Why Does My Child's Back Hurt?
When your child complains that their back hurts, it can be hard to know what to make of it. Back pain feels like an "adult problem," so hearing it from a 10-year-old or a busy teenage athlete can be worrying.
The good news is that most back pain in children and teens is caused by muscle strain, overuse, or the demands of a growing body, and it improves with the right care. Back pain in kids is also more common than many parents realize, especially in the teen years. However, there are certain situations where back pain needs a closer look, and knowing the difference can help you make the right decision for your child.
If your child is limping as well as complaining of back pain, you may also find our article "Why Is My Child Limping? When Should You Be Concerned?" helpful.
What Counts as Back Pain in Children?
Back pain is any pain, ache, or stiffness felt anywhere from the base of the neck down to the buttocks. In kids, it most often shows up in the lower back, but mid-back pain is common in teens too.
Younger children may not describe it clearly. Instead, you might notice them avoiding activities they normally enjoy, walking stiffly, refusing to bend forward to pick things up, or changing the way they sit. Teens are usually better at telling you where it hurts, but they may also downplay pain so they don't miss practice or a game.
Common Causes of Back Pain in Children
1. Muscle Strain and Overuse
This is by far the most common cause. Kids are active, and back muscles can get sore just like any other muscle.
Common triggers include:
A new sport or a sudden jump in training
Heavy or poorly worn backpacks
Falls, tackles, or awkward landings
Long periods of sitting or screen time
There is usually a clear activity link, the pain is worse with movement and better with rest, and it gradually improves over a few days to a couple of weeks. Trampolines are a frequent culprit, and our Trampoline Safety for Kids guide has practical tips for preventing these injuries.
2. Spondylolysis (A Stress Fracture in the Spine)
Spondylolysis is one of the most common identifiable causes of low back pain in young athletes. It is a stress fracture in a small part of the vertebra called the pars interarticularis, caused by repeated arching (extension) of the back.
It is most often seen in:
Gymnasts and dancers
Figure skaters and divers
Hockey, football, and volleyball players
Athletes going through a growth spurt
The classic sign is low back pain that is worse when leaning backward. Because it is a stress fracture, it needs proper diagnosis and a structured return to activity, much like any other fracture. Our article When Can My Child Safely Return to Sports After a Fracture? explains why rushing back can set recovery back.
In some children, the fracture allows one vertebra to slip forward on the one below. This is called spondylolisthesis and is usually monitored by a physician.
3. Growth Spurts and Tight Muscles
During rapid growth, bones often grow faster than the muscles around them. This can leave the hamstrings and hip flexors tight, which pulls on the pelvis and lower back.
This is the same growth-related process behind other common conditions we see, like Osgood-Schlatter Disease at the knee and Sever's Disease at the heel.
4. Scheuermann's Kyphosis
Scheuermann's kyphosis is a condition where the vertebrae in the mid-back grow into a slight wedge shape, creating a rounded upper back that does not straighten out when the child stands tall.
It usually appears in early adolescence and may cause:
An aching mid-back, especially after sitting or activity
A noticeable rounded or "hunched" posture
Tight hamstrings and chest muscles
This is different from simple slouching, which corrects when your child stands up straight.
5. Scoliosis
Scoliosis is a sideways curve of the spine. Parents often first notice uneven shoulders, a shoulder blade that sticks out, or clothes that hang unevenly.
It is important to know that the most common type of scoliosis in children (adolescent idiopathic scoliosis) is usually not painful. If your child has scoliosis and significant back pain, they should be assessed to make sure nothing else is going on.
6. Disc Problems
Disc injuries are much less common in children than adults but can happen in teens, especially those in heavy lifting or contact sports. Symptoms may include back pain with pain, numbness, or tingling that travels down the leg.
When Is Back Pain an Emergency?
Although uncommon, some causes of back pain in children need prompt medical attention. These include spinal infections, inflammatory conditions, and, rarely, tumours.
Seek medical attention right away if your child has:
Fever, or seems generally unwell
New numbness, tingling, or weakness in the legs
Changes in bladder or bowel control
Severe pain that is not settling
Difficulty walking or refusal to walk
Book a medical assessment soon if your child has:
Back pain under the age of 5
Pain that wakes them at night or is worse at night
Constant pain that is not related to activity
Unexplained weight loss or fatigue
Morning stiffness lasting more than 30 minutes
A stiff, rigid back or a scoliosis curve that is painful
In young children especially, back pain is less likely to be a simple muscle strain, so it is always worth having it checked.
How Can Physiotherapy Help?
For most kids and teens with back pain, physiotherapy is a key part of getting better and staying better. A physiotherapist will assess how your child moves, where the pain is coming from, and whether anything needs further investigation.
Treatment often focuses on:
Building core and hip strength to support the spine
Improving flexibility in tight hamstrings and hip flexors
Adjusting training load so your child can stay active while healing
Teaching good lifting, sitting, and backpack habits
A step-by-step plan to return to sport safely
Rest alone rarely fixes back pain, and the right amount of movement is often part of the solution. It is also normal for some exercises to feel a little uncomfortable at first. If you're wondering about that, our article "Physio Made Me Worse!" explains what's expected and when to speak up.
That's A Lot Of Info… So When Should You Seek Medical Attention?
Arrange an assessment if your child:
Has had back pain for more than 2 weeks
Has pain that is getting worse instead of better
Has pain when arching backward, especially if they play a sport that involves a lot of back bending
Is missing sport, school, or activities because of pain
Has a visible change in posture or the shape of their back
Keeps having repeated episodes of back pain
Has any of the warning signs listed above
The Bottom Line
Most back pain in children and teens is caused by muscle strain, overuse, or growth-related changes, and it improves with the right care and a gradual return to activity. However, back pain should never be ignored if your child is very young, has a fever, has pain at night, or has any numbness, weakness, or changes in bladder or bowel control. When in doubt, it's always safest to have your child assessed. Early diagnosis helps identify the cause quickly and gets kids back to the activities they love.
Our BBR for Kids team works with children and teens every day. If you have concerns about your child's back pain, contact us to book an assessment.
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