Back pain is a common source of pain in adults, but it is being more frequently diagnosed in children and teenagers as well. Most parents don’t expect their usually healthy children to complain about back pain. However, back pain can also occur in children and teenagers.

Some reasons that back pain is becoming more common in children include higher average body weights, higher rates of obesity, higher intensity and year-round sports, and the increasing weight of backpacks that students have to carry. 

Some of the worries around back pain include knowing when the problem might be more serious than an injury and when specialized tests might be in order. There are warning signs to watch for to help you tell when back pain might be a more serious issue. 

Warning Signs To Know

Every parent who has a child with back pain worries that there might be a more serious problem. There are serious cases of back pain, but most back pain in children and adolescents is caused by muscle or ligament injury, with no structural abnormality. 

Some of the warning signs of a more serious problem that you should look out for include:

  • Night pain, especially pain that wakes your child up
  • Constant symptoms of pain
  • Symptoms of illness, such as fever, chills, malaise, or weight loss
  • Symptoms in very young children
  • Leg pain, numbness, or weakness

These warning signs don’t always mean that there is a more serious issue, but they are a good way to tell if more tests should be carried out. For example, muscular back pain can persist for months, but if the symptoms have been going on for several weeks, it’s a good idea to investigate either. 

Muscular Back Pain

Muscular back pain is the most common cause of back pain in young people. Common injuries include muscle strains, ligament strains, overuse injuries, posture problems, and poor conditioning of the muscles in the back. 

In most cases, imaging, like x-rays and MRIs, aren’t useful for making this diagnosis, and tests like this are not usually needed unless there are other symptoms. 

As with any test, there are downsides to excessive testing, such as exposure to radiation or tests that lead to more unnecessary testing or procedures, so talk to your doctor about what the value of doing any specific imaging study would be. 

In most cases, muscular back pain will respond to rest and changes to daily activity. Many treatments will give temporary relief, but long-term effects of treatments are debatable, although usually safe. These treatments include physical therapy, chiropractic treatment, stretching programs, yoga, or massage treatment. 

Stress Fractures

Stress fractures can happen in the spine. In most cases, these stress fractures happen in adolescents, and these teenagers might never know that an injury has happened. Over time, signs of the stress fracture might begin to show. 

The most common kind of spinal stress fracture is called a spondylolysis, which is an injury to the bone in the back of the spinal column. This injury is most common in teenagers who do sports that involve repetitive bending backward, like gymnastics and diving. 

If the stress fracture happens on both sides of the spinal column, this can make the spinal column unstable, which is called spondylolisthesis. This is sometimes known as a spinal slip and can lead to a shift to the vertebral column alignment.

Stress fractures can be a worry because these injuries don’t heal. They can cause symptoms well into adolescence and young adulthood. However, most children and teenagers who suffer from spondylolysis are treated without surgery and do better with less-invasive treatments. 

Surgery is usually only needed for those who have persistent pain even after lots of nonsurgical treatment or for those who have severe slips leading to loss of spinal alignment. 

Long-term studies show that the chance of having back pain in adulthood isn’t usually changed by a stress fracture in childhood. This can be a source of later problems, but the chance of developing back pain in adulthood is not changed much by spondylolysis as a child. 

Alignment Abnormalities

Problems with the alignment of the spine can cause a deformity that is noticeable and might be associated with back pain. However, more subtle deformities, while noticeable, usually don’t cause issues with pain. 

The most common spinal deformities in children are scoliosis and Scheuermann’s kyphosis. Scoliosis is a deformity that causes the spine to take on an S-shaped curve, which can be seen from the back. You can learn more about scoliosis from the Southwest Scoliosis Institute. Scheuerman’s kyphosis causes a sharp bend in the spine which can be seen from the side. 

These two conditions are different, but the treatments aren’t dissimilar. With less severe deformities, observation is the best first treatment. If the deformity later progresses to a more problematic level, which is determined by measurement of angles seen on X-ray images, a brace might be needed for treatment. 

Surgery is only needed as a treatment for these conditions for the most severe deformities. Even when surgery is considered, a deformity of the spine can carry on, as the full correction of the deformity might cause more problems than just a partial correction. 

Back pain in children and teens is not that unusual and is becoming more common. This is partly due to changes in the activities of most children, and partly due to changes in the conditioning of children. 

If your child has back pain, especially if it comes with any other warning signs, it’s worth having them checked over by your doctor. 

Getting the proper treatment and making sure symptoms are progressing in the right way can help to make sure that the problem doesn’t keep causing pain. If the symptoms are unusual or concerning, further tests might be in order to check a more unusual condition is not the cause. 

The good news is, the majority of children with back pain find lasting relief. Back pain can interfere with sports and other activities, but with proper treatment, children almost always return to full health with no ongoing discomfort.