Back pain in children

Overview

Back pain in children is a pain or discomfort in the back area, from the neck down to the tailbone. It’s less common in children than in adults, but it can happen and is usually not serious.

Back pain in children is not as common as in adults, but it affects many children, especially during the teenage years. About 1 in 5 children may experience it at some point.

It can affect children of any age, but it is more common in teenagers, especially those who are very active in sports or carry heavy school bags.

Symptoms

Common symptoms

• A dull ache or stiffness in the back
• Pain that gets worse with activity, like running or bending
• Mild pain that goes away with rest

Symptoms in children

• Complaints of back pain after physical activities or sports
• Shifting posture to avoid pain, like leaning to one side
• Irritability or trouble sleeping due to discomfort

Symptoms in older adults

• Not applicable – this article focuses on children

Causes

Main causes

• Muscle or ligament strain from overuse, sports, or awkward lifting
• Poor posture, such as slouching while sitting or standing
• Carrying a heavy backpack improperly (e.g., on one shoulder)
• Injuries from falls or accidents

Risk factors

• Being overweight or having weak core muscles
• Spending long hours sitting in front of a computer or at school
• Heavy backpacks that weigh more than 10–15% of the child’s body weight
• Playing contact sports or doing high-impact activities without proper training

When to see a doctor

See a doctor urgently if:

• If your child has any of the emergency symptoms listed above, seek immediate medical help.
• If back pain follows a serious injury like a car accident or fall from height.

Book a routine appointment if:

• If back pain lasts longer than a week with home care
• If the pain is getting worse or interfering with school or daily activities
• If you are worried about your child’s back pain, even if it seems mild

Diagnosis

A doctor will start by asking about your child’s symptoms, activities, and any recent injuries. They will then perform a physical exam, checking the back for tenderness, flexibility, and strength.

Tests that may be done

• X-rays to look at the bones of the spine
• MRI or CT scans if more detail is needed, especially if nerve problems are suspected
• Blood tests if an infection or inflammation is possible

What to expect at your appointment

The doctor may ask your child to move in different ways to see what hurts. They will also check reflexes and strength in the legs. Most children do not need any special tests. The doctor will explain the findings and recommend next steps.

Treatment

Most back pain in children is treated with simple home care and lifestyle changes. The goal is to relieve discomfort and help the child return to normal activities.

Self-care at home

• Rest for a day or two, but avoid prolonged bed rest – gentle movement helps healing
• Apply ice packs for the first 48 hours, then heat packs for muscle relaxation
• Encourage good posture when sitting, standing, and sleeping
• Use a backpack with both straps and adjust so it fits snugly

Medical treatments

If home care is not enough, a doctor may suggest over-the-counter pain relievers (such as paracetamol or ibuprofen) to be used as directed by a healthcare professional. In some cases, physical therapy may help strengthen back muscles. For more stubborn pain, a child might see a specialist like a paediatrician or orthopaedic surgeon.

When is surgery considered?

Surgery is rarely needed for back pain in children. It may be considered only if there is a specific structural problem, such as a slipped disc or spine deformity, that does not improve with other treatments.

Living with this condition

Help your child maintain good habits to manage back pain. Encourage them to take breaks from sitting, use a supportive chair, and avoid carrying heavy loads.

Lifestyle tips

• Promote regular physical activity to keep back muscles strong
• Ensure a healthy weight to reduce stress on the back
• Teach proper lifting techniques (bend at the knees, not the back)

Diet and exercise

A balanced diet with enough calcium and vitamin D supports bone health. Exercise like swimming, walking, or yoga can gently strengthen the back and reduce pain.

Mental health and emotional wellbeing

Chronic pain can affect a child’s mood and school life. If your child feels frustrated or worried about the pain, talk to them and consider speaking with a counsellor or psychologist who works with children.

Prevention

Many cases of back pain can be prevented by encouraging good posture, using backpacks correctly, staying active, and maintaining a healthy weight. Teach your child to listen to their body and avoid overdoing it.

Complications

If left untreated

• Rarely, underlying issues like an infection or spine problem could worsen if ignored
• Prolonged pain may lead to missed school or reduced physical activity

Long-term outlook

The outlook for children with back pain is generally very good. With simple steps, most children recover fully within a few weeks and return to all their usual activities. Even in rarer cases where there is a specific cause, treatment is usually effective and children do well.

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