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).

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