Back Pain

Usually, back pain in children is not caused by a serious condition.

Children and teenagers may feel pain in their backs if they have been carrying something heavy, such as a backpack or a laundry basket. (Research studies do not clearly tell us if carrying a backpack hurts children’s backs.)

They may hurt their backs if they fall while running or playing or if they are injured during sports.

Both children and adults are less likely to have back pain if they do regular aerobic activity, such as running or playing hard enough to get out of breath, for a half-hour or so 3 to 4 times a week.

• The Spine Program team includes doctors, surgeons, physician assistants and nurse practitioners from Orthopedics and Sports Medicine who are skilled at evaluating and treating back pain.
• We take care to find out what is causing your child’s back pain. Our experts do a careful evaluation to understand your child’s condition, how it affects your child and whether it’s linked with other health concerns.
• We offer your child the support of an entire medical center. Based on your child’s needs, we involve specialists from other areas of Seattle Children’s, such as Adolescent Medicine, Rehabilitation Medicine, Rheumatology, Neurosurgeryand Pain Medicine.

• When we evaluate your child’s back pain, design their treatment and provide their care, we consider your child’s needs based on their age.
• The team from our Spine Program is trained not only to treat back pain, but also to care for all types of spine problems in children and teens, whose bodies are still developing.
• If your child needs imaging that uses radiation, we use the lowest amount possible to produce the best image. We also have a low-dose radiation X-ray machine, called the EOS, for safe full-body images, and the largest group of board-certified pediatric radiologists in the Northwest.

• We believe that surgery is not necessary for most back problems in children.
• Nonsurgical treatment commonly means bracing, medicine, physical therapy or rest. We have on-site orthotists, who build and fit braces, and on-site physical therapy.
• If your child does need surgery, our pediatric orthopedic surgeons have expanded fellowship training in spine problems and have a national reputation for excellence in all types of spine surgery.
• We have the technology and expertise to perform spine surgery using precise CT (computed tomography) guidance, as well as using X-rays during surgery.
• Our surgical spinal cord monitoring team leads the country in developing new techniques for making back surgery safer. Neuromonitoring helps us prevent a spinal cord injury during surgery.

For most children, back pain goes away after a few days of rest.

In young children, back pain usually does not limit activity for more than 1 or 2 days.

An increasing number of teenagers complain of ongoing (chronic) back pain. Up to 30% of teens have times when back pain is bad enough to limit their activities for a few days to a few weeks.

Our team will ask about your child’s medical history, and we’ll ask questions like these to find out what is wrong:

• How bad is the pain? Does it prevent your child from sleeping at night, going to school or playing? Does your child have to stop participating in sports or other activities they enjoy?
• How long has your child had back pain?
• Is the back pain worse early in the day or late in the day?
• Does your child feel numbness, tingling or weakness in their legs?
• Has the back pain changed bladder control or bowel movements?
• Has your child lost a lot of weight or had a high fever along with the back pain?

We will assess your child’s nervous system, check their reflexes and perform other tests. We may ask that your child have X-rays.

After reviewing the X-rays, the exam results and your child’s symptoms, we may ask your child to have more tests to evaluate their back, including:

• Blood tests to check for arthritis
• Bone scan to look for inflamed areas in the bones of the spine
• MRI (magnetic resonance imaging) scan to look at the spinal cord and other structures of the spine that are not bone

Most children who have back pain are helped with:

• Bracing
• Medicines that reduce pain and swelling (anti-inflammatories)
• Physical therapy
• Rest

Children rarely need surgery for back pain. Your child might need surgery if their pain is related to a more complex condition, such as spondylolisthesis or a benign tumor.