Back pain in children and teens

Adults aren't the only ones who suffer from back pain. Children and teens – particularly those who participate in competitive sports – are also likely to experience upper or lower back pain. In fact, one study found that as many as one in three adolescents ages 10 to 18 experienced back pain in the past year.

Troy Smurawa, M.D., Director of Pediatric Sports Medicine at the Children's Health℠ Andrews Institute for Orthopaedics and Sports Medicine, points to the repetitive twisting and straining associated with competitive sports as one of the most common causes of back pain in children and teens.

"Back pain in adolescents is usually caused by a structural injury – something has happened to the spine," explains Dr. Smurawa. "Simple muscle strains, the most common cause of back pain in adults, are less likely to happen to children and teens."

Dr. Smurawa shares his insight on common causes of lower and upper back pain and how children and teens can prevent back injuries.

Causes of lower back pain in children and teens

Teenage athletes are more likely to develop low back pain, typically caused by overuse – such as repetitive twisting, rotating or hyperextension (bending backward). This movement is common in many sports, including:

• Dancing

• Football

• Gymnastics

• Soccer

• Volleyball

• Weight lifting

Repetitive movements that stress the spine can eventually lead to spondylolysis or a PARS stress fracture. Spondylolysis occurs when small cracks appear in the vertebra or other parts of the spine, such as the pars interarticularis. This is one of the most common causes of low back pain. Symptoms of spondylolysis include:

• Localized pain

• Pain on one or both sides of the spine

• Constant, achy pain that worsens with activity

Low back pain can also cause a posterior element overuse injury. This injury affects the muscles and ligaments along the spine and is caused by repetitive twisting and hyperextension. However, it does not cause structural damage to the spine like in spondylolysis.

Less common causes of lower back pain in teens and children can also include:

• Disc herniation

• Infection

• Traumatic back injury

• Tumor

Causes of upper back pain in children and teens

Upper back pain, while not as common in adolescents, is generally caused by one culprit: – rounding of the upper back due to poor posture.

"Most of the upper back pain we see is caused by poor posture related to technology," explains Dr. Smurawa. "Parents see this all the time in their children. They're hunching over phones to text, slouching down while playing video games or bending over a computer for school work."

Proper posture can help relieve back pain and prevent it from occurring in the first place.

Upper back pain can also be caused by:

• Infection

• Trauma

• Scheuermann's kyphosis

How is back pain treated?

The first step in treating back pain is to treat the symptoms. Over-the-counter anti-inflammatories, ice and rest can help relieve symptoms and reduce swelling.

"Back pain in kids and teenage athletes often improves in a few days or weeks with rest and care at home," reassures Dr. Smurawa. "It's very uncommon to need surgery at this age."

Physical therapy, exercise programs and sometimes a back brace can help the back heal and even prevent further injuries if at-home care doesn't help relieve pain.

When should children and teens see a doctor about back pain?

Contact a doctor if back pain does not improve within three weeks. Younger children (under age 8) who experience back pain with no known history or recent injury should be examined by their pediatrician sooner rather than later.

"The best thing to do for children or teens with back pain is to see your child's pediatrician or family practitioner," says Dr. Smurawa. "They can treat a lot of simpler injuries or conditions, and if needed, refer your child to a specialist."

If your child experiences fever or a rash with back pain, contact your pediatrician immediately. These may be signs of a more serious injury or infection.

How can back pain be prevented?

Back injuries, including those caused by overuse, can be prevented. Teenage athletes can reduce their risk of back pain and injury with a few simple steps:

• Prepare for upcoming seasons with proper conditioning

• Strengthen the core and hips to support the back

• Learn the proper technique for sports and weight lifting

• Pay attention to posture at all times

Dr. Smurawa also cautions parents to keep a close eye on young athletes during growth spurts.

"An athlete's flexibility and muscle balance can decrease during a rapid growth spurt, which leads to instability of the spine," he explains. "This can ultimately increase a teen's risk of back injury and pain."

Females tend to experience growth spurts between the ages of 12 and 14 years old. Girls also tend to grow more slowly and may not even notice they have grown. Boys, on the other hand, experience growth spurts later – any time throughout high school – but are more aware of their growth.

"Shoe size will change before height, so when kids suddenly outgrow their shoes, it may be a sign of an upcoming growth spurt," Dr. Smurawa says – adding with a laugh, "or, a skyrocketing grocery bill may also signal a growth spurt is around the corner."

Learn more

The team at Children's Health Andrews Institute for Orthopaedics & Sports Medicine can help athletes recover from a back injury and create a plan to prevent future injury. Learn more about our wide range of orthopedic and sports medicine services.

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