“Back pain that regularly occurs at night and awakens a child is usually associated with tumors or infections, such as osteomyelitis, diskitis, osteoid osteoma, osteoblastoma, and spinal cord tumors. Other possible symptoms associated with nighttime back pain include fever, malaise, and weight loss. Back pain that occurs at night is an indication for immediate medical evaluation.” ABFM critique
Bernstein RM, Cozen H: Evaluation of back pain in children and adolescents. Am Fam Physician 2007;76(11):1669-1676. 2)