In this section
Back pain is uncommon in young children, but common in adolescence.
Watch out for red flags:
Look for any evidence of spinal deformity as well as radicular signs or any abnormal neurologic findings.
Most back pain is self-limited and requires no medical imaging.
If there is concern for spinal deformity (scoliosis/kyphosis) then an upright complete spine x-ray (PA and lateral) is most appropriate. An EOS scan would be the best option in the Greater Melbourne area.
If there is concern of abnormal neurologic findings then an MRI is the best imaging modality in most cases.
Back pain without radiologic abnormality and in the absence of radicular symptoms should be managed conservatively. Referral to local physiotherapy or similar would be appropriate. Heat and massage can be helpful adjuncts.
Short courses of oral analgesia may be appropriate when necessary.
Back pain without radiologic abnormality or radicular symptoms does not need specialist referral to the RCH.