BackgroundIt is difficult to gain an overview of musculoskeletal extremity complaints in childhood although this is essential to develop evidence-based prevention and treatment strategies. The objectives of this systematic review were therefore to describe the prevalence and incidence of musculoskeletal extremity complaints in children and adolescents in both general and clinical populations in relation to age, anatomical site and mode of onset.MethodsMEDLINE and EMBASE were electronically searched; risk of bias was assessed; and data extraction was individually performed by two authors.ResultsIn total, 19 general population studies and three clinical population studies were included with children aged 0-19 years. For most of the analyses, a division between younger children aged 0-12 years, and older children aged 10-19 years was used. Lower extremity complaints were more common than upper extremity complaints regardless of age and type of population, with the most frequent pain site changing from ankle/foot in the youngest to knee in the oldest. There were about twice as many non-traumatic as traumatic complaints in the lower extremities, whereas the opposite relationship was found for the upper extremities in the general population studies. There were relatively more lower extremity complaints in the general population studies than in the clinical population studies. The review showed no pattern of differences in reporting between studies of high and low risk of bias.ConclusionsThis review shows that musculoskeletal complaints are more frequent in the lower extremities than in the upper extremities in childhood, and there are indications of a large amount of non-traumatic low intensity complaints in the population that do not reach threshold for consultation. A meta-analysis, or even a simple overall description of prevalence and incidence of musculoskeletal extremity complaints in children and adolescents was not feasible, due to a large variety in the studies, primarily related to outcome measurements.Electronic supplementary materialThe online version of this article (10.1186/s12891-017-1771-2) contains supplementary material, which is available to authorized users.

BackgroundMusculoskeletal pain is common in childhood and adolescence, and may be long-lasting and recurrent. Musculoskeletal problems tend to follow adolescents into adulthood, and therefore it is important to design better prevention strategies and early effective treatment. To this end, we need in-depth knowledge about the epidemiology of musculoskeletal extremity problems in this age group, and therefore, the aim of this study was to determine the prevalence, frequency and course of musculoskeletal pain in the upper and lower extremities in a cohort of Danish school children aged 8–14 years at baseline.MethodsThis was a prospective 3-year school-based cohort study, with information about musculoskeletal pain collected in two ways. Parents answered weekly mobile phone text messages about the presence or absence of musculoskeletal pain in their children, and a clinical consultation was performed in a subset of the children.ResultsWe found that approximately half the children had lower extremity pain every study year. This pain lasted on average for 8 weeks out of a study year, and the children had on average two and a half episodes per study year. Approximately one quarter of the children had upper extremity pain every study year that lasted on average 3 weeks during a study year, with one and a half episodes being the average. In general, there were more non-traumatic pain episodes compared with traumatic episodes in the lower extremities, whereas the opposite was true in the upper extremities. The most common anatomical pain sites were ‘knee’ and ‘ankle/ft’.ConclusionLower extremity pain among children and adolescents is common, recurrent and most often of non-traumatic origin. Upper extremity pain is less common, with fewer and shorter episodes, and usually with a traumatic onset. Girls more frequently reported upper extremity pain, whereas there was no sex-related difference in the lower extremities. The most frequently reported locations were ‘knee’ and ‘ankle/ft’.Electronic supplementary materialThe online version of this article (10.1186/s12891-017-1859-8) contains supplementary material, which is available to authorized users.

The main objective was to investigate whether children aged 9–15 years at baseline were more likely to experience an incident event of spinal pain after experiencing lower extremity pain. Children’s musculoskeletal pain was monitored by weekly mobile phone text message responses from parents, indicating whether the child had spinal pain, lower extremity pain, or upper extremity pain the preceding week. Data were analyzed using mixed effect logistic regression models and cox regression models. The association between an incident event of spinal pain and LE pain the preceding weeks increased with increasing observation period and was statistically significant for 12 and 20 weeks (OR = 1.34 (95% CI 1.05 to 1.70) and OR = 1.39 (95% CI 1.11 to 1.75), respectively). We found that the likelihood increased in children with more frequent or longer duration of lower extremity pain. The reversed relationship was investigated as well, and we also found a positive association between spinal pain and a subsequent incidence event of lower extremity pain, but less pronounced.Conclusion: Children were more likely to experience an incident event of spinal pain after experiencing lower extremity pain. The likelihood increased in children with more frequent or longer duration of lower extremity pain. What is Known: • Both spinal pain and lower extremity pain often start early in life and is common already in adolescence. What is New: • Children were more likely to experience an incident event of spinal pain after experiencing LE pain. • The likelihood increased in children with more frequent or longer duration of LE pain Electronic supplementary materialThe online version of this article (10.1007/s00431-018-3235-6) contains supplementary material, which is available to authorized users.

Background: Knowledge about the occurrence and distribution of musculoskeletal problems in early life is needed. The objectives were to group children aged 8 to 16 according to their distribution of pain in the spine, lower-and upper extremity, determine the proportion of children in each subgroup, and describe these in relation to sex, age, number-and length of episodes with pain. Method: Data on musculoskeletal pain from about 1,000 Danish schoolchildren was collected over 3 school years (2011 to 2014) using weekly mobile phone text message responses from parents, indicating whether their child had pain in the spine, lower extremity and/or upper extremity. Result are presented for each school year individually. Results: When pain was defined as at least 1 week with pain during a school year, Danish schoolchildren could be divided into three almost equally large groups for all three school years: Around 30% reporting no pain, around 40% reporting pain in one region, and around 30% reporting pain in two or three regions. Most commonly children experienced pain from the lower extremities (~60%), followed by the spine (~30%) and the upper extremities (~23%). Twice as many girls reported pain in all three sites compared to boys (10% vs. 5%) with no other statistically significant sex or age differences observed. When pain was defined as at least 3 weeks with pain during a schoolyear, 40% reported pain with similar patterns to those for the more lenient pain definition of 1 week. Conclusion: Danish schoolchildren often experienced pain at more than one pain site during a schoolyear, and a significantly larger proportion of girls than boys reported pain in all three regions. This could indicate that, at least in some instances, the musculoskeletal system should be regarded as one entity, both for clinical and research purposes.

Background Low back pain (LBP) is a very frequent cause for care seeking and often a long-lasting condition. However, little is known about individuals' care seeking patterns over time. Therefore the objectives of this study were 1) to describe care seeking patterns 1 year after an initial chiropractic consultation, and 2) to examine how care seeking patterns related to pain intensity trajectories. Methods Danish chiropractic clinics recruited 947 adult patients at the initial consultation for LBP. From this cohort, 617 (65%) responded to questions about care seeking within the last 2 weeks at all of the followups 2 weeks, 3 months and 12 months after inclusion. Based on these responses, we described care seeking patterns and investigated if care seeking was associated with trajectories of LBP severity. The LBP trajectories had previously been derived from weekly measures of pain intensity collected via SMS-tracking. Results Care seeking after the initial visit was reported by 95% of the patients. The most frequent care seeking pattern (51%) was to report care seeking at the 2-weeks follow-up and not later, 29% reported care seeking only 2 weeks and 3 months after the initial consultation, and 11% reported care seeking at all follow-up time points. Of those seeking care after 2 weeks, 3 months and 1 year, 98%, 76% and 50% respectively had chosen to see a chiropractor at those time points. At 1-year followup 18% of care seekers had visited a general practitioner and 27% a physiotherapist. Care seeking was associated with LBP trajectories: Most people who recovered from pain stopped care seeking, and those with persistent severe pain did most frequently seek care at all follow-ups. However, those with mild to moderate LBP had more diverse care seeking behaviours. For example in LBP trajectories of on-going moderate pain, 25% did not report care seeking after 2-weeks, and another 25% reported care seeking at all time points. Conclusions Most patients consulting Danish chiropractors for LBP are seen again within two weeks of the initial consultation and do not report continued care seeking after 3 months. One year after the initial visit, around half of the care seekers see other health care providers for their LBP instead of a chiropractor. Care seeking is related to LBP symptoms, but not in a uniform way, and it should be investigated why some people with on-going LBP continue to seek care while others do not. The study was presented to the local ethics committee. The committee found that it did not need approval, since there was no intervention involved, which is in line with Danish law (Danish National Committee on Biomedical Research Ethics. Guidelines about Notification. (http://www.nvk.dk/english/act-on-research). The project was approved by the Danish Data Protection Agency (J-no. 2004-41-4763 and J-no. 2010-41-5163 Introduction Degenerative lumbar spinal stenosis causing neurogenic claudication is a leading cause of pain, disability and loss of independence in older adults. Effective non-surgical approaches...