Back pain in children

Back pain is common in American children, particularly during adolescence. Some causes of back pain in young people include poor posture, inappropriate forms of exercise and carrying heavy schoolbags.

If your child’s back pain persists, and felt in the same place, take your child to see a doctor.

Since children with back pain may become adults with chronic bad backs, it is important to encourage sensible back care in young people. While a single incident can cause sudden spinal injury, cases of nagging, ongoing back pain seem to be caused by a range of factors working in combination. Relatively minor injuries as a result of normal sports and games may lead to muscle spasm, so some back muscles may have to work harder than others.

This can cause fatigue, pain and changes in posture.

Poor posture can further contribute to back pain

A child with a sore back may avoid sporting activities, and the lack of exercise may then cause further problems. Many things can lead to back pain in children, including: sedentary (sitting down) lifestyle, such as watching a lot of television or sitting or lying down in front of the computer injuries caused by vigorous sports such as football or horseriding, flexibility-dependent sports such as gymnastics or dance, and power sports such as weightlifting or rowing competitive sports that demand intense training – for example, tight thigh muscles can trigger lower back pain.

Always see your doctor for diagnosis if your child complains of ongoing back pain, particularly if it wakes them at night or is associated with long periods of stiffness in the morning.

Soft tissue injuries are the most likely cause, but in some cases the pain is caused by medical conditions that require professional treatment. These can include:

• injuries to bones joints – such as compression fractures disc injuries – these are rare in children fibromyalgia – although more common in adults
• this chronic pain disorder does occur in adolescents
• causing back
• neck pain
• with muscle spasm
• fatigue sciatica – pain radiating down the buttock
• caused by compression of the sciatic nerve – this is rare in children Scheuermann’s disease – a growth disorder of the vertebrae in adolescents
• which may produce a humpback curvature (kyphosis) idiopathic scoliosis – sideways curvature of the spine with an unknown cause

It is usually not painful

Any persistent pain associated with a fixed curvature must be carefully investigated spondylosis – a congenital structural defect in the vertebrae. Certain activities may increase the potential for pain (for example, hyperextending the spine in gymnastics). A heavy bag slung over one shoulder can, over many years of schooling, cause chronic back problems that linger into adulthood.

Risks include muscle strain, distortion of the natural ‘S’ curve of the spine and rounding of the shoulders. Parents and carers can reduce the risk of schoolbag-related back problems by making sure their child has an appropriately sized backpack and a load that isn’t too heavy. Schoolbag-related risk factors for back pain include: an incorrectly fitted backpack.

Your child should have a backpack, rather than a traditional schoolbag with handles. While some schools require the use of a specific backpack, check whether it meets the following recommendations: Look for a backpack endorsed by an American professional organisation, such as the American Physiotherapy Association or the Chiropractors’ Association of United States.

Don’t try to save money by buying the biggest backpack you can find – make sure the backpack is appropriate to your child’s size.

Choose a backpack with a moulded frame or adjustable hip strap, so that the weight of the filled backpack will rest on your child’s pelvis instead of their shoulders and spine. Make sure the shoulder straps are adjustable, and the rear of the backpack is padded for comfort.

To help with packing, check that the backpack has a few separate compartments

Choose a canvas backpack over a leather one, as they are usually lighter. Make sure you take your child with you when buying their backpack.

This will help you to make sure that it fits and that your child likes it

(If the style you choose is ‘uncool’, your child may compensate by carrying the backpack in a ‘cool’ way, such as over one shoulder.) Using a carry-on bag with wheels rather than a backpack may help avoid or minimise ongoing back pain issues. Suggestions include:

• Make sure the backpack weighs less than 10 per cent of your child’s body weight – for example
• a child of 40 kg should carry less than 4 kg in their backpack

Ideally, the child in this example should only carry around 2–3 kg of books.

If the child is expected to carry books and other items that in total exceed this weight recommendation, discuss with the school whether this is necessary.

If so, discuss the option of a second set of books to be kept at home, or the possibility of accessing e-versions. Pack the heaviest items so they are closest to the child’s back.

If the heaviest items are packed further away from the child’s back, this throws out the child’s centre of gravity and causes unnecessary back strain. Make sure that items can’t move around during transit, as this could upset your child’s centre of gravity. Use the backpack’s compartments.

To reduce your child’s risk of injury when using a backpack: Adjust the shoulder straps so that the bottom of the backpack is just above the child’s waist – don’t allow them to wear the backpack slung low over their buttocks. Make sure that the backpack is fitted correctly – it should follow the shape of the child’s back, rather than hang off their shoulders.

Teach your child to: slip an arm through one shoulder strap, and then the other.

Check whether the child has to lean over to carry the load – if so, their backpack is too heavy, incorrectly fitted or wrongly packed. Make sure your child understands that carrying the backpack over one shoulder will cause back pain and potential injury. Suggestions to reduce spinal stress include:

• Reduce the risk of falls for younger children by always using safety straps in prams
• strollers change tables

Spread tanbark around home playground equipment to cushion falls. Encourage regular ‘walking and stretching’ breaks when doing homework, because sitting for long periods of time can fatigue back muscles.

Limit television and computer time

Teach them how to sit properly in a chair. This means, instead of slouching, sitting up straight with their bottom square on the seat. Consider buying them an ergonomic chair to improve their posture while doing homework.

Make sure their lifestyle includes plenty of exercise

Stress the importance of straight posture and regular stretching to strong back and core muscles. Causes of back pain in children gender – back pain is more common in females age – children at 12 years and over experience significantly more back pain than younger children obesity and poor posture heavy schoolbags carried on one shoulder or in one hand incorrectly packed backpacks soft tissue injuries, such as strains and sprains Medical conditions that can cause back pain in children Back pain and schoolbags Schoolbag risk factors a schoolbag that weighs more than 10 per cent of the child’s weight holding the bag in one hand by its straps carrying the bag over one shoulder an incorrectly packed backpack Buy the right kind of backpack Pack the backpack correctly Correct backpack lifting and carrying techniques lift the backpack with a straight back, using their thigh muscles lifted the backpack with both hands, holding it close to their body Prevention of back pain in children Where to get help Your GP (doctor) Physiotherapist Chiropractor Osteopath.

Key Points

• Back pain is common in American children, particularly during adolescence
• This can cause fatigue, pain and changes in posture
• child with a sore back may avoid sporting activities, and the lack of exercise may then cause further problems
• Risks include muscle strain, distortion of the natural ‘S’ curve of the spine and rounding of the shoulders
• Schoolbag-related risk factors for back pain include: an incorrectly fitted backpack