by Clark Gillett M.D.

Q: My son is complaining of back pain, and I don’t know what to do other than give
him Advil. My husband says it’s probably growing pains. But sometimes it hurts so
bad he cannot participate in sports and has difficulty Sleeping. What should I do?

A: Back pain is fairly common in children especially adolescents; however, dismissing it as just “growing pains” can be dangerous. Typically, general muscle aches and pains should be relieved with cessation of the activity and rest. Anti-inflammatories such as Advil can be administered if the pain is more than just mild. For the majority of symptoms, these remedies should resolve mild to moderate back pain.

Despite the advances in medicine, there is no firm evidence that shows the growth of bones causes pain. The most likely cause of “growing pains” is from the discomforts present in muscles after the running, jumping and climbing that fill a child’s day. Usually, these pains occur in the early afternoon, but on occasion can awaken a child from sleep and be quite severe. These episodes should be rare, not frequent, and they should improve over a short period of time.

In addition, other things can elicit back pain in children and teenagers. Improper wearing of a book bag is a very common occurrence and is a significant source of back pain in teenagers. Also, poor posture and body mechanics, such as slouching in chairs. These activities force the back muscles into the position of holding and supporting the spine whereas the bones of the spine should be relatively vertical so that they can support the body (not the other way around). If the back muscles are forced to support the spine in this abnormal position throughout the day, then these muscles fatigue and our bodies sense this as back pain.

There are certain “red flags” that should be evaluated by a physician if a child does complain of them. These are night pain that awakens a child from sleep (and is not attributable to something else), pain that limits the child’s sporting activity or other “fun” activity, constant back pain not relieved with rest and/or anti-inflammatory medication, back pain associated with fevers or night sweats, any abnormal curvature of the spine noticed while standing, or back pain associated with pain radiating into the legs.

Although the vast majority of back pain complaints in children and adolescents are relieved with simple remedies, persistent back pain or back pain not improving over time should be Evaluated by a pediatrician or spine surgeon. In the case of the child mentioned in the question above, I would recommend he come into the office to see me for a thorough evaluation.

Dr. Pahl is a board certified orthopaedic spine surgeon at the Hughston Clinic and can be reached at 706.494.3148.

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