Back Pain and Scoliosis in Children: When to Seek Care

An independent educational resource prepared by Mark M. Simonian, MD, FAAP

Sources checked: August 9, 2026     |     Medical review completed: August 10, 2026

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare

2497 E. Herndon Avenue, Suite 101, Clovis, CA 93611     |     559-538-3070

Most new back pain in children and teens follows a muscle strain, sports, play, a fall, or overuse and improves with time. Back pain in a young child, pain that persists or worsens, or pain with neurologic symptoms, fever, or a change in walking needs evaluation.

Urgent Warning Signs - Check This First

Do not ask a child with possible spinal injury to keep walking or to 'test' their back. After a major fall, collision, diving injury, or sports impact, keep the child still and call for help if there is concern for a neck or spinal injury.

CALL 911 NOW

  • Back or neck pain after a major injury with weakness, numbness, tingling, loss of sensation, inability to move normally, or concern for spinal injury

  • Loss of bladder or bowel control after a back injury, or a child who cannot walk because of new weakness

  • A child who is unresponsive, has severe breathing difficulty, or another life-threatening emergency

GET EMERGENCY MEDICAL CARE NOW

  • Severe back pain with fever, a child who looks very ill, severe headache or stiff neck, confusion, or persistent vomiting

  • Back pain with new leg weakness, numbness, saddle-area numbness, inability to urinate, or loss of bladder or bowel control

  • A visible spinal deformity after injury, severe pain after a fall or collision, or inability to walk or bear weight normally

  • Severe one-sided back or flank pain with blood in urine, vomiting, or fever

CONTACT YOUR CHILD'S HEALTHCARE PROFESSIONAL TODAY

  • Back pain in a child younger than 10, back pain without a clear strain or injury, or pain that is severe, worsening, or wakes the child from sleep

  • Pain that lasts more than 1 to 2 weeks, occurs repeatedly, limits school, sports, or normal activities, or returns whenever activity resumes

  • Pain that shoots into the buttock or leg, causes a limp or changed posture, or is accompanied by numbness, tingling, or weakness

  • Fever, weight loss, unexplained fatigue, night sweats, abdominal pain, pain or burning with urination, or other illness symptoms

  • A new uneven shoulder, rib prominence when bending forward, leaning to one side, or other concern for scoliosis or spinal asymmetry

Common Back Strain and Overuse Pain

  • Muscle strain or bruising can occur after a new activity, lifting, twisting, sports, play, a fall, or carrying a heavy load.

  • Overuse pain may occur in young athletes, especially with repetitive bending, twisting, extension, or a sudden increase in training.

  • A clear strain is often tender in the muscles and worse with certain movements. It should gradually improve rather than become more severe or spread into the legs.

Scoliosis: What Families May Notice

Scoliosis is a side-to-side spinal curve that usually develops during growth and is often not painful. It is not caused by poor posture, a backpack, or ordinary activity. Families may notice uneven shoulders or hips, one shoulder blade more prominent, a leaning posture, or a rib prominence when the child bends forward. A clinician should examine suspected scoliosis; imaging is not needed for every visible asymmetry.

  • Scoliosis may progress during a rapid growth spurt, so follow-up matters even when the child feels well.

  • Most children with scoliosis can participate in normal activities. Treatment and activity recommendations are individualized by the clinician or orthopedic specialist.

  • Back pain is uncommon in uncomplicated scoliosis; significant pain deserves its own evaluation.

Home Care for a Clear, Minor Strain

  • Pause activities that increase pain, but avoid prolonged bed rest. Gentle usual movement is preferable when the child can move comfortably.

  • Use a wrapped cold pack for short periods during the first day if it helps; later, gentle warmth may be comforting. Never apply ice or heat directly to skin and do not sleep with a heating pad.

  • Use clinician-approved pain medicine only as directed for the child. Do not use another person's prescription medicine.

  • Return to sports gradually only after the child has normal daily movement without pain, limp, weakness, or neurologic symptoms. Stop if pain returns.

Prevention

  • Increase sports training, resistance, distance, and skill demands gradually. Include rest and recovery days.

  • Use good lifting mechanics and avoid lifting or twisting with loads that are too heavy for the child.

  • Choose a backpack with two wide straps, use both straps, and carry only what is needed. A child should not have to lean forward to carry a backpack.

  • Discuss recurrent back pain, training demands, footwear, equipment, and sport technique with the child's healthcare professional or qualified coach or therapist.

Call Preparation

  • Age, exact pain location, onset, injury or activity trigger, what makes pain better or worse, and whether pain wakes the child

  • Ability to walk, run, bend, sit, sleep, and participate in school or sports; any limp, posture change, leg symptoms, weakness, or numbness

  • Fever, weight change, urinary symptoms, abdominal pain, recent infection, and medicines already used

  • For possible scoliosis: when asymmetry was first noticed, growth changes, family history, and any prior examination or imaging

Related Guides

  • Sports Injuries in Children: When to Seek Care

  • Limping, Leg Pain, and Refusal to Walk: When to Seek Care

  • Dizziness and Fainting in Children: When to Seek Care

  • Urinary Symptoms and Possible UTI: When to Seek Care

Sources and Medical Review

  • HealthyChildren.org (AAP), Back Pain in Children and Teens https://www.healthychildren.org/English/health-issues/conditions/orthopedic/Pages/Back-Pain-in-Children-Teens.aspx

  • HealthyChildren.org (AAP), Scoliosis https://www.healthychildren.org/English/health-issues/conditions/orthopedic/Pages/Scoliosis.aspx

  • American Academy of Orthopaedic Surgeons, Scoliosis Overview https://orthoinfo.aaos.org/en/diseases--conditions/introduction-to-scoliosis/