Back Pain in Adolescents
How to respond to back pain in children and teens without dismissing symptoms or predicting adult degeneration.
The mechanic's rule: A diagnostic label is a clue, not a verdict. The useful question is how symptoms behave under posture, motion, and load.
Take It Seriously Without Creating Fear
Back pain in adolescents is common, but prevalence estimates vary by age and definition. It should not be dismissed as “growing pains,” nor does it mean a teen is starting an inevitable path to adult disc degeneration.
Ask about training changes, falls, illness, sleep, stress, school demands, and symptoms in the legs. Persistent pain, night waking, fever, weight loss, neurological symptoms, gait change, significant trauma, or very young age deserves pediatric assessment.
Sport, Strength, and School
Young people can benefit from age-appropriate resistance training with qualified supervision and progressive loads. Growth does not create a universal ban on deadlifts, flexion, extension, or sport. Repetitive high-load extension in some sports can be relevant to pars stress injuries, so localized persistent athletic pain should be assessed.
Backpacks may contribute to temporary discomfort but have not been shown to cause scoliosis or long-term spine disease. Use both straps, fit the bag close to the body, carry what is needed, and respond to discomfort rather than enforcing one universal percentage.
Keep the teen involved in decisions. Movement, school participation, sleep, mental health, and gradual sport return all matter. The McGill Big 3 is one exercise option, not a required prevention program.
The Mechanic's Brief
- Adolescent back pain deserves attention without catastrophic predictions.
- Warning signs and persistent athletic pain warrant pediatric evaluation.
- Strength training can be appropriate with supervision and progression.
- Backpacks may cause discomfort but do not establish long-term damage.
- No single core routine or posture prevents future back pain.
- Include the adolescent’s goals, school, sleep, stress, and sport context.