Back & Neck Pain Causes & Risk Factors 7 Causes of Back Pain in Teens and Kids Minor Conditions and When to Worry By Jonathan Cluett, MD Jonathan Cluett, MD LinkedIn Twitter Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Updated on March 21, 2023 Medically reviewed by Laura Campedelli, PT, DPT Medically reviewed by Laura Campedelli, PT, DPT LinkedIn Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults. Learn about our Medical Expert Board Print Back pain is usually considered a problem during middle and older age, but a 2020 study found that more than a third of children and adolescents reported experiencing back pan in the previous year, and almost 9% reported severe back pain in the previous year. Some reasons that back pain in teens and kids occurs include obesity, intense year-round sports activities, and wearing a heavy backpack at school. This article will go over the possible causes of back pain in teens and younger children. You’ll also learn the warning signs that would mean it’s time to call your child’s provider. Verywell / Cindy Chung Understanding the Different Kinds of Back Pain 1 Muscular Pain Muscular back pain is the most common reason for back pain in children and adolescents. They might say their back aches or feels sore and tender. This kind of back pain is often from muscle strains and ligament strains, as well as overuse. Kids that play intense, year-round sports are particularly at risk for these injuries. Problems with posture can also lead to back pain in people of any age and can be a source of long-term discomfort. Children who are overweight or have obesity can also have pain from the stress that extra weight puts on their back muscles, ligaments, and bones. What Spinal Ligaments Do Diagnosing Muscular Pain Tests like X-rays, magnetic resonance imaging (MRI), and other imaging tests are not helpful for diagnosing muscular back pain. If your child does not have other symptoms, your provider probably won’t order these tests. There are downsides to doing more testing than is needed, including exposing a child to a lot of medical radiation. Don’t hesitate to ask your child’s provider why they are ordering a test and if it’s really necessary. How to Avoid Medical Tests You Don't Need Treating Muscular Pain Muscular back pain will usually get better if your child rests. Using heat and ice treatments can also help soothe the ache. In the short term, your child might benefit from physical therapy, stretching programs, yoga, or massage treatment. However, these treatments may not help with long-term back pain. Low Back Muscular Strain 2 Stress Fractures Stress fractures in the spine are common causes of back pain in adolescents. However, your teen might not even realize they are injured, as symptoms can take time to show up. If they do start to feel pain from the fracture, it will probably feel like a dull ache in the place where the break has occurred. They might also notice that the pain gets worse when they’re moving and feels better when they’re resting. What Broken Bones Look Like Types of Stress Fractures The most common type of spinal stress fracture is called spondylolysis. It’s a bone injury that happens in the back of the spinal column. The injury is common in adolescents who do sports that involve repeatedly bending backward (hyperextension), such as gymnastics and diving. What Is Joint Hyperextension? If the stress fracture occurs on both sides of the spinal column, it can become unstable. This condition is called spondylolisthesis or a “spinal slip,” and it can cause alignment problems within the backbones (vertebrae). Teens with this type of fracture may also notice stiffness in their back and legs, which might affect their ability to walk. If the slip is very bad, a teen might start having numbness and tingling in their back or legs. Can You Feel a Broken Bone Healing? Will My Child Need Surgery? Most kids and teens with spondylolysis do not need surgery. Many young patients actually do better with nonsurgical treatments like physical therapy, chiropractic care, and wearing a brace. Surgery is typically reserved for children with pain that doesn’t go away even after many months of trying other options. Children with severe slips that lead to loss of spinal alignment may need surgery as well. Even with treatment, the symptoms of a stress fracture may last into adolescence and young adulthood. The Best Back Braces of 2022 3 Disc Problems A disc herniation of the spine means that the soft cushion between two vertebrae is ruptured. The disc material is squeezed out and can push against the nerves and spinal cord. Can a Bulging Disc Cause Back Pain? In children, the disc material is very elastic, which helps the spine handle unusual forces. As we get older, the discs lose their elasticity and are more likely to rupture. However, discs can rupture in a child’s back if they experience excessive forces (like a traumatic injury). Ruptures can also happen if the discs have an abnormal structure. Symptoms of a disc herniation include: Leg pain Numbness and tingling in the legs Leg weakness Difficulty bending or straightening the spine Disc herniations are much less common in children than in adults. However, when they do happen, they can cause serious problems. Overview of Spinal Disc Herniation Diagnosing and Treating Disc Problems MRI tests can be helpful to diagnose disc herniation. X-rays, on the other hand, will typically be normal. Disc herniations can usually be managed without surgery. However, children and adolescents with severe pain or signs of nerve injury may benefit from surgery to relieve pressure on the nerve. Herniated Disc Symptoms and Diagnosis 4 Spine Infections Toddlers, children, and adolescents can get infections that involve their spines. The symptoms of these infections vary but can include back pain, low-grade fevers, and a general feeling of being sick (malaise). Spinal Meningitis One of the most serious infections of the spine is meningitis. It can be caused by bacteria, viruses, fungi, and other germs. Meningitis that is caused by bacteria is a medical emergency.If your child has back pain and any of these symptoms of meningitis, go to the emergency room right away:High feverStiff neckSevere headacheSensitivity to lightSeizuresVomitingConfusion, behavior changes Diagnosing and Treating Infections Infections of the spinal bones or discs can be hard to diagnose, but there are some key things a provider will look for. Abnormal blood tests showing signs of infection or markers of inflammation will be clues about the cause of your child’s back pain. Imaging tests can be used to help providers figure out where the infection is. If the infection is caused by bacteria, your child will need to have antibiotics. They may need to get them through an IV instead of by mouth. Surgery is only considered if the infection has damaged the spinal cord, is not getting better with antibiotics, or other complications develop. Why Kids Might Need to Take Antibiotics 5 Alignment Problems If your child’s spinal alignment is abnormal, it can cause back pain. It may change how your child’s back looks as well. Sometimes, the deformities are easy to see but don’t cause pain. The two most common spinal deformities in children are: Scoliosis is a deformity that causes an S-shaped curve in the spine. You can see the deformity when you look at your child’s back. Scheuermann’s kyphosis is a condition that causes a sharp bend in the spine. You can see the shape when you look at your child from the side. A provider can measure the curve of your child’s spine by taking X-ray or MRI images. Measuring Cobb Angle to Diagnose Scoliosis Will My Child Need Surgery? While these two conditions are very different, the treatments are similar. If the deformity is severe, a child may need to wear a back brace. Surgery is only considered for severe deformities. However, deformity of the spine may remain after surgery, as a full spinal correction can cause more problems than a partial one. Encouraging Your Child to Wear a Scoliosis Brace 6 Tumors Several noncancerous (benign) and cancerous (malignant) bone tumors can occur in the spinal column. While spinal tumors are a very uncommon cause of back pain in children and teens, a provider may still consider them a possibility. Some tumors cause a lot of pain, while others may not cause any symptoms. Some of the “red flag” signs that can happen with back pain caused by a tumor are pain at night, generalized illness, or weight loss.If a child has these symptoms, their provider may want to order tests to look for a tumor. Can Cancer Cause Lower Back Pain? Treating Spinal Tumors The treatment for spinal tumors depends on the type of tumor. Even tumors that are not cancer may require surgery because they can lead to spine deformities. Cancerous tumors in the spine often need a combination of treatments, including medications, radiation, and surgery. Spinal Cord Compression from Tumors 7 Kidney Infections A child may complain of lower back pain if they have a kidney infection (also called pyelonephritis). Most kidney infections in children are caused by a bacterial urinary tract infection (UTI) that has spread from the bladder to the kidneys. About three in 100 children develop a UTI each year. Some factors that increase the chances of bacteria entering or staying in the urinary tract include: Wearing tight fitting clothesTaking bubble bathsWiping from back to frontNot peeing enough during the dayAbnormal structure of the urinary tractBrain or nervous system illnessesHaving a condition called vesicoureteral reflux, which is when urine flows back up into the urethra and kidneys In addition to back pain, children may also experience fever, appetite changes, and belly pain. They may also urinate more often, feel like they have to urinate more often, and experience pain when urinating. Treating a Kidney Infection A urine sample is needed to diagnose a UTI in a child. In young children, a urine sample may be collected by a catheter or a needle placed into the bladder that collects urine. If your child is diagnosed with a UTI, they will need to take antibiotics right away. Kids who can't swallow a pill can take antibiotics in liquid form or as a chewable tablet, and children younger than two may need to go to the hospital to take it intravenously. The length of treatment depends on the severity of the symptoms, whether the child has had a UTI before, and how long the symptoms take to go away. Does My Child Need to See a Provider for Back Pain? There are many reasons a child can have back pain. While it can be something minor like a pulled muscle, back pain can also have a more serious cause. Back pain is more likely to point to a serious problem in kids than it is in adults. This is especially true if a child’s back pain does not get better in a few days or starts to get worse. Call your child’s provider if your child: Has back pain and is age 4 or younger Has pain at night (especially if it wakes them up) Has constant pain or pain that lasts for more than several weeks Has pain that shoots down one or both legs When to Go to the ER Seek emergency care if your child has back pain along with these symptoms: Fever, chills, malaise Weight loss without trying Weakness, numbness, or trouble walking Problems controlling their bladder or bowels Back Pain "Red Flags" to Know Summary While it’s not as common as it is in adults, back pain can be a problem for kids and teens. Children who play sports, lug heavy backpacks at school, or are at a higher body weight are more likely to have back pain. Muscular injuries, stress fractures, and disc herniations are common reasons that young people have back pain. Less commonly, serious conditions like spinal infections and tumors can cause back pain in kids. In these cases, there are usually “red flag” symptoms in addition to back pain. Talking to Your Provider About Back Pain A Word From Verywell If your child has back pain, it’s natural to be concerned. As their caregiver, you don’t want to see them be uncomfortable or have to miss out on their favorite activities. That said, most causes of back pain in kids and teens will get better if they take it easy and rest. However, if your child’s back pain isn’t getting better, is getting worse, or they have other symptoms that are troubling, it’s time to call their provider. How to Prevent Back Pain from Becoming Chronic 14 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Fabricant PD, Heath MR, Schachne JM, Doyle SM, Green DW, Widmann RF. The epidemiology of back pain in American children and adolescents. Spine (Phila Pa 1976). 2020;45(16):1135-1142. doi:10.1097/BRS.0000000000003461 Patel DR, Kinsella E. Evaluation and management of lower back pain in young athletes. Transl Pediatr. 2017;6(3):225-235. doi:10.21037/tp.2017.06.01 American Academy of Orthopaedic Surgeons. Back pain in children. Garet M, Reiman M, Mathers J, Sylvain J. Nonoperative treatments in lumbar spondylosis and spondylolisthesis. Sports Health. 2013;5(3):225-232. doi:10.1177/1941738113480936 American Academy of Orthopaedic Surgeons. Herniated disk in the lower back. Tyagi R. Spinal infections in children: a review. J Orthop. 2016;13(4):254-258. doi:10.1016/j.jor.2016.06.005 Centers for Disease Control and Prevention. Bacterial meningitis. American Association of Neurological Surgeons. Scoliosis. Sardar ZM, Ames RJ, Lenke L. Scheuermann’s kyphosis: diagnosis, management, and selecting fusion levels. J Am Acad Orthop Surg. 2019;27(10):e462-e472. doi:10.5435/JAAOS-D-17-00748 De la Garza Ramos R, Goodwin R, Abu-Bonsrah N, et al. Patient and operative factors with complications following adolescent idiopathic scoliosis surgery: an analysis of 36,335 patients from the Nationwide Inpatient Sample. J Neurosurg Pediatr. 2016;18(6):1-7. doi:10.3171/2016.6.PEDS16200 DePalma MG. Red flags of low back pain. JAAPA. 2020;33(8):8-11. doi:10.1097/01.JAA.0000684112.91641.4c Nationwide Children's. Pyelonephritis. National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts about bladder infection in children. MedlinePlus. Urinary tract infection - children. By Jonathan Cluett, MD Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit