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Pediatric Health

Understanding Back Pain

Warning signs and treatment options

October 01, 2011
If your child complains about or shows signs of back pain, it could be caused by a wide variety of issues. The most common cause is muscle sprain and strain. Less common reasons might include vertebrae (spinal bone) abnormalities, infections, arthritis and, rarely, cancer. Here's what to watch for and when you should call your Healthcare provider.

Back Pain by Age Group

Different age groups experience different causes for back pain.

Normally, infants and toddlers don't experience muscle strains or sprains. Their back pain could be caused by:

• Severe constipation

• Urinary tract infections (UTIs), especially in girls

• Discitis, an infection between the bones in the spine

• Meningitis, which can cause high fevers, headaches and neck pain

• Infections, which can spread and cause abscesses on the spinal cord

• Tumors that develop from the neural system, but this is rare

Generally, school-aged children have different problems although UTIs may be the cause. Other reasons may be:

• Spondylolysis, which is a stress fracture in one of the bones (vertebrae) that make up the spinal column. It can be caused by genetics, overuse (from sports such as gymnastics or wrestling), or both.

• Tight hamstrings in boys because of rapid growth

• Leukemia or bone tumors—but this is rare

Teenagers can experience many of the same symptoms as school-aged children. Other sources can be:

• Back pain from backpacks—due to weight or carrying it on one shoulder

• Obesity, as body fat can pull the spine forward

• Adult forms of back pain from muscle strains and sprains.

Treating Muscle Sprains and Strains

If your child has back pain but none of the warning signs described below, you may want to treat the back pain at home first. If there's no improvement, contact your child's healthcare provider.

Home treatments can include:

• Non-prescription pain medications, such as acetaminophen (e.g., Tylenolฎ) or ibuprofen (e.g., Advilฎ)

• Heat using a heating pad, hot water bottle or other hot pack

• Continuation of regular activities and light exercise that do not cause pain

Warning Signs

Here are signs you should watch for. Contact your healthcare provider if your child is less than 5-years-old or has one or more of the following symptoms with the back pain:

• Severe pain, occurs at night or wakes the child from sleep, or worsens over time

• Fever (temperature of 100.4บ F or higher)

• Weight loss

• Leg weakness, walking with a limp, or refusing to walk

• Recent injury

• Change in bowel or bladder control (e.g., new accidents)

• Unable to participate in normal activities.

For more information, visit www.RileyHospital.org.

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Dr. Suzanne Bowyer, director of Pediatric Rheumatology, Riley Hospital for Children at Indiana University Health

Tags: In This Issue, Health, Parenting

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