Back Pain

What is it?

Back pain is pain anywhere in the back form the neck to the low back. Most back pain in children is related to activity and overuse of the muscles that are in the back. Pain can also occur acutely during sporting events if a child has an injury during practice or game. Here in Colorado back pain may be related to an injury or fall during skiing or snowboarding. Not all low back pain is actually due to a problem in the back. There are occasions when back pain is caused by a problem with the hip joint or musculature. Back pain can also be caused by fracture, arthritis, disc problems, or bony malalignment. If a child has persistent back pain, changes in bowel or bladder habits, night waking pain, fevers or weakness, numbness or tingling, contact your doctor for evaluation.

What are the Symptoms?

Symptoms of back pain can be different for each individual child. Some of these include:

• Increasing pain with bending or movement, including participating in sports
• Relief of pain with rest
• Relief of pain with anti-inflammatory medication
• Pain that travels down the buttocks and leg or down the arms and fingers
• Numbness or tingling in the legs, feet, hand or fingers

How is it Diagnosed?

Usually back pain is diagnosed by your primary care physician. If your doctor has concerns about your child’s pain then he or she may send the child to Children’s Orthopedic Department for evaluation. Back pain is often simply diagnosed by the symptoms the child is having and by a complete physical exam. Tests of your child’s movement, strength and a neuromuscular exam will help the doctor to determine the cause of the pain. 

How is Back Pain Treated?

The majority of injuries to the back are related to the muscles and are thus, treated conservatively. The doctor will usually begin with a series of x-rays to be certain that there is no bony abnormality which is the cause of your pain. If the bones are unaffected and there are no other physical findings that are concerning to the doctor, he or she will begin your conservative treatment which will last between 4-8 weeks. This means using ice/heat, anti-inflammatory medications, rest and in many cases Physical Therapy will be prescribed.

If a child has no relief of pain with conservative therapy, or his or her symptoms are worsening, then the pain may be caused by another underlying problem. In these cases, your Orthopedic doctor may ask you to get an MRI (Magnetic Resonance Imaging), or CT (Computed Tomography). He or she may also order a blood draw to check lab values on your child for infection or other problem. These tests will help identify other causes of pain such as pinched nerve, bulging disc, infection or a growth on the spine.  Based on the findings of further testing, a treatment plan can then be determined. 

It is very uncommon for a child to need surgery for back pain.  Your doctor will determine if that is necessary.