We are witnessing a significant increase in cases of back pain among children and adolescents, similar to the high prevalence of back pain complaints in adults (which, along with the common cold, is the most frequent complaint during visits to family doctors).
In the past, back pain was a very rare complaint among children. Therefore, when a child presented with back pain, a comprehensive investigation was carried out, including examinations of abdominal issues (digestion, urine, reproductive system), strict orthopedic assessment (X-rays, bone mapping, and later computerized imaging based on suspicions), and other investigations based on specific complaints and findings. Nowadays, due to its high prevalence, we often encounter "muscular pain" in the back, which is similar to adult back pain.
During the first visit, we conduct an in-depth discussion with the child and parents and perform a meticulous physical examination. If there are no "red flags," we may initially proceed with observation only. "Red flags" are any signs that are atypical of muscular pain (e.g., waking up due to pain, night sweats, unexplained weight loss), and anything that originates from somewhere other than the back (e.g., flank pain accompanied by burning during urination).
At the same time, we guide the child in performing exercises at home and advise them to keep a journal of the pain's course (date of occurrence, duration, intensity, specific location of the pain, etc.) and whether over-the-counter medications helped.
During the second visit, about a month later (if the pain persists), we review the findings and decide on the next steps (imaging, investigating abdominal issues, physical therapy, or continued observation).
We do not consider back pain in children as a type of "growing pain."