1
|
Fazaa A, Cherif I, Miladi S, Boussaa H, Makhlouf Y, Abdelghani KB, Laatar A. Prevalence of spine pain among Tunisian children and adolescents and related factors. Pediatr Rheumatol Online J 2024; 22:84. [PMID: 39252107 PMCID: PMC11386316 DOI: 10.1186/s12969-024-01007-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/25/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND The prevalence of back and neck pain is common in children and adolescents, and in some series the numbers are alarming. Various risk factors have been identified, although some are controversial. OBJECTIVE To determine the prevalence of neck and back pain in children and adolescents and to investigate the potential association with various risk factors identified in the literature. METHODS We established a questionnaire targeting parents of children and adolescents aged between 6 and 18 years old in Tunisia. The recruitment of participants was done online using the Google Forms application. The questionnaire was divided into 2 parts: Part one collected the sociodemographics characteristics of the participants : age, gender, body mass index (BMI), exposure to passive smoking, the practice of a physical activity, puberty status and age at puberty if applicable, type and weight of the schoolbag, mean daily time spent on electronic devices, type of school the child attends (private/public), mode of transport from home to school, parental history of neck and/or back pain (mid or low back pain (LBP)), posture of the sitting position of the child, and finally whether the child reports neck/ back pain. The second part was aimed at parents whose child reported neck and/or back pain. We asked about the weekly frequency of neck/back pain, school absenteeism due to neck/back pain, whether it prevented the child from practicing physical activity and, finally, whether the child had ever seen a doctor/chiropractor/physiotherapist for their neck/back pain. RESULTS Eighty-eight children (45 females, 43 males) were enrolled. Mean age was 11.9 ± 3.8 years [6-18]. Mean BMI was 18.8 ± 4.2 [15.8-35.5]. Thirty-four (38.6%) were pubescent. Twenty-five (28.4%) children were exposed to passive smoking. Parental history of spine pain was found in 58% of cases. A poor sitting position was noted in n = 49 (55.7%). Mean daily screen time was 88.3 ± 75.56 min [0-360]. Prevalence of spine pain was 44% (n = 39) distributed as follows: neck pain (n = 21, 23.8%), mid back pain (n = 15, 17%), LBP (n = 26, 29.5%), neck, mid back and low back pain (n = 4, 4.5%) Professional help seeking for spine pain in children was reported by 15 participants (25.3%). Among them, 20.3% visited a physician and 5% consulted a chiropractor or physiotherapist. A significant correlation was found between spine pain and age (p = 0.006) and BMI (p = 0.006). A significant association was found between LBP and exposure to passive smoking, puberty status, type of school bag and poor posture. A positive parental history of spine pain was significantly associated with the presence of spine pain in their children with p = 0.053 (neck pain), p = 0.013 (back pain) and p < 0.00 (LBP) respectively. A significant association was found between the presence of spine pain and school absenteeism, participation in sports, consultation with a doctor or physiotherapist/chiropractor (p < 0.0001 respectively). CONCLUSION The prevalence of spinal pain was frequent in our series. A positive parental history of spinal pain, a bad posture while sitting, passive smoking, use of backpack, higher age and higher BMI were potential associated factors.
Collapse
Affiliation(s)
- Alia Fazaa
- Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia
- Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia
| | - Ines Cherif
- Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia.
- Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia.
| | - Saoussen Miladi
- Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia
- Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia
| | - Hiba Boussaa
- Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia
- Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia
| | - Yasmine Makhlouf
- Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia
- Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia
| | - Kaouther Ben Abdelghani
- Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia
- Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia
| | - Ahmed Laatar
- Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia
- Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia
| |
Collapse
|
2
|
Falch-Joergensen AC, Andersen PK, Budtz-Jorgensen E, Hestbaek L, Strandberg-Larsen K, Nybo Andersen AM. Body height and spinal pain in adolescence: a cohort study from the Danish National Birth Cohort. BMC Musculoskelet Disord 2023; 24:958. [PMID: 38082386 PMCID: PMC10712045 DOI: 10.1186/s12891-023-07077-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES To investigate how body height and trajectories of height from infancy through childhood and adolescence were associated with spinal pain in pre- and late adolescence. METHODS This prospective study included 43,765 individuals born into The Danish National Birth Cohort (DNBC) from 1996 to 2003. DNBC-data were linked with health and social data identified from Statistics Denmark registers. Spinal pain was self-reported in both the 11-year- and 18-year follow-up of DNBC and classified according to severity. Body height was measured from birth and onwards and further modelled as distinct developmental height trajectories by using latent growth curve modelling. Associations were estimated by using multinomial logistic regression models. RESULTS Taller body height in childhood and adolescence was associated with approximately 20% increased likelihood of spinal pain in pre- and late adolescence among girls compared to their peers in the normal height group. For boys, taller body height was associated with spinal pain by late adolescence only. Spinal pain in pre-adolescence almost doubled the likelihood of spinal pain in late adolescence regardless of body height at age 18. Height trajectories confirmed the relationship for girls with the tall individuals being most likely to have spinal pain in both pre- and late adolescence. CONCLUSION Tall body height during childhood and adolescence predisposes to spinal pain among girls in both pre-and late adolescence, and among boys in late adolescence. Body height is a contributing factor to the pathogenesis of spinal pain in adolescence; however, the mechanisms may be related to growth velocity, but for now uncertain.
Collapse
Affiliation(s)
- Anne Cathrine Falch-Joergensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Oster Farimagsgade 5, Box 2099, Copenhagen K, DK-1014, Denmark.
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen K, Denmark
| | - Esben Budtz-Jorgensen
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen K, Denmark
| | - Lise Hestbaek
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Katrine Strandberg-Larsen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Oster Farimagsgade 5, Box 2099, Copenhagen K, DK-1014, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Oster Farimagsgade 5, Box 2099, Copenhagen K, DK-1014, Denmark
| |
Collapse
|
3
|
Li R, Lopez DA, Gupta M, Palermo TM. Pubertal development and pain incidence and characteristics in children: a 1-year prospective cohort study of a national sample. Pain 2023; 164:2725-2736. [PMID: 37343155 DOI: 10.1097/j.pain.0000000000002969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023]
Abstract
ABSTRACT Sex differences in pain become apparent during puberty. However, the influence of key pubertal characteristics and pubertal hormones on pain is largely unknown. We examined the prospective associations between self-reported and hormone-indicated pubertal characteristics and pain incidence and severity in 10- to 11-year-old pain-free youth in the Adolescent Brain Cognitive Development (ABCD) Study over 1 year. Puberty was measured at baseline and follow-up with self-report (Pubertal Development Scale [PDS]) and hormonal assessment (salivary dehydroepiandrosterone [DHEA], testosterone, and estradiol). Pain status (yes/no), intensity, and interference (0-10 numerical rating scale) in the past month were self-reported at follow-up. Pubertal maturity, progression, and asynchrony were examined in relation to pain onset and severity through confounder-adjusted generalized estimating equations modified Poisson and linear mixed regression models. Among 6631 pain-free youth at baseline, 1-year incident pain was 30.7%. In both sexes, higher PDS scores were associated with greater risk of pain onset (relative risk [RR] = 1.10 to 1.27, P s < 0.01). In boys, higher PDS item variance was associated with greater pain incidence (RR = 1.11, 95% CI, 1.03-1.20) and interference (beta = 0.40, 95% CI, 0.03-0.76); higher PDS overall and gonadal scores were associated with higher pain intensity ( P s < 0.05). Associations with hormones were seen in boys only, with each 10-fold higher testosterone levels associated with a 40% lower risk of pain incidence (95% CI, -55% to -22%) and 1.30-point lower (95% CI, -2.12 to -0.48) pain intensity, and higher DHEA levels were associated with lower pain intensity ( P = 0.020). Relationships between pubertal development and pain in peripubertal adolescents are sex specific and puberty measurement specific and warrant further investigation.
Collapse
Affiliation(s)
- Rui Li
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Daniel A Lopez
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Meenal Gupta
- Division of Endocrinology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States
| |
Collapse
|
4
|
Ito T, Sugiura H, Ito Y, Narahara S, Natsume K, Takahashi D, Noritake K, Yamazaki K, Sakai Y, Ochi N. Relationship between low-back pain and flexibility in children: A cross-sectional study. PLoS One 2023; 18:e0293408. [PMID: 37948451 PMCID: PMC10637693 DOI: 10.1371/journal.pone.0293408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023] Open
Abstract
Low-back pain is common among school-aged children. Decreased trunk flexibility in childhood influences low-back pain in adulthood. Previous studies examining the association between low-back pain and trunk flexibility in children are insufficient. Examining this association among elementary school children may help to better understand trunk flexibility in children with low-back pain and to modify the management of inflexibility. Therefore, this study aimed to identify the prevalence of low-back pain and its relationship with physical function among elementary school students. School-aged children aged 6-12 years were recruited in Japan between May 2018 and March 2023. Fingertip-to-floor distance, back muscle strength, pelvic tilt angle during gait, and the visual analog scale for low-back pain were measured. In addition, factors independently related to low-back pain were determined through logistic regression analysis. Low-back pain was reported in 9.6% of the 394 participants (boys, 191; girls, 203). All children with low-back pain presented with back pain when they moved; however, the pain was non-specific. Logistic regression analysis showed that the fingertip-to-floor distance was an independent risk factor for low-back pain (odds ratio, 0.921; p = 0.007). The odds ratios calculated in the logistic regression analysis confirmed that low-back pain frequency increased as the fingertip-to-floor distance decreased. The risk of low-back pain was associated with inflexibility, regardless of sex and muscle strength. These findings suggest that children with low-back pain must increase their trunk and lower extremity flexibility.
Collapse
Affiliation(s)
- Tadashi Ito
- Three-Dimensional Motion Analysis Laboratory, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki, Japan
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yuji Ito
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Pediatrics, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki, Japan
| | - Sho Narahara
- Department of Pediatrics, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki, Japan
| | - Kentaro Natsume
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Daiki Takahashi
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Koji Noritake
- Department of Orthopedic Surgery, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki, Japan
| | | | - Yoshihito Sakai
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Nobuhiko Ochi
- Department of Pediatrics, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki, Japan
| |
Collapse
|
5
|
Lauridsen HH, Meldgaard E, Hestbæk L, Hansen GK. Development of the Young Disability Questionnaire (spine) for children with spinal pain: field testing in Danish school children. BMJ Open 2023; 13:e064382. [PMID: 37197823 DOI: 10.1136/bmjopen-2022-064382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
OBJECTIVE The objective of this study was to finalise the development of the Young Disability Questionnaire (YDQ-spine) to measure the consequences of neck, midback and low back pain, relevant for schoolchildren aged 9-12 years. DESIGN A cross-sectional field test of the YDQ-spine was carried out. SETTING Danish primary schools. PARTICIPANTS Children aged 9-12 years from all Danish schools were invited to complete the questionnaire. METHODS Eight hundred and seventy-three schools were invited to participate. Consenting schools received information material, instructions and a link to an electronic version of the prefinal YDQ-spine. Local teachers distributed the electronic YDQ-spine to children aged 9-12 years. Descriptive statistics and item characteristics were carried out. Item reduction was performed using partial interitem correlations (scrutinising correlations>0.3) and factor analyses (items loading>0.3 were retained) to eliminate redundant items and to obtain insight into the structure of the questionnaire. RESULTS A total of 768 children from 20 schools answered of the questionnaire and 280 fulfilled the inclusion criteria of having back and/or neck pain (36%). Multisite pain was reported by 38%. Partial interitem correlations and factor analyses resulted in elimination of four items which were considered redundant leaving 24 items in the final YDQ-spine with an optional section on what matters most to the child. The factor analyses showed a two-factor structure with a physical component (13 items) and a psychosocial component (10 items) in addition to one standalone item (sleep). CONCLUSION The YDQ-spine is a novel questionnaire with satisfactory content validity measuring physical and psychosocial components (including sleep disturbances) of spinal pain in children aged 9-12 years. It also offers an optional section on what matters most to the child allowing targeted care in clinical practice.
Collapse
Affiliation(s)
- Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Emilie Meldgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lise Hestbæk
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Chiropractic Knowledge Hub, University of Southern Denmark, Odense, Denmark
| | - Gabrielle Kristine Hansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
6
|
Nahman-Averbuch H, Li R, Boerner KE, Lewis C, Garwood S, Palermo TM, Jordan A. Alterations in pain during adolescence and puberty. Trends Neurosci 2023; 46:307-317. [PMID: 36842946 DOI: 10.1016/j.tins.2023.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/16/2023] [Accepted: 01/27/2023] [Indexed: 02/26/2023]
Abstract
During adolescence and puberty, alterations in pain, both experimental and clinical, are observed. In addition, adolescents undergo extensive biopsychosocial changes as they transition from childhood to adulthood. However, a better understanding of how the biopsychosocial changes during adolescence impact pain is needed to improve pain management and develop targeted pain interventions for adolescents. This review synthesizes the literature on alterations in pain during adolescence in humans, describes the potential biopsychosocial factors impacting pain during adolescence, and suggests future research directions to advance the understanding of the impact of adolescent development on pain.
Collapse
Affiliation(s)
- Hadas Nahman-Averbuch
- Washington University Pain Center and Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St Louis School of Medicine, St. Louis, MO, USA.
| | - Rui Li
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Katelynn E Boerner
- Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Christopher Lewis
- Division of Endocrinology and Diabetes, Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA; Transgender Center at St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah Garwood
- Transgender Center at St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA; Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Abbie Jordan
- Department of Psychology and Centre for Pain Research, University of Bath, Bath, United Kingdom
| |
Collapse
|
7
|
Senger-Carpenter T, Scott EL, Isaman DJM, Lenko R, Seng J, Ploutz-Snyder R, Robinson-Lane SG, Cofield C, Chen B, Voepel-Lewis T. Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence: Analysis of the ABCD Cohort. Clin J Pain 2022; 38:670-679. [PMID: 36094004 PMCID: PMC9561068 DOI: 10.1097/ajp.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/30/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Multi-region pain during adolescence is associated with a higher symptom burden and lower quality of life. The purpose of this study was to describe and compare the biopsychosocial attributes of single-region and multi-region pain among healthy young adolescents. MATERIALS AND METHODS We analyzed data from 10,320 children aged 10.6 to 14 years who self-reported pain in the Adolescent Brain and Cognitive Development Study. Pain was coded as single-region or multi-region based on body map data. RESULTS One in 5 young adolescents indicated recent multi-region pain. Sequential regression supported improved model fit when psychological and sociocultural factors were added to a biological model of pain; however, these models improved the classification of multi-region but not single-region pain. A significant interaction effect of sex and puberty remained constant across models with increased odds of pain at each advancing pubertal stage for both sexes compared with prepuberty, but no difference between girls and boys at late puberty (adjusted odds ratio [OR]=2.45 [1.72, 3.49] and adjusted OR=1.63 [1.20, 2.23], respectively). Psychological factors improved the classification of multi-region pain with significant effects of anxiety, somatic symptoms, and somnolence. Finally, compared with White and non-Hispanic children, Black and Hispanic children were less likely to report pain (adjusted OR=0.70 [0.61, 0.80]; adjusted OR=0.88 [0.78, 0.99], respectively) but had significantly higher pain interference when pain was present (adjusted OR=1.49 [1.29, 1.73] and adjusted OR=1.20 [1.06, 1.35], respectively). DISCUSSION Pain is a biopsychosocial phenomenon, but psychological and sociocultural features may be more relevant for multi-region compared with single-region pain during early adolescence.
Collapse
Affiliation(s)
| | - Eric L. Scott
- Michigan Medicine Department of Pediatrics, The University of Michigan, Ann Arbor, MI 48109
- Michigan Medicine Department of Anesthesiology at The University of Michigan, Ann Arbor, MI 48109
| | - Deanna JM Isaman
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Rachel Lenko
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Julia Seng
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | | | | | - Cherie Cofield
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Bingxin Chen
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Terri Voepel-Lewis
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
- Michigan Medicine Department of Pediatrics, The University of Michigan, Ann Arbor, MI 48109
| |
Collapse
|
8
|
Lund T, Schlenzka D, Lohman M, Ristolainen L, Kautiainen H, Klemetti E, Österman K. The intervertebral disc during growth: Signal intensity changes on magnetic resonance imaging and their relevance to low back pain. PLoS One 2022; 17:e0275315. [PMID: 36194584 PMCID: PMC9531821 DOI: 10.1371/journal.pone.0275315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Life-time prevalence of low back pain (LBP) in children and adolescents varies from 7% to 72%. Disc changes on magnetic resonance imaging (MRI) have been reported in up to 44% of children with earliest observations around pre-puberty. In this longitudinal cohort study, our objective was to determine the natural history of disc changes from childhood to early adulthood, and the possible association of these changes to LBP. Healthy 8-year-old schoolchildren were recruited for this longitudinal study consisting of a semi-structured interview, a clinical examination, and an MRI investigation at the age of 8-9 (Y8), 11-12 (Y12) and 18-19 (Y19) years. The interview inquired about LBP without trauma. T2-weighted sagittal MRI of the lumbar spine was acquired. Life-long prevalence of LBP was determined, and the disc signal intensity (SI) at the three lowest lumbar levels was assessed both visually using the Schneiderman classification (Bright-Speckled-Dark), and digitally using the disc to cerebrospinal fluid -SI ratio. Possible associations between SI changes and LBP were analyzed. Ninety-four of 208 eligible children were included at Y8 in 1994, 13 and 23 participants were lost to follow-up at Y12 and Y19, respectively. Prevalence of LBP increased after the pubertal growth spurt reaching 54% at Y19. On MRI, 18%, 10% and 38% of participants had disc SI changes at Y8, Y12 and Y19, respectively. No significant associations between self-reported LBP and either qualitative or quantitative disc SI changes were observed at any age. Life-time prevalence of LBP reached 54% by early adulthood. Disc SI changes on MRI traditionally labeled as degenerative were seen earlier than previously reported. Changes in disc SI were not associated with the presence of LBP in childhood, adolescence or early adulthood.
Collapse
Affiliation(s)
- Teija Lund
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- * E-mail:
| | | | - Martina Lohman
- Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | | | | |
Collapse
|
9
|
Shimonovich M, Pearce A, Thomson H, Katikireddi SV. Causal assessment in evidence synthesis: A methodological review of reviews. Res Synth Methods 2022; 13:405-423. [PMID: 35560730 PMCID: PMC9543433 DOI: 10.1002/jrsm.1569] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 03/11/2022] [Accepted: 05/07/2022] [Indexed: 11/10/2022]
Abstract
In fields (such as population health) where randomised trials are often lacking, systematic reviews (SRs) can harness diversity in study design, settings and populations to assess the evidence for a putative causal relationship. SRs may incorporate causal assessment approaches (CAAs), sometimes called 'causal reviews', but there is currently no consensus on how these should be conducted. We conducted a methodological review of self-identifying 'causal reviews' within the field of population health to establish: (1) which CAAs are used; (2) differences in how CAAs are implemented; (3) how methods were modified to incorporate causal assessment in SRs. Three databases were searched and two independent reviewers selected reviews for inclusion. Data were extracted using a standardised form and summarised using tabulation and narratively. Fifty-three reviews incorporated CAAs: 46/53 applied Bradford Hill (BH) viewpoints/criteria, with the remainder taking alternative approaches: Medical Research Council guidance on natural experiments (2/53, 3.8%); realist reviews (2/53, 3.8%); horizontal SRs (1/53, 1.9%); 'sign test' of causal mechanisms (1/53, 1.9%); and a causal cascade model (1/53, 1.9%). Though most SRs incorporated BH, there was variation in application and transparency. There was considerable overlap across the CAAs, with a trade-off between breadth (BH viewpoints considered a greater range of causal characteristics) and depth (many alternative CAAs focused on one viewpoint). Improved transparency in the implementation of CAA in SRs in needed to ensure their validity and allow robust assessments of causality within evidence synthesis.
Collapse
Affiliation(s)
- Michal Shimonovich
- MRC/CSO Social & Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Anna Pearce
- MRC/CSO Social & Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Hilary Thomson
- MRC/CSO Social & Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | | |
Collapse
|
10
|
Prevalence and Characteristics of Back Pain in Children and Adolescents from the Region of Murcia (Spain): ISQUIOS Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020946. [PMID: 35055768 PMCID: PMC8775889 DOI: 10.3390/ijerph19020946] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
Puberty is a vulnerable period for musculoskeletal disorders due to the existence of a wide inter-individual variation in growth and development. The main objective of the present study was to describe the prevalence of back pain (BP) in the past year and month in school-aged children according to sex, age, maturity status, body mass index (BMI) and pain characteristics. This study involved 513 students aged between 9 and 16 years. Anthropometric measures were recorded to calculate the maturity stage of the students using a regression equation comprising measures for age, body mass, body height, sitting height and leg length. An ad hoc questionnaire composed of eight questions was used to describe BP prevalence in school-aged children. The results showed that the prevalence of BP in school-aged children was observed in 35.1% over the last year (45% boys and 55% girls), and 17.3% (40.4% boys and 59.6% girls, with an association found between female sex and BP) in the last month. The prevalence of back pain in the past year and month was higher the older the students were, or the more pubertal development they had experienced. The prevalence of BP in the last year was also higher in those with overweight or obesity. After adjustment for sex, there was an association between BP and older age and higher BMI in boys and an association between BP and higher pubertal development in girls. In summary, the present study showed that the prevalence of BP was related to the maturity stage and weight of the participants, with different prevalence patterns found according to sex.
Collapse
|
11
|
Henriot-Jéhel C, Lemire J, Teulier C, Bussières A, Lardon A. Factors associated with back pain in children aged 6 to 12 years of age, an eight months prospective study. Sci Rep 2022; 12:603. [PMID: 35022415 PMCID: PMC8755799 DOI: 10.1038/s41598-021-04060-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/14/2021] [Indexed: 12/03/2022] Open
Abstract
Associated factors of back pain (BP) development before puberty and its persistence are poorly documented. We investigated the association and possible temporality between prior BP history (PBPH), muscular endurance (ME), aerobic capacity (AC), sport activity variables (SAV) and BP in children aged 6 to 12. We collected baseline characteristics (demographics, PBPH, ME, AC and SAV) of children from three primary schools in Canada. Parents replied to weekly text messages regarding their children BP status over an 8-month period. Logistic regression models were adjusted for potential confounders. Data from 242 children (46% female; 8.6 ± 1.7 years) were included. Over the 8-month survey BP prevalence was 48.1%, while the cumulative incidence was 31.9%. The occurrence of at least one BP event was associated with PBPH [OR (IC 95%) = 6.33 (2.35-17.04)] and high AC [2.89 (1.21-6.90)]. High AC was also associated with the development of a first BP episode [2.78 (1.09-7.07)], but ME and SAV were not. BP appears to be relatively common before puberty. BP history seems to be strongly associated with BP recurrence in children. Aerobic capacity is associated with first BP episode development.
Collapse
Affiliation(s)
- Claire Henriot-Jéhel
- Université Paris-Saclay CIAMS, 91405, Orsay, France.
- Université dOrléans CIAMS, 45067, Orléans, France.
- Institut Franco-Européen de Chiropraxie, 24 Boulevard Paul Vaillant Couturier, 94200, Ivry sur Seine, France.
| | - Jocelyn Lemire
- Université du Québec À Trois-Rivières, Trois-Rivières, Canada
| | - Caroline Teulier
- Université Paris-Saclay CIAMS, 91405, Orsay, France
- Université dOrléans CIAMS, 45067, Orléans, France
| | - André Bussières
- Université du Québec À Trois-Rivières, Trois-Rivières, Canada
- Faculty of Medicine and Health Science, McGill University, Quebec, Canada
| | - Arnaud Lardon
- Université Paris-Saclay CIAMS, 91405, Orsay, France
- Université dOrléans CIAMS, 45067, Orléans, France
- Institut Franco-Européen de Chiropraxie, 24 Boulevard Paul Vaillant Couturier, 94200, Ivry sur Seine, France
| |
Collapse
|
12
|
Sidiq M, Alenazi W, Kashoo FZ, Qasim M, Lopez MP, Ahmad M, Mani S, Shaphe MA, Khodairi O, Almutairi A, Mir SA. Prevalence of non-specific chronic low-back pain and risk factors among male soldiers in Saudi Arabia. PeerJ 2021; 9:e12249. [PMID: 34721972 PMCID: PMC8519176 DOI: 10.7717/peerj.12249] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 09/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background Non-specific chronic low back pain (NSCLBP) is the most common musculoskeletal disorder affecting health and work among the military population. NSCLBP is a complex disorder with several risk factors contributing to its occurrence. Therefore, the objective of our study was to estimate the prevalence and contribution of risk factors towards NSCLBP among male soldiers in Saudi Arabia. Methods A cross-sectional study was conducted from March 2020 to January 2021 among the military personnel at Hafar Al-Batin military base, Saudi Arabia. The entire population (n = 62, 000) at the military base were invited to participate in the study. The participants were invited to participate in the study either through direct referral from in-patient and out-patient departments of the military hospital or by invitation through pamphlets, email, and advertisement across the offices and residential areas. Soldiers reporting lower back pain for at least 12 weeks were screened for inclusion criteria at the physical therapy department of the military hospital. Inclusion criteria included pain or discomfort originating from the lower back without any known spinal diseases. Participants with a systemic inflammatory disorder, trauma, neurological symptoms, and recent spinal surgery were excluded. All eligible participants were assessed for demographic variables and risk factors and complete the Rolland Morris Disability Questionnaire and WHO-Five Well-Being Index. Results This study identified a 46.3% prevalence of pain originating from the spine with a 2.7% prevalence of NSCLBP. Spearman's rho correlation between the severity of disability due to NSCLBP was strongly associated with age (rs = 0.834, p < 0.01), quality of sleep (rs = 0.790, p < 0.01), body mass index (BMI) (rs = 0.617, p < 0.01), smoking (rs = 0.520, p < 0.01), co-morbidity (rs = 0.357, p < 0.01), but not with the level of physical activity (rs = 0.044, p = 0.07). Conclusion There was a high prevalence of pain originating from the spine among male Saudi soldiers with a relatively low prevalence of NSCLBP. However, the prevalence of disability due to NSCLBP was strongly associated with age, sleep quality, BMI, smoking habit, and co-morbidity.
Collapse
Affiliation(s)
- Mohammad Sidiq
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia.,Faculty of Physiotherapy, Madhav University, Abu Road, Rajasthan, India
| | - Wadha Alenazi
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia
| | - Faizan Z Kashoo
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Mjamaah University, Al Majmaah, Saudi Arabia
| | - Mohammad Qasim
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia
| | - Marisia Paz Lopez
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia
| | - Mehrunnisha Ahmad
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Almajmaah, Saudi Arabia
| | - Suresh Mani
- Department of Physiotherapy, Lovely Professional University, Phagwara, Punjab, India
| | - Mohammad Abu Shaphe
- College of Applied Medical Sciences, Physical Therapy Department, Jazan University, Jazan, Saudi Arabia
| | - Omaymah Khodairi
- Department of Physical Therapy, College of Applied Medical science, Jazan University, Jazan, Saudi Arabia
| | - Abdulqader Almutairi
- Department of Physical Therapy, College of Applied Medical science, Jazan University, Jazan, Saudi Arabia
| | - Shabir Ahmad Mir
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, Riyadh, Saudi Arabia
| |
Collapse
|
13
|
Prevalence of Back Pain and Idiopathic Scoliosis in Adolescents From the Semiarid Region of Brazil: A Cross-sectional Study. J Chiropr Med 2021; 20:97-107. [DOI: 10.1016/j.jcm.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022] Open
|
14
|
Innes S, Jacques A, Scott K, Walker B. Early age at menarche is associated with post-menarche back pain: An analysis of the Raine Study. Eur J Pain 2021; 25:2155-2165. [PMID: 34219328 DOI: 10.1002/ejp.1828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/25/2021] [Accepted: 06/16/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Back pain (BP) experienced by females during adolescent years appears to predispose them to an increased likelihood of its presence in adulthood. Understanding this phenomenon by identifying risk factors of those at risk potentially fosters preventative strategies and effective treatments. OBJECTIVES To investigate for associations between post-menarche BP and low back pain (LBP) and age at menarche (AAM) in Australian adolescents using the Western Australian pregnancy cohort (The Raine Study). METHODS This study used data from a longitudinal cohort study. BP data were collected retrospectively using a questionnaire. Menarche data was split into three established age classifications early (<12-years), normal (≥12 to >14-years) and late (≥14-years). Logistic regression models examined the effect of AAM on BP. RESULTS 666 female participants provided valid menarche data with 183 (27.5%) early AAM, 429 (64.4%) normal AAM and 54 (8.1%) with late AAM. The mean AAM was 12.59 years. BP was disclosed by 27.5% in the 14-year follow-up and 31.5% in the 17-year follow-up. Participants who had early AAM had 79% higher odds of experiencing BP compared to participants who had normal AAM, after adjusting for confounders at the 14-year follow-up (adjOR 1.79, 95% CI 1.18-2.64). CONCLUSION There is evidence of an association, in this cohort, of early AAM with post-menarche BP. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures. SIGNIFICANCE Age at menarche is related to a range of health issues. This study sought to investigate if it was a risk factor for spinal pain. We used an existing Australian data base to explore this possibility and found an association with early age onset and post-menarche back pain. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures.
Collapse
Affiliation(s)
- Stanley Innes
- Murdoch University, College of Science, Health, Education & Engineering, Perth, Western Australia, Australia
| | | | - Karin Scott
- Murdoch University, College of Science, Health, Education & Engineering, Perth, Western Australia, Australia
| | - Bruce Walker
- Murdoch University, College of Science, Health, Education & Engineering, Perth, Western Australia, Australia
| |
Collapse
|
15
|
Are psychological symptoms a risk factor for musculoskeletal pain in adolescents? Eur J Pediatr 2021; 180:2173-2183. [PMID: 33655417 PMCID: PMC8195761 DOI: 10.1007/s00431-021-04002-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/31/2021] [Accepted: 02/18/2021] [Indexed: 12/21/2022]
Abstract
Adolescent musculoskeletal pain is common and is associated with musculoskeletal pain in adulthood. Psychological symptoms, also common in adolescence, have been shown to be associated with musculoskeletal pain, but the current evidence is mixed and may be dependent on effect modifiers. This study investigated whether adolescents with psychological symptoms (internalizing and externalizing constructs) at age 13 years were at higher odds for musculoskeletal pain at age 17 years and whether the associations were modified by pubertal status and sex. A prospective cohort design examined data on 3865 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC). Associations between baseline (aged 13 years) internalizing and externalizing symptoms and musculoskeletal pain at follow-up (aged 17 years) were investigated using logistic regression producing odds ratios (OR) and 95% confidence intervals (95% CI). In total 43.1% of adolescents reported musculoskeletal pain at follow-up. Externalizing symptoms at baseline increased the odds of musculoskeletal pain (OR 1.68, 95% CI 1.28, 2.20), and internalizing symptoms demonstrated a non-significant increase (OR 1.26, 95% CI 0.98, 1.62). Effect modification analysis showed an increased effect dependent on pubertal status.Conclusion: Adolescents with externalizing symptoms, and to some extent internalizing symptoms, are at increased odds of later musculoskeletal pain. Future research is now required to understand the reasons for these associations. What is Known: • Current evidence regarding the association between internalizing symptoms and externalizing symptoms and future musculoskeletal pain in adolescents is mixed. What is New: • This study found that adolescents with externalizing symptoms, and to some extent internalizing symptoms, are at increased odds for musculoskeletal pain, with an increased influence dependent on pubertal status. • These results are of interest for the development of timely preventative interventions designed to reduce the risk of musculoskeletal pain.
Collapse
|
16
|
Takei S, Taketomi S, Tanaka S, Torii S. Growth pattern of lumbar bone mineral content and trunk muscles in adolescent male soccer players. J Bone Miner Metab 2020; 38:338-345. [PMID: 31701340 DOI: 10.1007/s00774-019-01060-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/22/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Previous studies have reported that the peak in lean body mass (LBM) precedes the peak in bone mineral content (BMC). However, it is unknown whether the trunk region growth is similar. MATERIALS AND METHODS We investigated the difference between pubertal peak age in the increase of LBM in the trunk (trunk LBM) and pubertal peak age in the increase of BMC in the lumbar spine (lumbar BMC) in a longitudinal study of 201 Japanese male adolescent soccer players. The age of peak height velocity (PHV) and the developmental age were calculated. The participants were followed over a 2-year period, with height and dual-energy X-ray absorptiometry scans taken every 6 months. RESULTS The trunk LBM (ρ = 0.732, p < 0.0001) and the lumbar BMC (ρ = 0.621, p < 0.0001) significantly correlated with the developmental age. The increase of trunk LBM and lumbar BMC was significantly different according to the developmental stages (Kruskal-Wallis test; p < 0.0001 and p < 0.001, respectively). We used a cubic spline to estimate the developmental age, when the increase reached its peak: the peak age of the increase in trunk LBM was estimated to be - 0.08 years (approximately - 1 month) prior to PHV age, whereas the peak age of the increase in lumbar BMC was estimated to be 0.42 years (approximately 5 months) after the PHV age. CONCLUSIONS The maximal increase in trunk LBM occurs just before PHV age and approximately 6 months before the maximal increase in lumbar BMC during the pubertal growth spurt in the Japanese adolescent male soccer players.
Collapse
Affiliation(s)
- Seira Takei
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyouku, Tokyo, 113-0033, Japan
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Shuji Taketomi
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyouku, Tokyo, 113-0033, Japan
| | - Sakae Tanaka
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyouku, Tokyo, 113-0033, Japan
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
| |
Collapse
|
17
|
Beynon AM, Hebert JJ, Lebouef-Yde C, Walker BF. Potential risk factors and triggers for back pain in children and young adults. A scoping review, part I: incident and episodic back pain. Chiropr Man Therap 2019; 27:58. [PMID: 31827766 PMCID: PMC6862727 DOI: 10.1186/s12998-019-0280-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background The one-month prevalence of back pain in children and adolescents has been reported at 33, 28 and 48% at ages 9, 13 and 15 respectively. There are many suspected risk factors and triggers of back pain in young people. Objective The purpose of this scoping review was to identify potential risk factors and potential triggers for back pain in young people. The purpose of part I was to identify potential risk factors for incident and episodic back pain in young people. Part II included all eligible studies with unclear or mixed types of back pain. Methods Due to the vast number of studies on "risk factors" for back pain, a two-part scoping review of the literature was chosen as the best way to summarise the evidence. We adhered to the PRISMA-ScR guideline for scoping reviews. General potential risk factors and triggers for back pain in children and young adults (≤ 24 years) were included, incorporating physical, environmental, and/or physiological factors. A search was conducted using PubMed and Cochrane databases from inception to September 2018, limited to the English language. Within part I, and because of their importance, only the results of the studies that investigated risk factors of incident back pain and back pain episodes are presented. Results The search identified 7356 articles, of which 91 articles were eligible for this scoping review. The majority of the eligible articles had an unclear definition of back pain (results presented in scoping review part II). There were 7 inception cohort studies included and 1 cohort study that met the criteria for part I. The most consistent risk factors for incident and episodic back pain are female sex and older age. Conclusion Due to inconsistent ways of reporting on the type of back pain, no definitive risk factor for back pain has been identified. In general, females often report more symptoms, also for other diseases, and older age is not a useful risk factor as it merely indicates that the onset may not be in childhood. Clearly, the time has come to study the causes of back pain from different angles.
Collapse
Affiliation(s)
- Amber M Beynon
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, Western Australia 6150 Australia
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, Western Australia 6150 Australia
- Faculty of Kinesiology, University of New Brunswick, 3 Bailey Drive, Fredericton, New Brunswick E3B 5A3 Canada
| | - Charlotte Lebouef-Yde
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, Western Australia 6150 Australia
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, Western Australia 6150 Australia
| |
Collapse
|
18
|
Beynon AM, Hebert JJ, Lebouef-Yde C, Walker BF. Potential risk factors and triggers for back pain in children and young adults. A scoping review, part II: unclear or mixed types of back pain. Chiropr Man Therap 2019; 27:61. [PMID: 31827768 PMCID: PMC6862810 DOI: 10.1186/s12998-019-0281-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Back pain is a global problem in terms of disability and financially, with a large burden both to the individual and to society. Back pain was previously believed to be uncommon in children. However, there is a growing body of evidence that this is not the case. Objective Part I of this scoping review studied risk factors of incident and episodic back pain. In this part II we aimed to identify all risk factors and triggers with unclear or mixed type back pain in young people and to identify any gaps in the literature. Methods A scoping review design was selected to summarise the evidence, as there are many studies on "risk factors" for back pain. The scoping review followed the PRISMSA-ScR guidelines. We considered all studies that tested potential risk factors and triggers for thoracic and/or lumbar spine pain, in children, adolescents, and young adults (≤ 24 years). PubMed and Cochrane databases were searched from inception to September 2018, to identify relevant English language articles. The results regarding potential risk factors were separated into temporal precursors and bidirectional risk factors and the studies were classified by study design. Results Our comprehensive search strategy identified 7356 articles, of which 83 articles were considered eligible for this review (part II). There were 53 cross-sectional studies and 30 cohort studies. Potential risk factors for back pain were: female sex, older age, later pubertal status, positive family history of back pain, increased growth, and a history of back pain, most of which are temporal precursor variables. There was limited research for the illness factors, spinal posture, and muscle endurance in the development of back pain. Conclusion Many of the included studies approached risk factors in similar ways and found factors that were associated with back pain but were not obvious risk factors as causality was uncertain. Future research should be more rigorous and innovative in the way that risk factors are considered. This could be through statistical approaches including cumulative exposures, or longitudinal approaches including multi-trajectory methods. Additionally, data on proposed risk factors should be collected before the onset of back pain.
Collapse
Affiliation(s)
- Amber M Beynon
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
- Faculty of Kinesiology, University of New Brunswick, 3 Bailey Drive, Fredericton, New Brunswick E3B 5A3 Canada
| | - Charlotte Lebouef-Yde
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
| |
Collapse
|
19
|
de Oliveira RF, Fandim JV, Fioratti I, Fernandes LG, Saragiotto BT, Pena Costa LO. The contemporary management of nonspecific lower back pain. Pain Manag 2019; 9:475-482. [PMID: 31452452 DOI: 10.2217/pmt-2019-0016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Low back pain (LBP) is extremely common and causes an enormous burden on the society. This perspective article aims to provide an evidence-based summary in the field of LBP. More specifically, we aimed to present epidemiological data on cost, diagnosis, prognosis, prevention and interventions for patients with LBP. It is critical that both clinicians and policymakers follow best practices by using high-value care for patients with LBP. In addition, nonevidence-based procedures must be immediately abandoned. These actions are likely to reduce societal costs and will improve the quality of life of these patients.
Collapse
Affiliation(s)
| | - Junior Vitorino Fandim
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Iuri Fioratti
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Lívia Gaspar Fernandes
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Bruno Tirotti Saragiotto
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | |
Collapse
|
20
|
Noll M, Candotti CT, da Rosa BN, Vieira A, Loss JF. Back pain and its risk factors in Brazilian adolescents: a longitudinal study. Br J Pain 2019; 15:16-25. [PMID: 33633850 DOI: 10.1177/2049463719871751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Owing to the lack of longitudinal studies in Latin American countries, we aimed to evaluate back pain and its risk factors in a 3-year longitudinal study of Brazilian adolescents. We analysed data of 525 adolescents (aged 11-16 years) attending primary school (fifth to eighth grade) in Brazil. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument (BackPEI) questionnaire in 2011 and at a follow-up evaluation that was conducted 3 years later (2014). Back pain was the outcome variable; the exposure variables included exercise, behavioural, hereditary and postural factors. Generalized estimating equations were used to perform a Poisson regression model with robust variance to evaluate the risk factors for back pain. The prevalence of back pain at baseline was 56% (n = 294); this increased significantly at the 3-year follow-up evaluation to 65.9% (n = 346). The frequency of experiencing back pain also significantly increased after 3 years in both boys (p = 0.002) and girls (p = 0.001). The prevalence of back pain increased significantly in adolescents up to the age of 13 years, stabilized in those aged 14 years and older and was higher among girls. A family history of back pain (in the parents), watching television for lengthy periods and carrying a backpack asymmetrically were predictors for back pain.
Collapse
Affiliation(s)
| | | | | | - Adriane Vieira
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | |
Collapse
|
21
|
Hebert JJ, Leboeuf-Yde C, Franz C, Lardon A, Hestbæk L, Manson N, Wedderkopp N. Pubertal development and growth are prospectively associated with spinal pain in young people (CHAMPS study-DK). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:1565-1571. [PMID: 30740638 DOI: 10.1007/s00586-019-05905-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 01/26/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To examine the prospective associations of pubertal development and linear growth with spinal pain frequency and duration in children. METHODS We recruited students from 10 public primary schools. Over 42 months, pubertal development was assessed four times and categorized according to Tanner stages 1-5, and height was measured on seven occasions. Occurrences of spinal pain were reported weekly via text messaging. We constructed variables for spinal pain duration (total weeks with pain) and frequency (number of episodes). Potential associations between pubertal development and growth were examined with generalized estimating equations and reported with incident rate ratios (IRRs). All models were adjusted for potential confounders. RESULTS Data from 1021 children (53% female; mean [SD] age = 9.4 [1.4] years), with median participation duration of 39 months, were included. Advancing pubertal development was associated with increased spinal pain duration (IRR [95% CI] = 1.90 [1.45, 2.49] to 5.78 [4.03, 8.29]) and frequency of pain episodes (IRR [95% CI] = 1.32 [1.07, 1.65] to 2.99 [2.24, 3.98]). Similar associations were observed for each 1-cm change in height in 6 months with spinal pain duration (IRR [95% CI] = 1.19 [1.15, 1.23]) and frequency (IRR [95% CI] = 1.14 [1.11, 1.17]). The relations between pubertal development and spinal pain, as well as growth and spinal pain, were largely independent. CONCLUSIONS In young people, pubertal development and linear growth are likely to be independent risk factors for the development of spinal pain. Pubertal development demonstrates evidence of dose-response in its relationship with spinal pain. This knowledge may assist healthcare providers with clinical decision-making when caring for pediatric patients. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Jeffrey J Hebert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada. .,School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia.
| | - Charlotte Leboeuf-Yde
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Claudia Franz
- Private Practice, Haderslev, Denmark.,Danish Agency for Patient Complaints, Aarhus, Denmark
| | - Arnaud Lardon
- Institut Franco-Européen de Chiropraxie, Ivry sur Seine, France.,CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405, Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067, Orléans, France
| | - Lise Hestbæk
- Danish Agency for Patient Complaints, Aarhus, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Neil Manson
- Canada East Spine Centre, Saint John, NB, Canada.,Department of Orthopaedic Surgery, Saint John Regional Hospital, Saint John, NB, Canada.,Department of Orthopaedic Surgery, Dalhousie University, Halifax, NS, Canada
| | - Niels Wedderkopp
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada.,Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark.,Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| |
Collapse
|
22
|
Joergensen AC, Hestbaek L, Andersen PK, Nybo Andersen AM. Epidemiology of spinal pain in children: a study within the Danish National Birth Cohort. Eur J Pediatr 2019; 178:695-706. [PMID: 30788593 PMCID: PMC6459805 DOI: 10.1007/s00431-019-03326-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/09/2019] [Accepted: 01/16/2019] [Indexed: 12/11/2022]
Abstract
This study aims to describe the prevalence of spinal pain among Danish children, explore the differential nature of spinal pain, and investigate socio-demographic factors predisposing spinal pain. A descriptive study of 46,726 11-14-year-olds participating in the Danish National Birth Cohort was conducted. Self-reported spinal pain (neck, middle back, and low back pain) was registered and classified according to severity. Socioeconomic data on children and their parents were identified in Statistics Denmark registers. Associations between socio-demographic factors and aspects of spinal pain were estimated using multinomial logistic regression models. To account for sample selection, inverse probability weighting (IPW) was applied. Almost 10% boys and 14% girls reported severe spinal pain, whereas around 30% of all children reported moderate pain. Effect estimates indicated the risk to increase with increasing age. Further, children without biological full siblings, not living with both of their parents, or children living in less-educated or lower-income families were more likely to experience spinal pain. The study conclusions were essentially unaffected by IPW.Conclusion: A considerable number of children suffer from spinal pain, and it is more common among children in more disadvantaged families. Etiology of spinal pain needs to be explored further with the aim of informing efficient and targeted prevention. What is Known: • Childhood spinal pain may cause marked discomfort and impairment in children's everyday life, and is suggested as important predictor of later-in-life spinal pain. • Methodological heterogeneity in previous studies and complexity of measuring pain make inferences at a broader level inadequate. What is New: • Prevalence of severe spinal pain in 11-14-year-olds was estimated to almost 10% for boys and 14% for girls, and children in more disadvantaged families were more likely to experience spinal pain. • The results seemed unaffected by sample selection.
Collapse
Affiliation(s)
- Anne Cathrine Joergensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Oster Farimagsgade 5, bd. 24, DK-1014 Copenhagen K, Denmark
| | - Lise Hestbaek
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Oster Farimagsgade 5, 1014 Copenhagen K, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Oster Farimagsgade 5, bd. 24, DK-1014 Copenhagen K, Denmark
| |
Collapse
|
23
|
Wirth B, Potthoff T, Rosser S, Humphreys BK, de Bruin ED. Physical risk factors for adolescent neck and mid back pain: a systematic review. Chiropr Man Therap 2018; 26:36. [PMID: 30258567 PMCID: PMC6151922 DOI: 10.1186/s12998-018-0206-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 07/05/2018] [Indexed: 02/06/2023] Open
Abstract
Background Besides low back pain (LBP), also neck pain (NP) and mid back pain (MBP) are common health issues in adolescence. Psychological factors are regarded as main risk factors for spinal pain in adolescence, but recent studies suggest that the importance of physical factors might be underestimated. The purpose of this study was to summarize the results of studies on physical risk factors for adolescent NP and MBP. Methods Cross-sectional and prospective English studies on NP and MBP in adolescents aged 10 to 18 were searched by a professional librarian in Medline (OvidSP), Premedline (PubMed), EMBASE, Cochrane, CINAHL, PEDro and PsycINFO up to October 2016. Studies that were restricted to self-report via questionnaires were excluded. Results Eight cross-sectional studies could be included in this review. Some aspects of sagittal alignment in sitting (increased lumbar lordosis) and standing (anteroposition of the head, sway-back posture) were associated with NP. Study comparability was impeded by inconsistent definitions of NP and MBP and a wide variety of outcome measures. Conclusions This systematic review indicates that prospective studies using a consistent definition of NP and MBP are needed. Such studies might further investigate sagittal alignment in sitting and standing as possible risk factors for NP and MBP in adolescence using a consistent terminology for the outcomes and longitudinal research designs. Electronic supplementary material The online version of this article (10.1186/s12998-018-0206-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Brigitte Wirth
- 1Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Forchstr. 340, 8008 Zurich, Switzerland
| | - Tobias Potthoff
- 1Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Forchstr. 340, 8008 Zurich, Switzerland
| | - Sandra Rosser
- 1Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Forchstr. 340, 8008 Zurich, Switzerland
| | - Barry Kim Humphreys
- 1Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Forchstr. 340, 8008 Zurich, Switzerland
| | - Eling D de Bruin
- 2Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,3Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
24
|
Risk factors for low back pain and sciatica: an umbrella review. Spine J 2018; 18:1715-1721. [PMID: 29792997 DOI: 10.1016/j.spinee.2018.05.018] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 05/01/2018] [Accepted: 05/16/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Low back pain (LBP) is a highly prevalent condition and it is associated with significant disability and work absenteeism worldwide. A variety of environmental and individual characteristics have been reported to increase the risk of LBP. To our knowledge, there has been no previous attempt to summarize the evidence from existing systematic reviews of risk factors for LBP or sciatica. PURPOSE To provide an overview of risk factors for LBP, we completed an umbrella review of the evidence from existing systematic reviews. STUDY DESIGN An umbrella review was carried out. METHODS A systematic literature search was conducted in MEDLINE, EMBASE, PubMed PsychINFO, and CINAHL databases. To focus on the most recent evidence, we only included systematic reviews published in the last 5 years (2011-2016) examining any risk factor for LBP or sciatica. Only systematic reviews of cohort studies enrolling participants without LBP and sciatica at baseline were included. The methodological quality of the reviews was assessed independently by two review authors, using the Assessment of Multiple Systematic Reviews tool. RESULTS We included 15 systematic reviews containing 134 cohort studies. Four systematic reviews were of high methodological quality and 11 were of moderate quality. Of the 54 risk factors investigated, 38 risk factors were significantly associated with increased risk of LBP or sciatica in at least one systematic review and the odds ratios ranged from 1.26 to 13.00. Adverse risk factors included characteristics of the individual (eg, older age), poor general health (eg, smoking), physical stress on spine (eg, vibration), and psychological stress (eg, depression). CONCLUSION Poor general health, physical and psychological stress, and characteristics of the person increase risk for a future episode of LBP or sciatica.
Collapse
|
25
|
Relationship between growth, maturation and musculoskeletal conditions in adolescents: a systematic review. Br J Sports Med 2018; 52:1246-1252. [DOI: 10.1136/bjsports-2017-098418] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2018] [Indexed: 12/16/2022]
Abstract
ObjectiveTo determine whether there is a relationship between physical growth and development, as determined by markers of biological maturation, and musculoskeletal conditions in adolescents.DesignSystematic review.Data sourcesElectronic databases (PubMed, EMBASE and the Cumulative Index to Nursing and Allied Health Literature) were searched up to 6 September 2017.Eligibility criteria for selecting studiesStudies that evaluated the association between biological maturation or growth and musculoskeletal conditions in adolescents (chronological age 10–19 years).ResultsFrom 20 361 titles identified by the searches, 511 full-text articles were retrieved and assessed for eligibility; 56 studies, all at high risk of bias, evaluating the relationship between maturation and/or growth and musculoskeletal conditions were included. A total of 208 estimates of association were identified across the included studies, which generally indicated no association or an unclear association between maturation, growth and musculoskeletal conditions.Summary/ConclusionsWhile the relationship between maturation, growth and musculoskeletal conditions remains plausible, the available evidence is not supportive. The current body of knowledge is at high risk of bias, which impedes our ability to establish whether biological maturity and growth are independent risk factors for musculoskeletal conditions.
Collapse
|
26
|
Potthoff T, de Bruin ED, Rosser S, Humphreys BK, Wirth B. A systematic review on quantifiable physical risk factors for non-specific adolescent low back pain. J Pediatr Rehabil Med 2018; 11:79-94. [PMID: 30010152 DOI: 10.3233/prm-170526] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The aim of this systematic review was to analyze the results of studies on quantifiable physical risk factors (beyond questionnaires) for adolescent low back pain (LBP). METHODS A systematic search was conducted in Medline (OvidSP), Premedline (PubMed), EMBASE, Cochrane, CINAHL, PEDro and PsycINFO. Cross-sectional, prospective and retrospective English language studies on LBP in adolescents aged 10 to 18 years were included. RESULTS Twenty-two mostly cross-sectional studies were included. Trunk muscle endurance in particular seemed to be associated with adolescent LBP, while a possible association of trunk muscle strength and spinal flexibility was less clear. CONCLUSION There is a need for prospective studies on quantifiable physical risk factors for adolescent LBP. Such studies should focus on back and abdominal muscle endurance, possibly in combination with sagittal spinal mobility, sagittal postural alignment and neurodynamics as possible modifiable risk factors for LBP.
Collapse
Affiliation(s)
- Tobias Potthoff
- Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Sandra Rosser
- Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland
| | - Barry Kim Humphreys
- Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland
| | - Brigitte Wirth
- Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland
| |
Collapse
|
27
|
Musculoskeletal complaints while growing up from age 11 to age 14: the PIAMA birth cohort study. Pain 2017; 157:2826-2833. [PMID: 27780179 DOI: 10.1097/j.pain.0000000000000724] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For musculoskeletal complaints (MSCs) among adults, several risk factors are known, but the most important determinant is an earlier episode of MSCs. Research has shifted to younger ages, showing a high prevalence of MSCs among children and adolescents. Our purpose was to evaluate the prevalence of MSCs among those growing up from age 11 to 14 and to explore the role of several sociodemographic, growth and development, psychosocial, and lifestyle factors. Data collected at age 11 (n = 2651) and age 14 (n = 2522) in the ongoing Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study were used. Analyses included multiple logistic regression analyses using stepwise backward selection. The 1-year prevalence of any MSCs for at least 1 month increased from 15.8% at age 11 to 24.4% at age 14, and this was also found for upper extremity complaints (from 4.7% to 7.6%), back complaints (from 2.7% to 9.3%), and lower extremity complaints (from 11.9% to 14.7%). More MSCs were found among girls, those with sports injuries, those with sleeping problems, and those with daytime tiredness, although complaints at age 11 were by far the most important factor associated with MSCs at age 14 for all pain sites. This study showed that MSC is already common at an early age and that already at age 14 the factor with the strongest association is an earlier episode of MSCs. Sleeping problems and tiredness may also play a role in the early development of MSCs, either as determinant or as a consequence.
Collapse
|
28
|
Andreucci MSc A, Campbell P, Dunn KM. Are Sleep Problems a Risk Factor for the Onset of Musculoskeletal Pain in Children and Adolescents? A Systematic Review. Sleep 2017; 40:3836926. [PMID: 28531332 DOI: 10.1093/sleep/zsx093] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Study Objectives Musculoskeletal pain is a major burden on the society. Adults with sleep problems are at higher risk of musculoskeletal pain onset, but there is no evidence for this relationship in children and adolescents. This study aimed to systematically review prospective studies on the risk of musculoskeletal pain onset in children and adolescents with sleep problems. Methods Five databases (MEDLINE, PsycINFO, AMED, EMBASE, and HMIC) were systematically searched to identify prospective studies that investigated if children and adolescents (aged 6-19 years) with sleep problems are at higher risk of musculoskeletal pain onset. Included studies were assessed for study quality and a best evidence synthesis was carried out on extracted data. Results Thirteen prospective studies were identified. Overall, evidence indicates that sleep problems (quality, quantity, and day time tiredness) are not risk factors for musculoskeletal pain onset. Further analysis on specific body regions shows strong evidence that sleep problems are a risk factor for neck pain onset (only in girls) and that sleep problems are not a risk factor for the onset of widespread pain. Conclusions Overall, sleep problems are not a risk factor for musculoskeletal pain onset in children and adolescents. Increased risk was found for some specific body regions and subgroups, but the evidence base was less strong and generally inconsistent. This review found a lack of quality in research methodology compared to research in adults, and further research with improved methodology is required.
Collapse
Affiliation(s)
- Alessandro Andreucci MSc
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, UK
| | - Paul Campbell
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, UK
| | - Kate M Dunn
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, UK
| |
Collapse
|
29
|
High prevalence of inadequate sitting and sleeping postures: a three-year prospective study of adolescents. Sci Rep 2017; 7:14929. [PMID: 29097779 PMCID: PMC5668289 DOI: 10.1038/s41598-017-15093-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 10/20/2017] [Indexed: 11/08/2022] Open
Abstract
There is a paucity of information regarding the development of body posture during adolescence. This three-year prospective study aimed to evaluate sitting and sleeping postures among adolescents, and to determine whether these postures are associated with age and sex. We assessed 525 adolescents aged 11-16 years from the fifth to eighth grades. These adolescents were reassessed three years later. The Back Pain and Body Posture Evaluation Instrument was used to evaluate the sleeping posture and three sitting positions: sitting to write, to use a computer, and during leisure activities. Our findings indicated a low prevalence of adequate sleeping and sitting postures at baseline, with a decrease in prevalence observed after three years for all postures. These changes were similar for both sexes. Moreover, we found a strong reduction of adequate posture prevalence for younger adolescents, but the oldest adolescents demonstrated no significant differences after three years. Early, rather than late, adolescence is a critical period for establishing inadequate sitting and sleeping postures. This has implications for posture throughout adulthood; hence, interventions targeted at this age group are needed.
Collapse
|
30
|
Abstract
Study Design Longitudinal cohort study. Background Spinal pain is responsible for a huge personal and societal burden, but its etiology remains unclear. Deficits in motor control have been associated with spinal pain in adults, and delayed motor development is associated with a range of health problems and risks in children. Objective To assess whether there is an independent relationship between the age at which infants first sit and walk without support and spinal pain at 11 years of age. Methods Data from the Danish National Birth Cohort were analyzed, using the age at which children first sat and first walked without support as predictors. Parents reported the predictors when the children were 6 months and 18 months of age, and also provided information in response to a comprehensive list of covariates, including child sex, birth weight, and cognitive development; socioeconomic indicators; and parental health variables. Outcomes were measured at 11 years of age using the Young Spine Questionnaire, which assesses the presence and intensity of spinal pain. Data were analyzed using multivariable logistic regression models to estimate determinants of neck, thoracic, lumbar, and multisite pain. Results The analyses included data from approximately 23 000 children and their parents. There were no consistent independent associations between the age at first sitting or walking and spinal pain at the age of 11. Odds ratios were between 0.95 and 1.00 for the various pain sites. Conclusion The age at which a child first sits or walks without support does not influence the likelihood that he or she will experience spinal pain in later childhood. Level of Evidence Prognosis, level 4. J Orthop Sports Phys Ther 2017;47(10):763-768. doi:10.2519/jospt.2017.7484.
Collapse
|
31
|
Kamper SJ, Henschke N, Hestbaek L, Dunn KM, Williams CM. Musculoskeletal pain in children and adolescents. Braz J Phys Ther 2017; 20:275-84. [PMID: 27437719 PMCID: PMC4946844 DOI: 10.1590/bjpt-rbf.2014.0149] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 12/09/2015] [Indexed: 12/31/2022] Open
Abstract
Introduction Musculoskeletal (MSK) pain in children and adolescents is responsible for
substantial personal impacts and societal costs, but it has not been intensively
or systematically researched. This means our understanding of these conditions is
limited, and healthcare professionals have little empirical evidence to underpin
their clinical practice. In this article we summarise the state of the evidence
concerning MSK pain in children and adolescents, and offer suggestions for future
research. Results Rates of self-reported MSK pain in adolescents are similar to those in adult
populations and they are typically higher in teenage girls than boys.
Epidemiological research has identified conditions such as back and neck pain as
major causes of disability in adolescents, and in up to a quarter of cases there
are impacts on school or physical activities. A range of physical, psychological
and social factors have been shown to be associated with MSK pain report, but the
strength and direction of these relationships are unclear. There are few validated
instruments available to quantify the nature and severity of MSK pain in children,
but some show promise. Several national surveys have shown that adolescents with
MSK pain commonly seek care and use medications for their condition. Some studies
have revealed a link between MSK pain in adolescents and chronic pain in
adults. Conclusion Musculoskeletal pain conditions are often recurrent in nature, occurring
throughout the life-course. Attempts to understand these conditions at a time
close to their initial onset may offer a better chance of developing effective
prevention and treatment strategies.
Collapse
Affiliation(s)
| | - Nicholas Henschke
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Lise Hestbaek
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kate M Dunn
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Christopher M Williams
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Australia
| |
Collapse
|
32
|
The prevalence, risk factors, prognosis and treatment for back pain in children and adolescents: An overview of systematic reviews. Best Pract Res Clin Rheumatol 2016; 30:1021-1036. [DOI: 10.1016/j.berh.2017.04.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
33
|
Dockrell S, Simms C, Blake C. Schoolbag carriage and schoolbag-related musculoskeletal discomfort among primary school children. APPLIED ERGONOMICS 2015; 51:281-290. [PMID: 26154227 DOI: 10.1016/j.apergo.2015.05.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 04/22/2015] [Accepted: 05/21/2015] [Indexed: 06/04/2023]
Abstract
Schoolbag carriage is a common occurrence and has been associated with musculoskeletal discomfort in children. The current study investigated the relationship between schoolbag-related musculoskeletal discomfort and individual, physical and psychosocial risk factors in primary school children in Ireland. A cross-sectional survey and pretest-posttest quasi-experimental design was used. The site and intensity of musculoskeletal discomfort was assessed before and after schoolbag carriage to provide a dose-response assessment of schoolbag-related discomfort for the first time. Objective measurements of the children, schoolbags and other additional items were made, and a researcher assisted questionnaire was completed on arrival at school. A total of 529 children (male 55.8%: female 44.2%) with a mean age of 10.6 years ± 7.14 months were included. The majority had backpacks (93.8%) and 89.7% (n = 445) carried the backpack over 2 shoulders. The mean schoolbag weight (4.8 ± 1.47 kgs) represented a mean % body weight (%BW) of 12.6 ± 4.29%. Only 29.9% carried schoolbags that were ≤10%BW. A significantly greater proportion of normal weight children carried schoolbags that were >10%BW compared to overweight/obese children (p < 0.001). The mean %BW carried was 18.3 ± 5.03 for those who had an additional item. The majority (77.5%) carried schoolbags to school for ≤10 min. The prevalence of baseline musculoskeletal discomfort was high (63.4%). Schoolbag-related discomfort was reported more frequently in the shoulders (27.3%) than in the back (15%). The dose-response assessment indicated that both statistically and meaningfully significant increases in discomfort were observed following schoolbag carriage. Multiple logistic regression models indicated that psychosocial factors and a history of discomfort were predictors of schoolbag-related back discomfort, while gender (being female) and a history of discomfort were predictors of schoolbag-related shoulder discomfort. None of the physical factors (absolute/relative schoolbag weight, carrying an additional item, duration of carriage, method of travel to school) were associated with schoolbag-related discomfort. This study highlights the need to consider the multi-factorial nature of schoolbag-related discomfort in children, and also the need to identify background pain as its presence can inadvertently influence the reporting of 'schoolbag-related' discomfort if it is not accounted for.
Collapse
Affiliation(s)
- Sara Dockrell
- Discipline of Physiotherapy, Trinity Centre for Health Sciences, St. James's Hospital, James's St., Dublin 8, Ireland.
| | - Ciaran Simms
- Mechanical and Manufacturing Engineering, Parsons Building, Trinity College, Dublin, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Population Science, Health Sciences Centre, University College Dublin, Bellfield, Dublin 4, Ireland
| |
Collapse
|
34
|
Lardon A, Leboeuf-Yde C, Le Scanff C. Is back pain during childhood or adolescence associated with muscle strength, muscle endurance or aerobic capacity: three systematic literature reviews with one meta-analysis. Chiropr Man Therap 2015; 23:21. [PMID: 26185617 PMCID: PMC4504178 DOI: 10.1186/s12998-015-0065-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 06/09/2015] [Indexed: 01/08/2023] Open
Abstract
Background Back pain is a common condition during childhood and adolescence. The causes of back pain are largely unknown but it seems plausible that some physical factors such as back muscle strength, back muscle endurance and aerobic capacity may play a role in its development, in particular in the early years. Objectives The objectives of this review were to investigate in childhood and adolescence 1) if muscular strength in trunk extension is associated with back pain, 2) if muscular endurance in trunk extension is associated with back pain and 3) if aerobic capacity is associated with back pain. Design Three systematic critical literature reviews with one meta-analysis. Methods Systematic searches were made in June 2014 in PubMed, Embase and SportDiscus including longitudinal, retrospective or cross-sectional studies on back pain for subjects <20 years. Articles were accepted if they were written in French or English. The review process followed the AMSTAR recommendations. The possibility of conducting a meta-analysis was assessed for each research question. Results Four articles were included for the first objective, four for the second and three for the last. None of the included articles found an association between back muscle strength in extension and back pain. For the second objective, a protective association between back muscle endurance in extension and back pain was found, later confirmed in a meta-analysis (OR = 0.75, 95 % CI 0.58-0.98). The association between aerobic capacity and back pain is not clear. Conclusions High back muscle endurance in extension appears protective of back pain in youngsters, but the roles of high back muscle strength in extension and aerobic capacity are less clear.
Collapse
Affiliation(s)
- Arnaud Lardon
- EA 4532 CIAMS, Université Paris-Sud, UFR STAPS, 91405 Orsay, France ; Institut Franco-Européen de Chiropraxie, 24 Bld Paul Vaillant Couturier, 94200 Ivry sur Seine, France
| | - Charlotte Leboeuf-Yde
- EA 4532 CIAMS, Université Paris-Sud, UFR STAPS, 91405 Orsay, France ; Institut Franco-Européen de Chiropraxie, 24 Bld Paul Vaillant Couturier, 94200 Ivry sur Seine, France ; Research Department Spine centre of Southern Denmark Hospital, Hospital Lillebælt Middelfart, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | |
Collapse
|