Back Pain

When To Call

Call 911 Now

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

Go to ER Now

• Loss of bladder or bowel control and follows back injury
• Can't pass urine or can only pass a few drops
• Can't walk or can barely walk
• Trouble Breathing

Call Doctor or Seek Care Now

• Severe pain
• Pain shoots into the buttock or back of the thigh
• Tingling or numbness (loss of feeling) in the legs or feet
• Blood in urine
• Pain or burning when passing urine and fever
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

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

Contact Doctor During Office Hours

• Age is less than 5 years old
• 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 (exercise or work) lasts more than 2 weeks
• Back pains are a frequent problem
• You have other questions or concerns

Self Care at Home

• Strained back muscles (from exercise or work) present less than 2 weeks

Care Advice

What You Should Know About Back Pain:

• Most new lower back pain is caused by lifting heavy objects. Lifting while the back is twisted is a common cause. Muscle overuse from exercise also causes strained back muscles.
• 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 an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Use as needed.
• Reason: helps back pain and muscle spasms.

Cold Pack for Pain:

• 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.

Use Heat After 48 Hours:

• 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.
• Reason: increase blood flow and improve healing.
• Caution: avoid burns.

Sleep on the Side:

• 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.

Activity:

• 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.

Prevent Backpack Pain:

• Limit the weight of what is carried. It needs to be less than 15% of body weight. That means a 100-pound (45 kg) child should not carry more than 15 pounds (7 kg).
• A sign of carrying too much weight is having to lean forward when walking.
• Buy a well-made backpack with wide, padded shoulder straps.
• Never carry the pack on just one shoulder. Reason: causes shoulder and neck pain.

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
• Fever occurs
• Pain lasts more than 2 weeks
• You think your child needs to be seen
• Pain gets worse

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