What to do if your child is experiencing back pain

Back pain in children is becoming increasingly common. In most cases, the cause of the pain is due to muscular strain and will subside on its own. However, in some cases back pain in children can be a sign of a more serious underlying disorder, therefore early identification and treatment is needed.

So, how do you identify whether your child’s back pain is something that you need to see a medical practitioner about? Well, as a consultant spine surgeon, I specialise in paediatrics and see children and adolescents daily with different back conditions and complaints, so here I have provided an overview of the common signs and symptoms of back pain in children, how you can help, and when to see a specialist. 

Muscular strains

Muscular strain is the most common cause of back pain in children. This is usually due to children carrying very heavy school bags or twisting and straining their back whilst playing sport. Muscular pain could also be an indicator of tight hamstring muscles, weak abdominal muscles, bad posture and poor conditioning of the muscles in the back.

Common signs that your child is suffering from a muscular strain is pain and stiffness particularly in the lower back which gets worse when they bend, stretch, cough and/or sneeze. Sometimes this pain can go down into the buttocks and the back of the thigh.

Muscular back pain will get better with regular light exercises and stretches to aid flexibility. 

Spinal conditions

Back pain in children can also be a warning sign of a spinal condition – usually caused by an injury particularly if the spine has been fractured, or from a malformation of the spine. Conditions can include:

• Scoliosis – the back curves in an ‘S’ or ‘C’ shape
• Kyphosis –the back rounds and causes poor posture
• Spinal arthritis – usually inflammatory in children and can wear down the cartilage in the spine
• Spondylolysis – a defective bridge of bone at the back of the spine
• Spondylolisthesis – forward slippage of the vertebra
• Herniated disc – which can push onto the nerves in the back
• Stress fracture
• Spinal stenosis – narrowing of the spine usually present at birth in children
• Osteoporosis – rare in children but can weaken the bones.

Children who are suffering from a spinal condition will usually experience a great deal of pain that is aggravated by standing, sitting, twisting and bending and is only eased when rested. In some cases, children can experience numbness and tingling in the legs and weakness, may have trouble walking and also experience bowel and bladder problems.

In conditions like scoliosis and kyphosis, the malformation of the spine is usually noticeable. However, for other conditions such as inflammatory arthritis or a stress fracture there will unlikely be any physical signs to spot. 

Therefore, if you notice your child has an unusual shaped back or is experiencing unrelenting pain and any of the symptoms above you should book to see a specialist straight away. 

Infection

In rare circumstances back pain in children can be a sign of an infection of the bone or disc in the spine. Symptoms include generalised back pain, fever and feeling unwell. 
In most cases, the infection can be treated with antibiotics but occasionally surgery is required if damage to the spinal structure is likely. 

If your child is suffering from back pain alongside a fever, seek medical attention to get a proper diagnosis and treatment plan.

Tumour

Similarly to infections, tumours of the spine are very rare, but can cause back pain. They are often in the middle or lower back and pain is constant and gets worse and worse over time. Night time pain may disturb sleep.

If your child is experiencing extreme pain that continues to worsen and disturbs their sleep, I suggest seeing a specialist, so they can carry out a full examination. 

Summary

In summary, if your child is experiencing back pain, it is most likely to be muscular and will get better with some light exercises, stretching and rest however, it is important to be aware that if they are also suffering from the following symptoms, this could be a warning for an underlying condition and must be reviewed by a specialist:

• fever
• weight loss
• weakness or numbness
• trouble walking
• bowel or bladder problems
• pain that keeps the child from sleeping.

Contact Mr Colin Nnadi at The Portland Hospital, part of HCA Healthcare UK, by calling 020 3733 5928.