Lower back pain (LBP) is a frequent concern for parents and young individuals, often leading to the question of whether the discomfort is simply a byproduct of a growth spurt. The lifetime prevalence of back pain in young people can be as high as 50% by the age of 20. Attributing LBP solely to “growing pains” can be misleading and potentially prevent a timely evaluation of the actual cause. While most cases are benign and transient, a distinction must be made between common aches and symptoms that may indicate a significant underlying condition. Understanding the relationship between skeletal growth and spinal discomfort is key to appropriate management.
Separating Growth from Pain
The concept of “growing pains” is well-established, but this phenomenon typically presents as deep, aching pain in the legs (shins, thighs, or calves), and rarely involves the lower back itself. Low back pain in adolescents is not a direct sign of the growing process, but rapid skeletal elongation can be an associated factor. During a growth spurt, bones can lengthen faster than the surrounding muscles and soft tissues can adapt, creating a temporary physiological mismatch.
This disparity often results in increased tension and stiffness, particularly in the large muscle groups that stabilize the pelvis and spine, such as the hamstrings and hip flexors. Tight hamstrings can alter pelvic mechanics and place excess strain on the lumbar spine. Furthermore, the rapid change in height and body proportions shifts an individual’s center of gravity, which may temporarily affect coordination and posture. These indirect effects create a mechanical environment where the back is susceptible to strain.
Common Non-Growth Related Causes
The majority of LBP cases in young people are not due to bone growth itself but are attributed to external, mechanical, and behavioral factors. One frequent cause is postural strain, often stemming from the prolonged use of electronic devices or lengthy periods of sitting. Slouching or hunching over a desk or screen puts continuous stress on the spinal muscles and ligaments, leading to fatigue and discomfort in the lower back. Encouraging regular breaks and maintaining an upright seated position can help mitigate this strain.
Another significant contributor is the improper use or excessive weight of backpacks, which can overload the spine and lead to poor posture and muscle fatigue. The strain involves the body compensating for the heavy load by leaning forward, which increases the stress placed on the lumbar spine and supporting musculature. In active individuals, muscle strain or overuse from sports activities is a prevalent cause, especially in sports that involve repetitive movements, high impact, or hyperextension of the back, such as gymnastics or football. This pain is typically muscular in origin and often resolves with rest and conservative measures.
A lack of sufficient core strength and flexibility underlies many of these issues, as these are necessary for stabilizing the lumbar spine during movement. Weak abdominal and back muscles are less able to support the body’s structure, causing the stress of movement and load to be absorbed improperly by the passive structures of the spine. Incorporating core-strengthening exercises and regular stretching, particularly for the hamstrings and hip flexors, is a preventative measure. Learning proper lifting and movement techniques also helps protect the back against acute injury.
When to Seek Medical Attention
While most episodes of lower back pain in youth are benign and short-lived, certain symptoms act as “red flags” that signal the need for a prompt medical evaluation. Pain that is severe, progressively worsening, or persists beyond four to six weeks should not be dismissed, as it may indicate an underlying structural issue. Pain that wakes the individual up from sleep at night, or pain that is constant and does not ease when lying down, warrants immediate medical assessment.
Neurological symptoms require urgent attention, including numbness, tingling, or weakness that radiates down one or both legs. A sudden loss of bowel or bladder control is a rare but serious symptom that must be evaluated immediately. Systemic signs such as unexplained fever, chills, night sweats, or unintentional weight loss accompanying the back pain are also indicators of a potentially serious non-muscular pathology, such as infection or inflammation.