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Back Pain - Allied Physicians Group - Pediatric Medicine
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    • Pain or discomfort in the upper, mid or lower back
    • Minor muscle strain from overuse and back injury are included

    First Aid for Suspected Spinal Cord Injury:

    • Don’t move your child until a spine board and neck brace are put on.


    • Strained back muscles cause most of these symptoms:
    • The pain is in the middle or lower back
    • The pain is made worse by bending
    • The muscles near the spine are tender to the touch
    • The muscles may be tight (in spasm)


    • New backaches in teens are mostly from strained back muscles (muscle overuse). There are 200 muscles in the back that allow us to stand upright.
    • Triggers are carrying something too heavy or lifting from an awkward position. Bending too far backward or sideways can cause back pain. Digging in the garden for too long causes overuse of back muscles.
    • Sciatica is pain caused by a pinched nerve in the lower back. Sciatica gives a burning pain in the buttock without back pain. The pain shoots into the back of the leg. The most intense pain can be in the lower leg and foot. Leg weakness, numbness or tingling can also occur. Sciatica is rare in children but common in adults.

    Pain Scale

    • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
    • Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
    • Severe: The pain is very bad. It keeps your child from doing all normal activities.

    When to Call Us for Back Pain

    Call 911 Now (your child may need an ambulance) If:

    • Pain starts after major injury (such as a car crash or football). See FIRST AID. (Caution: Do not move your child until a spine board is put on.)
    • You think your child has a life-threatening emergency

    Call Us Now (night or day) If:

    • Your child looks or acts very sick
    • Can’t pass urine or can only pass a few drops
    • Can’t walk or can barely walk
    • Pain is SEVERE
    • Pain shoots into the buttock or back of the thigh
    • Tingling or numbness in the legs or feet
    • Blood in urine
    • Pain or burning with passing urine and fever
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently
    • Pain or burning with passing urine, but no fever
    • Fever
    • Walks different than normal for more than 3 days

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • Age is less than 5 years
    • Pain in the upper back
    • Cause is not clear (no history of overuse or twisting)
    • Cause is bending backwards (such as in gymnastics)
    • Back pain from overuse lasts more than 2 weeks
    • Back pains are a frequent problem

    Parent Care at Home If:

    • Strained back muscles (with a history of overuse) present less than 2 weeks

    Care Advice for Back Pain

    What you should know:

    • Most new lower back pain is caused by lifting heavy objects. Lifting while the back is twisted is also a cause. This causes strained back muscles from muscle overuse.
    • Pain is not the only symptom. Walking a little bent over or stiff may occur for a few days.
    • Here is some care advice that should help.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
    • Reason: Helps back pain and muscle spasms.

    Cold Pack:

    • For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
    • Put it on the sore muscles for 20 minutes.
    • Repeat 4 times on the first day, then as needed.
    • Reason: Helps with the pain and muscle spasms.
    • Caution: Avoid frostbite.

    Heat Pack:

    • If pain lasts over 2 days, put heat on the sore muscle.
    • Use a heat pack, heating pad or warm wet washcloth.
    • Do this for 10 minutes, then as needed.
    • Caution: Avoid burns.


    • Sleep on the side with a pillow between the knees.
    • If your child only sleeps on the back, put a pillow under the knees.
    • Avoid sleeping on the stomach.
    • The mattress should be firm. Do not sleep on a waterbed.


    • Avoid any sports or work that increase the pain.
    • Avoid lifting or jumping until well.
    • After 48 hours, start gentle back stretching exercises.
    • Complete bed rest is not needed.

    What to Expect:

    • New back pain without a reason most often goes away in a few days.
    • Back pain from muscle overuse (strained back muscles) goes away in 1 to 2 weeks.

    Call Your Doctor If:

    • Pain becomes severe
    • Walks different than normal for more than 3 days
    • Pain starts to shoot into the leg
    • Pain lasts more than 2 weeks
    • Pain gets worse

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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