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Back Pain

Back Pain is a topic covered in the 5-Minute Pediatric Consult.

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Any condition causing pain of the thoracic, lumbar, or sacral spine


  • 12-month period prevalence: 10–20% of children
  • Lifetime prevalence: 12–50%


  • Dependent on underlying cause
  • Until skeletal maturity, partially ossified posterior column and vertebral body are weak points.
  • Hyperextension with rotational spinal loading in the case of pars defects (e.g., spondylolysis or spondylolisthesis)
  • Autoimmune or autoinflammatory processes as with juvenile idiopathic arthritis (JIA) or juvenile ankylosing spondylitis


  • Unidentified in 50% of cases
  • 30% of chronic cases (back pain >3 years) without clear etiology despite workup

Risk Factors

  • Poor conditioning or high athletic performance
  • Joint hypermobility
  • Role of backpack weight and style of wear undetermined
  • Role of overweight or obesity yet to be determined

General Prevention

  • Back muscle strengthening and hamstring stretching exercises may be helpful.
  • Maximum backpack load: 10–15% body weight
  • Weight loss and increased physical activity in overweight or obese children
  • 3 months off from sport per year, 1 day off from scheduled activity per week

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Cabana, Michael D., editor. "Back Pain." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617356/all/Back_Pain.
Back Pain. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617356/all/Back_Pain. Accessed April 22, 2019.
Back Pain. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617356/all/Back_Pain
Back Pain [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 22]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617356/all/Back_Pain.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Back Pain ID - 617356 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617356/all/Back_Pain PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -