Back pain is common in young people and for most young people is mild, infrequent and may not result in medical consultation. Like adults, most adolescent back pain is non-specific in nature and no obvious cause can be found. Differential diagnoses include inflammatory spine disease, idiopathic pain syndromes, tumour, infection, or metabolic, vascular and referred pain. A full clinical history including psychosocial assessment, mechanical factors, lifestyle including sports and family history, in addition to a full examination is important in all young people presenting with back pain. Management requires a multidisciplinary approach. There is good evidence for physiotherapy intervention efficacy for adolescent back pain.