It is fair to say that Back pain in children is not like back pain in adults. Compared to an adult, a child with a backache is more likely to have a serious underlying disorder. This is especially true if the child is 4 years old or younger or if a child of any age has back pain accompanied by:

· Fever or weight loss
· Weakness or numbness
· Trouble walking
· Pain that radiates down one or both legs
· Bowel or bladder problems
· Pain that keeps the child from sleeping

Causes
Muscle strain is the most common cause of back pain. It usually gets better on its own with rest.
Many teenagers may have more persistent back pain. This is often related to tight hamstring muscles and weak abdominal muscles. These children seem to improve with a physical therapy program that stresses hamstring stretching and abdominal strengthening.
More serious causes of back pain need early identification and treatment or they may become worse. Always see a doctor if your child's back pain lasts for more than several days or progressively worsens.

Doctor's Examination
The doctor will begin by learning about how the problem developed. Then, he or she will conduct a physical examination of your child.
History
The doctor will need to know everything about the child's health.
· How is the child's overall health?
· Does he or she have any diseases or medical conditions?
· Is there any family history of disease?
· Has the child been in an accident?
· The doctor will need to learn more about the back pain and any other medical problems.
· What is the exact location of pain?
· Does it extend into the legs?
· Is there any numbness, tingling, or weakness?
· Does the child have trouble with urination or bowel movements?
· The doctor will want to know when and how the pain began.
· Was the pain sudden, or did it develop slowly over time?
· When does it hurt?
· Does the pain occur all the time or only with movement?
· Does it hurt at night?
· What makes the pain better or worse?

It is important to let the doctor know whether the child is involved in sports or other activities.
· If so, what sports?
· How often does he or she train?
· On what surfaces does the child play?

Physical Examination
During the physical examination of the child, the doctor carefully examines the muscles, bones, and nerves. The doctor will be checking the following:
The Spine
The doctor feels each vertebra and looks for deformities in the alignment and mobility of the spine.

Posture
The doctor will check the posture for how the child walks (gait); whether he or she can bend over to touch the toes; and whether he or she can extend forward and bend to the right and left.

Nerves in the Back
With the child lying face up, the doctor raises the legs (straight leg raising test). The doctor may also raise the legs with the child lying face down (reverse straight leg raising test).

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