Monday Medical: Back pain in kids

Susan Cunningham
Monday Medical

Editor’s Note: This story is the first part in a two-part series on low back pain in kids. Part two will focus on treatment and prevention.

While low back pain may frequently be a complaint of older adults, it’s been less common in kids and teens — until now.

“Back pain in kids and teens is a growing concern due to the increased use of screens,” said Erika Barger, a physical therapist at UCHealth SportsMed Pediatric Therapy Clinic in Steamboat Springs. “Along with increased eye strain, sleep disruption, headaches and mental health problems, increased screen time can lead to an increase in low back pain.”

Poor posture with screens

On average, American children ages 8 to 12 spend four to six hours a day watching or using screens. Most of that time is spent sitting in a slouched position and looking down.

“This posture is often referred to as ‘text neck’ or ‘tech neck,'” Barger said. “When we have a poor seated posture for an extended period of time, we put more stress and strain on our neck and back muscles, ligaments and joints, especially with sitting in an awkward position for multiple hours at a time.”

Even sitting with good posture puts 40% more compressive force on these discs than standing, while also restricting the movements of much-needed nutrients and fluids.

“Our intervertebral discs are the largest ‘avascular’ structure in our body, meaning most of it has no direct blood supply,” Barger said. “In order for our discs to get nutrients pumped in and waste products pumped out, we must move.”

Other contributing factors

Screens aren’t the only culprit for low back pain in children and teens. The issue can also result from overuse injuries. For instance, sports in which the low back is arched over and over, such as gymnastics, dancing, ski jumping, wrestling or hockey, can cause issues.

Other common contributors to back pain in youth include a discrepancy in leg length, gait impairments, high BMI and recent growth spurts.

And not to be ignored is the impact of wearing a heavy backpack.

“A heavy backpack can cause a backwards pull,” Barger said. “Kids tend to overcompensate and fix this by leaning forward. However, this slouched forward posture creates increased load and force on the spine, which can cause more strain on the shoulders, neck and back.”

Most cases of low back pain in youth are due to muscle strain and other musculoskeletal impairments, but other sources of back pain in youth can include scoliosis, stress fractures, Scheuermann’s disease, constipation or a herniated disc.

Signs there may be an issue

Symptoms of low back pain include stiffness, achiness, increased pain with movement, increased pain with prolonged sitting or standing, radiating pain, and pain after playing sports.

Reach out to your medical provider if the pain lasts more than a few weeks or impacts your child’s participation in activities. It’s important to seek immediate help if low back pain is associated with other symptoms, such as fever, disrupted sleep, unexplained weight loss, and nerve pain, as this may signal a more serious underlying issue.

While low back pain can seem like a mild issue for kids and teens, it’s important to address early on.

“Slouching for a few minutes or leaning to one side while playing, studying or watching TV does not cause a permanent spinal deformity,” Barger said. “However, this continuous slouching posture can lead to increased risk for constant neck and back pain. Having low back pain as a child or adolescent is also a significant risk factor for having low back pain as an adult.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at

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