NECK OR BACK
Back Pain
Definition
Pain or discomfort in the upper, mid or lower back
Minor muscle strain from overuse and back injury are included
Causes of Back Pain
Strained Back Muscles. New backaches in teens are mostly from strained back muscles (muscle overuse). The pain is mostly in the lower back and near the center. There are 200 muscles in the back that allow us to stand upright.
Work Triggers. Carrying something too heavy or lifting from an awkward position can cause back pain. Bending too far backward or sideways can cause back pain. Digging in the garden for too long causes overuse of back muscles.
Exercise. New exercises or changes in an exercise routine can cause back pain. This is also called muscle overuse.
Back Packs. In school-age children, heavy backpacks have become a common cause. They also can cause shoulder and neck pains. Children who have not gone into puberty are at greater risk. Reason: They lack the muscle mass.
Kidney Infection (Serious). Pain is on one side in the middle of the back. Other symptoms are fever and pain when passing urine.
Kidney Stone (Serious). Pain is on one side of the mid-back and shoots into the lower belly. The pain is extremely severe. The urine has blood in it.
Sciatic Nerve Pain (Serious). Sciatica is pain caused by a pinched nerve in the lower back. Sciatica gives a burning pain in one buttock. The pain shoots into the back of the leg on that side. The most intense pain can be in the lower leg and foot. Leg weakness, numbness or tingling can also occur. A ruptured disk causes the pressure on the nerve. Sciatica is rare in children but common in adults.
Symptoms of Back Pain
Strained back muscles cause most of these symptoms:
The pain is in the middle or lower back
The pain is made worse by bending
The muscles near the spine are tender to the touch
The muscles may be tight (in spasm)
Pain Scale
Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
Severe: The pain is very bad. It keeps your child from doing all normal activities.
When To Call
Call 911 Now
Pain starts after major injury (such as a car crash or football). Caution: do not move your child until a spine board is put on.
You think your child has a life-threatening emergency
Go to ER Now
Can't pass urine or can only pass a few drops
Can't walk or can barely walk
Call Doctor or Seek Care Now
Severe pain
Pain shoots into the buttock or back of the thigh
Tingling or numbness (loss of feeling) in the legs or feet
Blood in urine
Pain or burning when passing urine and fever
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
Pain or burning when passing urine, but no fever
Fever
Walks different than normal for more than 3 days
You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
Age is less than 5 years
Pain in the upper back
Cause is not clear (no history of overuse or twisting)
Cause is bending backwards (such as in gymnastics)
Back pain from overuse (exercise or work) lasts more than 2 weeks
Back pains are a frequent problem
You have other questions or concerns
Self Care at Home
Strained back muscles (from exercise or work) present less than 2 weeks
Care Advice
What You Should Know About Back Pain:
Most new lower back pain is caused by lifting heavy objects. Lifting while the back is twisted is a common cause. Muscle overuse from exercise also causes strained back muscles.
Pain is not the only symptom. Walking a little bent over or stiff may occur for a few days.
Here is some care advice that should help.
Pain Medicine:
To help with the pain, give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Use as needed.
Reason: Helps back pain and muscle spasms.
Cold Pack for Pain:
For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
Put it on the sore muscles for 20 minutes.
Repeat 4 times on the first day, then as needed.
Reason: Helps with the pain and muscle spasms.
Caution: Avoid frostbite.
Use Heat After 48 Hours:
If pain lasts over 2 days, put heat on the sore muscle.
Use a heat pack, heating pad or warm wet washcloth.
Do this for 10 minutes, then as needed.
Reason: Increase blood flow and improve healing.
Caution: Avoid burns.
Sleep on the Side:
Sleep on the side with a pillow between the knees.
If your child only sleeps on the back, put a pillow under the knees.
Avoid sleeping on the stomach.
The mattress should be firm. Do not sleep on a waterbed.
Activity:
Avoid any sports or work that increase the pain.
Avoid lifting or jumping until well.
After 48 hours, start gentle back stretching exercises.
Complete bed rest is not needed.
Prevent Backpack Pain:
Limit the weight of what is carried. It needs to less than 15% of body weight. That means a 100-pound (45 kg) child should not carry more than 15 pounds (7 kg).
A sign of carrying too much weight is having to lean forward when walking.
Buy a well-made backpack with wide, padded shoulder straps.
Never carry the pack on just one shoulder. Reason: causes shoulder and neck pain.
What to Expect:
New back pain without a reason most often goes away in a few days.
Back pain from muscle overuse (strained back muscles) goes away in 1 to 2 weeks.
Call Your Doctor If:
Pain becomes severe
Walks different than normal for more than 3 days
Pain starts to shoot into the leg
Fever occurs
Pain lasts more than 2 weeks
You think your child needs to be seen
Pain gets worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Lymph Nodes - Swollen
Definition
Increased size of one or more lymph nodes. Most are in the neck.
Also, includes swollen lymph nodes in the armpit or groin
It's larger than the same node on the other side of the body
Normal nodes are usually less than ½ inch (12 mm) across. This is the size of a pea or baked bean.
Causes of Swollen Lymph Nodes
Neck Nodes. The cervical (neck) nodes are most commonly involved. This is because of the many respiratory infections that occur during childhood.
Viral Throat Infection. This is the most common cause of swollen nodes in the neck. The swollen nodes are usually ½ to 1 inch (12 -25 mm) across. They are the same on each side.
Bacterial Throat Infection. A swollen node with a bacterial throat infection is usually just on one side. It can be quite large; over 1 inch (25 mm) across. This is about the size of a quarter. Most often, it's the node that drains the tonsil.
Tooth Decay or Abscess. This causes a swollen, tender node under the jawbone. Only one node is involved. The lower face may also be swollen on that side.
Armpit Swollen Nodes. Causes include skin infections (such as impetigo). A rash (such as poison ivy) can do the same.
Groin Swollen Nodes. Causes include skin infections (such as athlete's foot). A retained foreign object (such as a sliver) can be the cause.
Shaving. Teen girls can cause low-grade infections when shaving the legs.
Widespread Swollen Nodes. Swollen nodes everywhere suggest an infection spread in the blood. An example is infectious mono. Widespread rashes such as eczema can also cause all the nodes to enlarge.
Normal Nodes. Lymph nodes can always be felt in the neck and groin. They are about the size of a bean. They never go away.
Lymph Nodes: What They Drain
The lymph nodes are filled with white blood cells. They filter the lymph fluid coming from certain parts of the body. They fight infections.
Neck Nodes in Front. These drain the nose, throat and lower face.
Neck Nodes in Back. These drain the scalp.
Armpit Nodes. These drain the arms and upper chest wall.
Groin Nodes. These drain the legs and lower stomach wall.
Common Objects Used to Guess the Size
Pea or pencil eraser: ÂĽ inch or 6 mm
Dime: Âľ inch or 1.8 cm
Quarter: 1 inch or 2.5 cm
Golf ball: 1 ½ inches or 3.8 cm
Tennis Ball: 2 ½ inches or 6.4 cm
When To Call
Call Doctor or Seek Care Now
Node in the neck causes trouble with breathing, swallowing or drinking
Fever over 104° F (40° C)
Skin over the node is red
Node gets much bigger over 6 hours or less
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
1 or more inches (2.5 cm or more) in size by measurement
Very tender to the touch
Age less than 1 month old
Node limits moving the neck, arm or leg
Toothache with a swollen node under the jawbone
Fever lasts more than 3 days
You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
In the neck and also has a sore throat
Large nodes at 2 or more parts of the body
Cause of the swollen node is not clear
Large node lasts more than 1 month
You have other questions or concerns
Self Care at Home
Mildly swollen lymph node
Care Advice
What You Should Know About Normal Nodes:
If you have found a pea-sized or bean-sized node, this is normal. Normal lymph nodes are smaller than ½ inch or 12 mm.
Don't look for lymph nodes, because you can always find some. They are easy to find in the neck and groin.
What You Should Know About Swollen Nodes from a Viral Infection:
Viral throat infections and colds can cause lymph nodes in the neck to get bigger. They may double in size. They may also become tender.
This reaction is normal. It means the lymph node is fighting the infection and doing a good job.
Here is some care advice that should help.
Pain Medicine:
To help with the pain, give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Use as needed.
Fever Medicine:
For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Note: Fevers less than 102° F (39° C) are important for fighting infections.
For all fevers: Keep your child well hydrated. Give lots of cold fluids.
Do Not Squeeze:
Don't squeeze lymph nodes.
Reason: This may keep them from shrinking back to normal size.
Return to School:
Swollen lymph nodes alone cannot be spread to others.
If the swollen nodes are with a viral illness, your child can return to school. Wait until after the fever is gone. Your child should feel well enough to participate in normal activities.
What to Expect:
After the infection is gone, the nodes slowly return to normal size.
This may take 2 to 4 weeks.
However, they won't ever completely go away.
Call Your Doctor If:
Node gets 1 inch (2.5 cm) or larger in size
Big node lasts more than 1 month
You think your child needs to be seen
Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Neck Pain or Stiffnes
Definition
Pain or discomfort in the back, side or front of the neck
Minor muscle strain from overuse and neck injury are included
Pain in the front of the neck often is from a sore throat. It can also be from a swollen lymph node.
Causes of Neck Pain
Strained Neck Muscles. In teens, new neck pain is mostly from stretched neck muscles (muscle overuse). The most common modern cause is working with the head flexed down. Such head bending occurs with texting or looking at smartphones and mobile devices. Reading lying in bed or working on a computer for hours can trigger neck pain. The neck likes to keep the head in a neutral position. This is because the head is heavy (12 pounds or 5.4 kilograms). Other triggers are sleeping in an awkward position or fixing something on the ceiling.
Infected Lymph Node. At all ages, it can be from a swollen lymph node. That can irritate and cause spasm of the neck muscle it lies against.