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I'm really worried about my nine-year-old son. He's been complaining of back pain for several weeks. The pediatrician said not to worry about it -- it will go away on its own. But this is a child who is very active on several sports teams, and this just isn't like him. How much longer should we wait before doing something?

Your pediatrician is right -- 80 to 90 per cent of children, teens, and adults with low back pain find that the symptoms go away gradually over a period of one to two weeks. But if it's already been several weeks with no change in a normally active child, then it's probably time to ask for a follow-up exam. Given that the majority of back pain resolves spontaneously, doctors don't order X-rays or other imaging studies routinely for back pain. Not only is it an added expense, but it can expose a child to unnecessary radiation at an early age. But when symptoms don't improve over time and/or the child gets worse, then an X-ray and even lab work may be helpful diagnostic tools. Some things may have changed from the first time your physician saw your son until now. That's another reason why a second visit would be timely. Given enough time, a serious problem (when present) will get worse and reveal itself more clearly. It's always better to catch things sooner than later. Early diagnosis and treatment can prevent more serious complications from developing.

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