Although low back pain is thought to be rare in children, surveys show that this problem reaches frequencies up to 30 percent. Waist-back pains often arise from simple reasons such as carrying heavy backpacks, sitting in improper positions in front of the computer for long periods of time, or forcing the body while doing sports. Therefore, parents can underestimate the low back pain that occurs in their children, sometimes thinking that there are 'simple causes'. However, especially in children under 4 years of low back and back pain, such as tumors, rheumatism or infection can lie in serious pictures. But as a parent, in what circumstances should you suspect a serious cause of low back pain and consult a physician without delay? Child Health and Diseases Specialist from Acıbadem Etiler Medical Center Anil Yesildal, children developing low back pain 'alarm' signaling symptoms, he said. Watch out for the 4s rule! Child Health and Diseases Specialist Anıl Yeşildal warns that the cause of low back and back pain should be investigated in detail especially in children under 4 years of age. Because back-back pain in this age group is likely to have a serious cause. Dr. Anıl Yeşildal, no matter how old children, more than 4 weeks of low back pain should be addressed more seriously, he says, saying: Less than 4 years, more than 4 weeks. Apart from these, regardless of your child's age and the duration of the pain, if you are accompanied by the following complaints, you are still in a situation where you need to take it seriously. “These symptoms signal 'alarm'! Dr. Dr. Anil Yesildal, back-back pain, rest, simple pain relievers do not pass, lasts long and / or the following symptoms are accompanied by, necessarily firstly a pediatrician, or even if necessary to refer to a specialist who deals with pediatric orthopedics. 1. Pain is stubborn and restricts the child's movements, arouses from sleep, 2. If general illness symptoms such as fever, cough, weight loss, fatigue and skin rash are accompanied, 3. If there are severe neurological symptoms such as urinary-fecal incontinence, weakness of the legs, numbness-tingling, 4. If pain spreads to legs, 5. A trauma such as a traffic accident or fall.WHICH DISEASE CAN BE A SIGNAL OF THE DISEASE? Dr. Anıl Yeşildal lists the serious factors underlying low back pain:1. Spine and spinal cord tumors or infectionsIn children, low back and back pain increases especially at night, arouses from sleep, and these complaints are accompanied by weight loss, fatigue and unexplained fever, pain spreading to arms or legs, loss of strength, numbness, numbness, urine, and large toilet incontinence. such as anomalies in the spinal cord. Low back and back pain, as well as the symptoms of the hernia is rare, but also can be seen in children. 2. Rheumatism, leukemia and distant organ tumorsSome rheumatic diseases such as Scheuermann's disease, juvenile rheumatoid arthritis and ankylosing spondylitis may also cause this problem in children. In this case, as well as low back and back pain, weight loss, fatigue and unexplained causes such as fever may be. The same complaints can also be seen in children with distant organ tumors, such as leukemia or brain tumors, neuroblastone, and Wilms tumor, spreading to the vertebral bones.3. Spine fracture or shiftIf lumbar-back pain suddenly occurs after an accident, it may be due to soft tissue injuries and growth plate slippage. In chronic low back pain, which usually starts after a trauma and lasts for a long time, spinal fractures (spondylolysis) and spinal displacement (spondylolisthesis) should be considered. These two diseases, especially in children engaged in exercise and similar sports, can occur without significant trauma.