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Clinical Reference Systems: Pediatric Advisor 10.0
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  • Your child complains of back pain.
  • Usually the middle or lower part of the back is involved.
  • The pain is worsened by bending.
  • The muscles on either side of the spine are tender or in spasm.
  • Mainly occurs in adolescents.


Backaches are usually symptomatic of a strain of some of the 200 muscles in the back that allow us to stand upright. Often the triggering event is carrying something too heavy, lifting from an awkward position, or overexertion of back muscles (for example, from digging).


The pain and discomfort are usually gone in 1 to 2 weeks. Recurrences are common.


  1. Pain-relief medicines

    Give acetaminophen or ibuprofen four times a day. Continue this medicine until 24 hours have passed without any pain. This is the most important part of the therapy because back pain causes muscle spasm and these medicines can greatly reduce both the spasm and the pain.

  2. Local heat

    A heating pad or hot water bottle applied to the most painful area for 20 minutes helps to relieve muscle spasm. Do this whenever the pain flares up.

  3. Sleeping position

    The most comfortable sleeping position is usually on the side. The mattress should be firm or reinforced with a board.

  4. Activity

    Have your child avoid lifting, jumping, horseback riding, motorcycle riding, and exercise until he is completely well. Complete bed rest is unnecessary.

  5. Prevention

    The only way to prevent future backaches is to keep the back muscles in excellent physical condition. This will require 5 minutes of back and abdominal exercises every day. Helpful strengthening exercises are sit-ups, 6- inch leg raises, flattening the back against the floor, and tucks of the leg to the chest. Also do stretching exercises. The strengthening exercises should be avoided when your child is having active back pain; however, the stretching exercises should be continued. Remind your child to lift objects with the leg muscles and not by bending or twisting the back.


  • The pain becomes very severe and persists more than 2 hours after your child takes pain medicine.
  • Your child can't walk.
  • Your child starts acting very sick.


  • The pain is no better after 3 days of treatment.
  • Your child still has pain after 2 weeks.
  • You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems