Paediatrics - Under 16 years Back Pain

This leaflet contains advice following your referral to us from your GP or healthcare professional.

Back problems are very common. Most back problems start for no obvious reason, which can be very frustrating. Your back problem may cause aching, hot, burning, shooting, or stabbing pains in your back and sometimes into one or both of your legs. You may also get pins and needles.

The spine is strong and back problems are rarely due to any serious disease or damage. Back problems should settle within 6 weeks following the advice provided here.

You will not normally need and x-ray or an MRI scan.

What should I do?

• Keep moving, even if slowly at first
• Keep living and schooling normally. This is important and is the best way to get better
• Don’t sit down for too long, change positions regularly wherever you are
• Avoid bed rest during the day
• Stay active and remember to re-introduce activities like heavy lifting gradually
• Exercise really helps your back and can relieve pain, start with light fitness training. Moving will make you stronger, keeping active is the best thing you can do

What about sports?

You will recover faster if you can try to stay active and remember to keep moving. Start with light fitness training, and play when you feel ready.

Good Posture in Children

What is good posture and why is it important?

Posture is the position of your body when you sit or stand. When you look at the spine from behind it should look like it runs in a straight line but when viewed from the side, it should have natural curves. Good posture allows us to sit or stand with minimal effort and without causing strain on our bodies. It also helps us avoid developing pain and stiffness. Braces and splints are not usually required to achieve a good posture. We encourage children to do this actively through exercise to build up their muscles.

What causes poor posture?

There are two types of poor posture; correctable and fixed. Correctable posture is usually caused by sitting or standing in a slouched position over a long period of time, whereas fixed cannot be altered and restricts movement.

What does poor posture look like?

• Poking chin
• Rounded shoulders
• Hyperextended knees
• Pelvis tilted forwards
• Bottom sticking out

Sitting at a desk

Leaning over a desk for long periods of time is not good for your posture and can lead to neck and back pain. Ideally sit at a desk where your feet are on the floor, your chair has a back rest and your bottom is as far back in the seat as you can get it.

Use of devices

Prolonged use of hand held tablets, gaming devices and mobile phones can lead to poor postures. When using these ensure that your maintain a good posture in sitting and/or standing. Take regular break and look to reduce the overall length of time being used

Poor sleeping posture

Sleeping without enough or with too many pillows causes your neck to tilt. To ensure a better sleeping position, make sure you use a pillow which fills the space between your head and shoulder, keeping your spine in a neutral position.

Carrying school bags

Carrying heavy bags on one shoulder causes you to lean over to one side, making the body asymmetrical. The best way to carry a school bag is to:

• Using both shoulder straps of a rucksack to distribute the load evenly
• Don’t load the bag too heavy — it should be less than 10% of your body weight
• Keep the straps tight so that the top of the bag is in line with the top of your shoulders

Adopting poor postures

Sitting and standing with poor posture weakens our muscles over time and causes stiffness. Weakness is caused by not using your core muscles in an effective way, this can be more difficult during a growth spurt. Stiffness is caused by the tightening of some muscles and the stretching of others when adopting a poor posture.

How to maintain a good posture

In sitting, gently lengthen the back of your neck by reaching the top of your head up towards the ceiling, so that you are looking straight ahead. Gently move your shoulder blades down your back and allow the muscles in your neck and shoulders to relax. Your feet should rest flat on the floor and your weight equally distributed through both buttocks.

In standing, make sure equal weight is distributed between both feet. Ensure your feet are hip distance apart, and your hips and shoulders are in line with your knees. Keep your knees soft and lengthen your spine by reaching the top of your head up to the ceiling.

Exercises to help maintain a good posture

Completing the following exercises on a daily basis will help with core strengthening and allow you to maintain a good posture for longer periods of time. Complete exercises 3 times a day.

Chin Tucks

Sitting straight-backed. Pull your chin in, keeping your neck and back straight (not tipping your head forwards). Hold for 5-10 seconds. Repeat 10 times.

Shoulder positioning exercise

Stand or sit. Move your shoulder blades gently back and down (small movement). Hold for 5-10 seconds. Repeat 10 times.

Shoulder press-up against a wall

Standing against a wall with your hands just wider than your shoulders, slowly bend your elbows so that your chest moves towards the wall. Then return to the start position. Repeat 10 times.

Clam

Lie on your side with your knees bent. Tighten your buttocks to lift your top knee as far as you can without letting your pelvis rotate forward or backwards. Keep your feet together and back straight during the exercise. Hold for up to 30-60 seconds. Repeat 3 times on each side.

Bridge

Lying on your back with your knees bent and feet on the floor. Lift your pelvis and lower back gradually off the floor. Hold for 5 seconds. Slowly return to the starting position. Repeat 10 times.

Superman

Start in a crawling position with your hands under your shoulders and knees under your hips. Keep your back straight and core muscles tight. Slowly lift one arm in front of you and hold for 10 seconds. Repeat 5 times with each arm. If this becomes easy, try with your leg or even your opposite arm and leg.

Can my back problem cause trouble anywhere else?

Sometimes when you get back pain you can also get pain in one or both legs. This can cause pins and needles or a shooting, stabbing pain to the legs. This can be very painful, but this is common when you have back pain.

Do I need to see a doctor or therapist?

Not usually – if you follow the right advice your back problem should improve over the next 6 weeks. If your back symptoms are still interfering with your ability to do normal things after 6 weeks, this is the time to seek further professional advice from either your GP or NHS Physiotherapist.

What should I look out for?

You should contact/go to the A&E Department/Urgent Treatment Centre as soon as possible if you develop any of these:

• Difficulty passing or controlling urine
• Numbness and/or altered sensation such as pins and needles around your back passage or genitals, e.g. when wiping after toileting

If you experience the following in conjunction with your back pain, you need to speak to your GP as soon as possible:

• Generally feeling unwell
• Back pain that starts when you have other problems, such as rheumatoid arthritis or cancer
• Numbness, pins and needles, or weakness in one or both legs that has not improved after one week
• Unsteadiness when you walk
• Your back problem has not improved within six weeks

Facts and figures

• 90% of the UK population has back pain at some point
• Most back pain settles within 6 weeks
• Keeping active is the best thing to help your back pain

Contact

Paediatric Physiotherapy
Bury Community Services
Bury Care Organisation
Bury Living Well Centre
Morley St
Bury BL9 9JQ
Tel: 0161 206 0657