Red Flags & When to Go In Person for Back Pain (Acute, Non-specific) in Children

Audience: pediatric

Back pain in children is common and often not caused by serious problems. Most cases are acute, meaning they start suddenly and are non-specific, which means no clear cause like injury or illness is found. Usually, this type of back pain improves with rest, gentle activity, and time. However, some signs mean a child should see a healthcare provider in person quickly. These include severe pain, weakness, numbness, or changes in bladder or bowel control. Telemedicine can help assess mild to moderate back pain, provide advice on care, and decide if in-person evaluation is needed. This guide helps parents and caregivers understand when to seek urgent care and what to expect from telemedicine visits.

Red flags — go in person / ER

• Severe back pain that worsens or does not improve with rest
• Weakness, numbness, or tingling in the legs or feet
• Loss of bladder or bowel control or difficulty urinating

What telemedicine can do

• Assess mild to moderate acute back pain symptoms
• Provide advice on home care and pain management
• Determine if in-person evaluation is needed
• Observe movement and posture via video

What telemedicine cannot do

• Perform hands-on physical examination
• Order or interpret imaging tests
• Provide emergency care for severe or worsening symptoms
• Diagnose serious underlying conditions

Understanding Acute, Non-specific Back Pain in Children

Acute, non-specific back pain means the pain started recently and does not have a clear cause like an injury or infection. In children, it often comes from muscle strain, poor posture, or carrying heavy backpacks. This type of pain usually improves in a few days to weeks with simple care such as rest and gentle movement.

When to Seek In-Person Care Immediately

Some symptoms may signal a more serious problem. If your child has any of the following, seek in-person medical care right away:

These signs may indicate conditions needing urgent evaluation.

What Telemedicine Can Do for Your Child’s Back Pain

Telemedicine providers can:

Telemedicine is a helpful first step for mild to moderate back pain without red flags.

Limitations of Telemedicine for Back Pain

Telemedicine cannot:

If your child has any red flags or worsening symptoms, an in-person visit is necessary.

Preparing for a Telemedicine Visit

Before your telemedicine appointment:

This preparation helps the provider assess your child effectively.

After the Telemedicine Visit

Follow the provider’s advice carefully. This may include:

Keep track of your child’s progress and reach out if you have concerns.

How to prepare for your tele-visit

• Write down the onset, location, and nature of the back pain
• Note any recent injuries, illnesses, or activities that may have caused pain
• Prepare a quiet, well-lit space for the video call
• Be ready to show your child's back and movements on camera
• Have a list of current medications and any previous medical history available

After your tele-visit

• Follow the telemedicine provider's advice on rest, activity, and pain relief
• Monitor your child's symptoms closely for improvement or worsening
• Schedule an in-person visit if red flags or new symptoms develop
• Keep a symptom diary to share with healthcare providers if needed
• Seek emergency care if severe symptoms or red flags appear

FAQs

What causes acute, non-specific back pain in children?

Acute, non-specific back pain in children often comes from muscle strain, poor posture, carrying heavy backpacks, or minor injuries. It usually does not involve serious conditions and tends to improve with rest and gentle activity.

When should I take my child to see a doctor in person?

You should seek in-person medical care if your child has severe or worsening back pain, weakness or numbness in the legs, difficulty walking, loss of bladder or bowel control, fever with back pain, or a recent back injury.

Can telemedicine providers prescribe medication for back pain?

Telemedicine providers can often recommend over-the-counter pain relief and advise on safe use. However, they may not prescribe stronger medications without an in-person evaluation, depending on local regulations and the child's condition.

How can I help my child feel better at home?

Encourage your child to rest and avoid activities that worsen pain. Gentle stretching and movement can help. Applying heat or cold packs may relieve discomfort. Always follow advice from your healthcare provider.

Is it safe to wait and see if the back pain improves?

For mild, non-specific back pain without red flags, it is often safe to monitor symptoms for a few days while providing home care. If pain worsens or new symptoms appear, seek medical care promptly.

Sources

1. Back Pain in Children and Adolescents — MedlinePlus, U.S. National Library of Medicine / NIH.
2. Low Back Pain in Children and Adolescents — American Academy of Pediatrics.
3. Acute Low Back Pain in Children and Adolescents — Mayo Clinic.
4. Telehealth: Delivering Care Safely During COVID-19 — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has any serious or worsening symptoms, seek immediate medical attention.