My child’s back hurts – what’s next?

My child’s back hurts – what’s next?

by Jason Determann, MD

Low back pain, while more common in adults, is almost equally prevalent in our pediatric population. Common causes include a variety of diagnosis; from muscle strains to scoliosis to disc problems. A pertinent history and physical exam can rule out most serious causes of low back pain. In most cases of nonspecific back pain, home-based exercise, physical therapy, and anti-inflammatory drugs can fix the problem. Either way, we are here to help.

Does carrying a heavy backpack lead to back problems? Short answer is no. Nonspecific low back pain in school-age children seems more influenced by psychosocial difficulties, conduct issues, and somatic disorders than it does mechanical problems, such as carrying a heavy backpack or long-term computer use. Nonetheless, the American Academy of Pediatrics recommends backpacks not to exceed 10-20% of the child’s body weight.

As a parent, the first step is asking your child to try to characterize the pain. Where is it located? When did it start and how long as it been going on? Is it constant or intermittent? What makes it better or worse? Also try to think if there any other symptoms that coincide with the onset of pain – fevers, poor appetite, weight loss or other symptoms that may or may not be related to your child’s aching back.

Acute back pain can be caused by muscle strains, herniated disks, and spondylolysis (a stress fracture or defect in the arch of the vertebral bone.) Chronic conditions can include inflammatory conditions, alignment problems (such as scoliosis or Schermann’s kyphosis.) Systemic symptoms can be associated with some rare causes of back pain, such as tumors or infections.

It is recommended that you schedule an appointment with your child’s healthcare provider if any of the following are present:

  • < 4 years old
  • Systemic symptoms (fever, malaise, etc.)
  • Nighttime pain
  • Neurologic symptoms (pain radiates into legs, numbness, etc.)
  • Self-imposed activity limitations

With a physical exam, we consider spinal alignment and mobility, tenderness, and neurological aspects.  Standard x-rays may be performed to help rule out any bony problem associated with your child’s condition. Depending on those results, bloodwork and other analysis may be involved.  Not all back pain involves this level of diagnosis, but serious conditions do exist. We’re here to help sort things out.

Jason R. Determann, MD

Dr. Determann received his MD from Louisiana State University in New Orleans, followed by residency in Orthopaedic Surgery at the University of Alabama in Birmingham.  He is Board Certified and Fellowship Trained in Sports Medicine with a specialty in Shoulder & Elbow Surgery.