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JAMA Pediatrics Patient Page
March 2017

Low Back Pain in Children and Adolescents

JAMA Pediatr. 2017;171(3):312. doi:10.1001/jamapediatrics.2016.3091

Low back pain is often thought of as an adult condition.

However, it is relatively common as children grow older. At 7 years of age, about 1% of children will have experienced low back pain; at 10 years of age, about 6% of children will have experienced low back pain; and at 14 to 16 years of age, about 18% of adolescents will have experienced low back pain. Unfortunately, having low back pain as a child or adolescent is a significant risk factor for having low back pain as an adult.

There are several risk factors for low back pain among children and teens. Children who engage in very little physical activity are more likely to have back pain than children who are more active. However, children who are very active in sports, especially highly competitive sports, are more likely to have back pain. Other risk factors include being female, having a recent growth spurt, having a previous back injury, or having a history of low back pain in the family. Although many people worry about children’s heavy backpacks for school, there is no strong evidence to support heavy backpacks as a cause of low back pain.

Most cases of low back pain in children or adults do not have an identifiable disease, injury, or cause to explain the pain. Research suggests that nearly 80% of cases of low back pain do not have a specific cause. Most back pain is musculoskeletal, which means that it comes from the normal use and strain put on muscles and bones, and is not caused by more serious diseases.

For musculoskeletal pain, there are several ways to help your child be more comfortable:

  • Strenuous exercise that may make the pain worse should be avoided.

  • A heating pad or hot bath may help.

  • Over-the-counter medicines such as ibuprofen may reduce inflammation and pain.

If symptoms such as fever, severe pain, weight loss, numbness, or tingling are present, contact your pediatrician. These uncommon symptoms may suggest that something more serious than musculoskeletal pain may be happening. Pain that is sudden and severe or that wakes your child from sleep is also a reason to seek medical attention. Furthermore, if the pain has been present for 4 weeks or more, it is a good idea to see a physician and have your child undergo a careful physical examination. The most common, and most effective, treatments for nonspecific low back pain are physical therapy and avoiding activities that make the pain worse. Physical therapy focuses on increasing muscle strength in the back and keeping the back flexible. Avoiding repetitive motions allows for healing and proper recovery.

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Conflict of Interest Disclosures: None reported.