Back Pain in Kids and Teens

 Back Pain in Kids and Teens

There are several unique aspects to consider when back pain occurs in a child or teenager. In rare cases, back pain may be a sign of a serious underlying condition that requires prompt medical attention.1

Back pain in children and adolescents may increase with age and typically affects girls more than boys.2

This article provides comprehensive information about back pain in children and teens, including the probable causes, diagnostic considerations, and available treatment options, to help parents and caregivers understand and support kids with this symptom.

Common Risk Factors for Back Pain in Kids and Teens

The most common risk factors for back pain in children and teens include sports participation; obesity; a sedentary lifestyle; and a family history of lower back pain, smoking, and/or psychological stress. For example, children and teens with a positive family history of lower back pain are almost twice as likely to experience back pain in childhood or adolescence versus their counterparts with no relevant family history. Evidence suggests that those with lower back pain in childhood are at higher risk of developing lower back pain in adulthood.3

School-age children who complain of back pain typically also have high levels of psychosocial difficulties, such as emotional distress and problems with behavior and/or everyday functions.1

Lower Back Strain Video Posterior view of the lower spine with a slight curvature.

A common cause of back pain in children is lower back strain, also referred to as a pulled muscle, which is caused by damage to the muscles and ligaments of the lower back. Watch Lower Back Strain Video

Typical Characteristics of Back Pain in Children and Adolescents

Depending on the underlying cause, pain may be restricted to a localized area of the back or may include the entire upper and/or lower back region. The common, benign causes of back pain in kids and teens generally have the following characteristics2:

In the initial stages, back pain in childhood and adolescence typically occurs with low intensity, and the pain commonly lasts for less than a week.

There is usually a high rate of recurrence of back pain within this specific age group.

When the pain recurs, it typically resurges with greater intensity.

There may be limitations in carrying out daily activities, missed school days, and the reduction of or hesitancy in performing physical activity.2

Types of Back Pain in Kids and Teens

Based on the underlying cause, a few types of back pain experienced by children may include1:

Acute pain. A sharp, stabbing, and/or shooting pain may occur in event of an injury, trauma, fracture of the vertebra or vertebral growth plate, or herniated disc.

Chronic pain. A constant ache, pain that comes and goes, or posture-related pain may occur due to inflammatory spondyloarthropathies, psychological issues, or developmental problems, such as Scheuermann's disease.

Pain that worsens with spinal movement. Flexion (forward bending) increases pressure on the front part of the spinal bones, aggravating pain from conditions such as a herniated disc, discitis, osteomyelitis, or vertebral body tumor.

Extension (backward bending) of the spine increases the strain on the posterior part of the spinal bones, including the facet joints, pars interarticularis, and pedicles. A lesion or injury, such as an osteoid osteoma, osteoblastoma, or spondylolysis, in this area can cause pain while bending backward.

Night-time pain. Frequent pain that occurs at night and awakens the child is typically associated with tumors or infections, such as osteomyelitis, discitis, osteoid osteoma, osteoblastoma, eosinophilic granuloma, aneurysmal bone cyst, leukemia, Ewing's sarcoma, or spinal cord tumors.