Although back pain is less of problem in children than adults, it is not completely rare. Most often, back pain in children and adolescents will improve by itself, or with rest, analgesics (such as ibuprofen) and sometimes, physical therapy. However, back pain that doesn't go away may require further investigation and possibly surgery.
The Children's Hospital of Philadelphia's orthopedic spine team uses the following to help determine the source of the back pain:
There can be several reasons that a child or adolescent has back pain.
Pain with activities can occur with scoliosis, but it is rarely disabling. Most children or adolescents can be helped with physical therapy. Severe pain in young patients with scoliosis is uncommon and urgently needs to be investigated.
A stress fracture is the usual cause of the low back pain experienced with these spinal problems. The pain occurs in otherwise healthy children or adolescents, and usually happens with vigorous activity. Most of these patients can be managed with nonoperative treatment such as pain relievers. However, in some cases surgical treatment is necessary to provide pain relief. When surgery is necessary, the procedure will most likely be a short spinal fusion, or less commonly, a reconstruction of the stress fracture.
Sometimes one of the discs that cushions the vertebrae ruptures or herniates. This puts pressure on the spinal nerves or the spinal cord. Although less common than the disc problems observed in adults, adolescents do develop disc disease. This can lead to considerable pain and disability. Long lasting, unrelieved pain may require surgical removal of the disc.
Pain also can be caused by an infection that involves the disc space, vertebra or the posterior part on the pelvis. Once diagnosed, the infection usually responds to medications. If diagnosis has been delayed, an abscess can develop. This would then require surgical drainage. Most often, recovery is complete.