When you've got a toddler complaining of back pain, it's hard to know what to do. They may have fallen, gotten tackled at daycare or they may have simply heard a big brother complaining about back pain and thought it sounded cool. It may not be easy to tell how serious it is or what's causing the pain.
However, rest assured most causes of back pain in young patients are fairly benign. You can take simple steps to treat the pain and determine if the cause may be something more serious to worry about.
First Steps When a Toddler Complains of Back Pain
The first thing to do when your 2-year old or 3-year old complains of back pain is to decide if they appear ill or are in acute distress and need to see a doctor immediately.
When to See a Doctor
Even though serious causes are rare, sometimes back pain warrants a doctor's visit. Take your child to see a doctor if any of the following signs and symptoms are present:
- Back pain was improving but is now getting worse.
- Burning with urination or urinating more frequently.
- Difficulty walking or reluctance to move.
- Irritability or lack of energy.
- Pain medicines worked initially but not now.
- Pain was intermittent but is now constant.
- Waking at night with pain.
Take your child to the emergency room right away if they are experiencing any of these more serious symptoms:
- Weakness or numbness
- Pain that radiates down one or both leg
- Bowel or bladder problems
- Fever and night sweats together with lack of appetite or recent weight loss
If your toddler does not exhibit these symptoms, you might consider an over-the-counter pain medicines that has been approved by their pediatrician.
The American Academy of Pediatrics (AAP) advises that parents and caregivers call their pediatrician before giving over-the-counter medications to a child under age 2 or if their child is under 3 months old and has a fever. They also advise that you read the label carefully and provide the appropriate dose based on your child's weight. The AAP also reminds parents not to give aspirin to a child unless your child's physician specifically advises you to do so.
Observe your toddler closely over the next two or three days. They will likely let you know if they are not improving. As long as the pain is resolving and there is no other reason for concern, you don't need to restrict activity.
Potential Causes of Back Pain in Toddlers
Back pain in young children rarely has a serious cause. So most of the time there is no need for concern. But it can be helpful to consider some of the potential circumstances that might lead your toddler to complain about their back hurting.
Injuries or Other Conditions
Some conditions or injuries that can lead to back pain are:
Infection in the vertebrae or discs (diskitis).
- Inflammation, which can be caused by juvenile rheumatoid arthritis.
- Injury to the spine, such as a vertebral fracture.
- Kidney infection or stone.
- Muscle strain (most common)
- Musculoskeletal problems such as kyphosis (rounded back), scoliosis or a vertebral disc herniation
Infrequently, back pain can stem from tumors or leukemia. But parents, no need to jump into an anxiety spiral. The vast majority of back pain complaints are simple toddler boo-boos.
Typically, children don't experience growing pains in their back. Growing pains are usually an uncomfortable achiness felt in the legs. The most common areas where this pain will occur are at the front of the thighs, calves or behind the knees.
So if your child is experiencing back pain, it probably isn't because their spine is stretching out by the minute. It may indicate an underlying problem or disorder. So, for worsening back pain, a visit to your child's doctor is recommended.
Back Pain Diagnosis
To understand the cause and appropriate treatment for your toddler's back pain, a doctor's evaluation will generally include the following steps.
- Detailed history - Before you go, make note of the history of your toddler's pain pattern, any associated problems, their history of illnesses, and your personal and family medical history. Be prepared for these questions:
- When did the pain begin?
- Was your child injured recently?
- Has it gotten better or worse?
- What activities or positions make the pain better or worse?
- Physical exam - The doctor will do a complete physical exam to look for the cause of the back pain and to determine the next steps.
- Further testing - This may include blood work to look for evidence of infection, inflammation, or immune diseases, as well as imaging studies such as x-rays and MRI scans, to look for bone, muscle, and soft tissue abnormalities.
In many cases, the cause of the back pain is diagnosed from the history and physical exam alone, and further testing is not necessary. A small percentage of cases are serious and require surgery. However, most of the time the problem can be helped by conservative treatment, such as pain medicine, antibiotics, physical therapy, or physical activity.
Prevention of Toddler Back Pain
You may wonder how you can possibly prevent back pain in toddlers. Aren't they supposed to be made of rubber? The truth is, toddlers can get aches and pains with inactivity or poor ergonomics just like their creaky old parents.
- If your child goes to daycare with a backpack, make sure they carry it on both shoulders.
- Encourage stretching breaks if your child is sitting for over 30 minutes.
- Help your child maintain a healthy weight by offering nutrient-packed snacks and meals.
- Avoid prolonged confinement in a chair, swing, playpen or bed.
Movement and activity will help your toddler continue to develop all their muscles and strengthen their back posture.
Rest assured that most of the time back pain in a toddler is not caused by a worrisome disease. Ensure that your toddler develops her muscles and good posture by giving her the freedom and opportunities to engage in a variety of spontaneous movements.