Parents are often surprised to hear that back pain is common in children, especially from around age 10 and into the teenage years. Most of the time it’s mechanical: the muscles and joints are being asked to do more than they’re ready for. But because back pain in children is more likely to have a specific cause than in adults, it deserves to be taken seriously.
Common causes
- Sport and activity. Repetitive bending backwards (gymnastics, dance, fast bowling, rugby, diving), heavy training loads, or a sudden jump in training.
- Growth spurts. Bones can grow faster than muscles lengthen, leaving teenagers temporarily tight and achy, especially in the hamstrings and lower back.
- Posture and screens. Long hours slumped over a phone, laptop or homework. Posture on its own isn’t “bad”, but staying in one position for hours is hard on anyone.
- School bags. Heavy bags, or bags carried on one shoulder. See our guide on school bags and back pain.
- Low fitness. Weak core and hip muscles make everyday loads feel heavier.
Warning signs: see a doctor first
Take your child to a GP or paediatrician, rather than starting with a chiropractor, if any of these apply:
- They’re young, under about 10, and the pain lasts more than a week or two
- The pain wakes them at night, or is worst at night or at rest
- Fever, feeling generally unwell, or unexplained weight loss
- Pain after a significant fall or accident
- Numbness, tingling or weakness in the legs, a change in how they walk, or trouble with bladder or bowel control
- Morning stiffness that lasts a long time, or joints that are swollen
- Pain that keeps getting worse despite rest and sensible changes
- A visible change in the shape of the back, such as one shoulder blade sticking out or one side of the waist higher than the other when they bend forward (this can be a sign of scoliosis)
Lower back pain in a child who does a lot of backward bending sport also deserves a proper assessment, because it can be a sign of a stress injury in the spine.
What usually helps
For the more common, mechanical kind of back pain:
- Keep moving. Bed rest generally makes back pain worse, not better.
- Modify, don’t necessarily stop, sport. Less of whatever aggravates it, for a while.
- Break up sitting. A movement break every 30 to 45 minutes during homework or gaming.
- Build strength. Simple core, hip and back exercises, done regularly, make a real difference.
- Sleep. Growing bodies recover during sleep, and teenagers often don’t get enough.
How I approach it
With a child or teenager I’ll start with a thorough history and examination, including checking for the warning signs above, and refer to a doctor if anything doesn’t add up. If the pain is mechanical, treatment is gentle and short: hands-on work for stiff joints and tight muscles where it helps, combined with practical changes and a few exercises. The aim is to get your child back to normal activity and teach them how to keep it that way, not to sign them up for endless visits.
Read next: is chiropractic safe for children? or teens, screens and neck pain.
Questions parents and patients ask
Is it normal for a child to have back pain?
Occasional back pain in older children and teenagers is fairly common and is usually mechanical, from things like sport, posture, growth spurts or carrying heavy bags. Back pain in a young child, or pain that is persistent, severe or comes with other symptoms, is less common and should be checked by a doctor.
Should my child stop sport if their back is sore?
Not necessarily. Most children do better staying active, but they may need to modify training while things settle. Pain that stops them playing, keeps coming back, or is in the lower back in a child who does a lot of bending backwards (like gymnastics, dance, cricket bowling or rugby) should be assessed.
What can a chiropractor do for a child's back pain?
A careful assessment to work out where the pain is coming from and rule out anything serious, gentle hands-on treatment where it's appropriate, and practical changes like adjusting school bags, desk and screen habits, and sport load, plus exercises to build strength.
This guide is general information, not a diagnosis. If you're worried about yourself or your child, get checked by a health professional. In an emergency, call 10177 or 112 from a cellphone.