01/19/2026
Your turn to be the doctor! (The patient here is my own daughter. 😄)
A two year old little girl comes to the office with complaints of back pain. Per parents, she will tell them her back hurts and will hold her lower back. She is playing like normal, walking normally, and has no other complaints.
What questions do you have? What would you do next? What are you worried about?
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Update! Y’all have it down! If I saw this patient in the office, I’d probably check her urine to rule out UTI, but usually by the time a UTI is causing back pain, it’s been around for a couple of days and other symptoms are also present. I would also ask about recent injury or repetitive movements that could cause overuse injury. I would consider an X-ray as well, to cover my bases. A spinal x-ray would give a little glimpse at bowels as well. I would discuss bowel habits as well, although back pain is rarer for constipation. Red flag signs for me would be new loss of bowel or bladder function, limp, any mass, headache, new rash, or overall fatigue. I always want to see any child in the office for a full history and exam if they have unexplained back pain.
In this case, the patient is copying her parents! Back pain is pretty uncommon in toddlers, but they are very perceptive. Often, they hear their parents say, “Oh! My back hurts,” without realizing it. I’ve learned through experience to always ask about parental back pain as well. 
