Back Spasm, No Trauma (Toddler)

Anything that puts stress on the muscles, ligaments, and bones can cause back pain and spasm. A muscle spasm is an involuntarily muscle contraction. The muscles cramp up and become very tight. They may feel hard. Muscle spasms can be very painful. They may occur in the upper or lower back, on one or both sides of the spine. This condition is called a back spasm.

Back spasms in toddlers can be caused by injury, too much activity, or very tired muscles.

Illnesses can also cause back pain. Because children have trouble describing things, it may be hard for you to tell if an illness is causing your child's pain, rather than injury. Other causes include dehydration, bladder infections, appendicitis, or abdominal infections. If your child has any of these symptoms, follow up with your healthcare provider:

  • Fever, chills, or weight loss

  • Weakness or numbness

  • Trouble walking

  • Pain that spreads down one or both legs

  • Bowel or bladder problems

  • Pain that keeps the child from sleeping

The earlier the cause of a problem is found, the better. Make sure to see a doctor if the back pain lasts for more than a few days or gets progressively worse. Depending on what your healthcare provider finds after talking to you and examining your child, tests may be done.

Treatment depends on the cause of the spasm. If an underlying condition is found, treatment for that condition will likely relieve the spasm. For muscle spasms due to over-exercise or tired muscles, gently massaging the muscles may help.

Home care

The healthcare provider may prescribe medicines to relieve pain or inflammation. Follow the healthcare provider's instructions for giving these to your child.

General care

  • Massage can help relax the back muscles. Try rubbing the area that hurts to see if it helps. Stop if it's too painful.

  • During the first 24 to 72 hours after an injury, put an ice pack wrapped in a thin towel on the painful area for 20 minutes and then remove it for 20 minutes. Do this over a period of 60 to 90 minutes, or as often as your child will tolerate it.

  • Allow your child to continue most normal activities. Resting in bed is not necessary.

  • Don't use a heating pad at bedtime. Sleeping with a heating pad can lead to skin burns or tissue damage.

  • You can alternate using ice and heat.

Follow-up care

Follow up with your child's healthcare provider, or as advised.

Call 911

Call 911 if any of the following occur:

  • Trouble breathing

  • Confusion

  • Very drowsy or trouble awakening

  • Fainting or loss of consciousness

  • Rapid or very slow heart rate

  • Loss of bowel or bladder control 

When to get medical care

Call your child's healthcare provider right away if any of these occur:

  • Fever (see "Fever and children" below)

  • Chills

  • Severe cramping; cramping that lasts a long time, doesn't go away with stretching, or keeps coming back

  • Pain, tingling, or weakness in the arms or legs

  • Pain that wakes the child up at night

  • Weight loss

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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