Management of Nonspecific Back Pain

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Nonspecific back pain does not have any cause that is obvious right away. A child will usually complain of soreness or aching in some part of the back. This pain is not related to a bone injury in the spine. It likely involves the muscles. This type of pain often occurs from over-use or poor posture.

It is also known as chronic back pain, back ache, and musculoskeletal (mus cu lo SKELE tal) back pain.

Risk Factors

Three of the most common risk factors are:

  • Poor posture
  • Poor weight training form
  • Hard physical work
  • Inactivity with tight muscles (not stretching properly)

Signs and Symptoms

  • Dull, aching pain (not sharp, shooting, or related to numbness or tingling)
  • Pain usually occurs after sitting with improper posture or standing for a long time
  • Stiff back, tight hamstring, poor core strength
  • Pain comes and goes
  • Pain not usually caused by an injury


  • First, your child will have x-rays that show the front and side views of the spine. These are used to rule out any bone abnormality.
  • A neurological exam will be done to rule out spinal cord involvement.
  • A physical exam of the back and spine will make sure there is no physical abnormality that could be causing the back pain.


  • Your child’s doctor can write a prescription for physical therapy. When your child does the exercises and stretching moves that the therapist teaches, it will help to strengthen the core muscles.
  • The doctor recommends aerobic exercise of the child’s choice for 30 minutes, 3 times a week. Cardiovascular exercise works especially well.

  • If your child takes an anti-inflammatory medicine for 4 to 6 weeks, as prescribed by the doctor, it will help to lessen back pain.

What to Do and Watch for at Home

  • Sometimes, after beginning physical therapy and exercise, your child will have sore muscles. More activity than your child’s usually gets can cause this.
  • Always give your child anti-inflammatory medicines with food to decrease the risk of an upset stomach. Call your child’s doctor if he or she is unable to tolerate the medicine.


  • Please schedule a 3-month follow-up appointment to assess your child’s back pain and find out how the child is doing. If the back pain is better, we will discuss tapering off the anti-inflammatory medicine at this visit.

Management of Nonspecific Back Pain (PDF)

HH-I-432 10/17 Copyright 2017 Nationwide Children's Hospital