low Back Pain. 2000 (cited 2002 March 14).
• Dowshen S. A Heavy Backpack Could Be Affecting Your Child's Health. KidsHealth. 2001 February (cited 2002 March 14).
• MEDLINEplus. Back pain- low. 2001 May 25 (cited 2002 March 14).

See related Patient Topics Back Pain, Bones, Joints and Muscles or Brain and Nervous System.

See related Provider Topics Back Pain, Bones, Joints and Muscles or Brain and Nervous System.

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