Backache: Teen Version

What is a backache?

A backache is pain and stiffness in the back. The middle or lower back is the most common area to have pain. Backaches are most common during adolescence.

With a backache:

• The pain is worsened by bending.
• The muscles on either side of the spine are tender or in spasm.

What causes backaches?

Backaches are usually caused by straining some of the 200 muscles in the back that allow us to stand upright. Often the strain is caused by carrying something too heavy (such as schoolbags), lifting from an awkward position, or overexertion of back muscles (for example, from digging).

Spondylolysis, or a stress fracture, may cause lower back pain in teens. Stress fractures may happen in sports such as gymnastics and football. Pain is usually mild and may spread to the buttocks and legs. It feels worse with activity and better with rest. With a stress fracture, you may notice that you tend to walk stiff-legged and with a shorter stride than usual.

How long does it last?

The pain and discomfort are usually gone in 1 to 2 weeks. However, it is common to have backaches many times, depending on your activities and health.

How can I take care of myself?

• Pain-relief medicines

  Take acetaminophen or ibuprofen. Continue this until 24 hours have passed without any pain. This medicine is the most important part of the therapy because back pain causes muscle spasm and these medicines can greatly reduce both the spasm and the pain.

• Cold

  During the first 2 days, massage the sore muscles with a cold pack or ice pack for 20 minutes 4 times per day. To avoid frostbite, do not leave the cold packs on too long.

• Heat

  After 2 days, put a heating pad or hot water bottle on the most painful area for 20 minutes to relieve muscle spasm. Do this whenever the pain flares up.

• Sleeping position

  The most comfortable sleeping position is usually on your side with your knees bent. The mattress should be firm if possible.

• Activity

  Avoid lifting, jumping, horseback riding, motorcycle riding, and exercise until you are completely well. Complete bed rest is unnecessary.

How can I prevent backaches?

The best way to prevent future backaches is to keep your back muscles in good physical condition. This will require 5 minutes of back and abdominal exercises every day.

Helpful exercises are:

• Standing hamstring stretch: Put the heel of the leg on your injured side on a stool about 15 inches high. Keep your leg straight. Lean forward, bending at the hips, until you feel a mild stretch in the back of your thigh. Make sure you don't roll your shoulders or bend at the waist when doing this or you will stretch your lower back instead of your leg. Hold the stretch for 15 to 30 seconds. Repeat 3 times.

  Repeat the same stretch on your other leg.

• Cat and camel: Get down on your hands and knees. Let your stomach sag, allowing your back to curve downward. Hold this position for 5 seconds. Then arch your back and hold for 5 seconds. Do 2 sets of 15.
• Quadruped arm and leg raise: Get down on your hands and knees. Pull in your belly button and tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and change sides. Do this 10 times on each side.
• Pelvic tilt: Lie on your back with your knees bent and your feet flat on the floor. Pull your belly button in towards your spine and push your lower back into the floor, flattening your back. Hold this position for 15 seconds, then relax. Repeat 5 to 10 times.
• Lower trunk rotation: Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles and push your lower back into the floor. Keeping your shoulders down flat, gently rotate your legs to one side as far as you can. Then rotate your legs to the other side. Repeat 10 to 20 times.
• Gluteal stretch: Lie on your back with both knees bent. Rest the ankle of your injured leg over the knee of your other leg. Grasp the thigh of the leg on the uninjured side and pull toward your chest. You will feel a stretch along the buttocks on the injured side and possibly along the outside of your hip. Hold the stretch for 15 to 30 seconds. Repeat 3 times.
• Double knee to chest: Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles and push your lower back into the floor. Pull both knees up to your chest. Hold for 5 seconds. Relax and then repeat 10 to 20 times.
• Partial curl: Lie on your back with your knees bent and your feet flat on the floor. Draw in your abdomen and tighten your stomach muscles. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Hold this position for 3 seconds. Don't hold your breath. It helps to breathe out as you lift your shoulders. Relax back to the floor. Repeat 10 times. Build to 2 sets of 15. To challenge yourself, clasp your hands behind your head and keep your elbows out to your sides.

Do not do the strengthening exercises until the back pain is gone. You should also try to be physically active for at least 30 minutes every day.

Also, learn how to properly lift heavy objects:

• To lift heavy objects, bend your knees and not your back.
• Never lift something while your back is twisted.
• Carry heavy objects close to your body and use both arms.

When should I call my healthcare provider?

Call IMMEDIATELY if:

• The pain becomes very severe AND persists more than 2 hours after taking a pain medicine.
• You can't walk.
• You have pain, tingling, or weakness in the legs.
• You have changes in bowel or bladder function.
• You start feeling very sick.

Call during office hours if:

• The pain is no better after 3 days of treatment.
• The pain is still present after 2 weeks.
• You have other concerns or questions.