Care-seeking behaviour of adolescents with knee pain: a population-based study among 504 adolescents

Abstract

BackgroundKnee pain is common during adolescence. Adolescents and their parents may think that knee pain is benign and self-limiting and therefore avoid seeking medical care. However, long-term prognosis of knee pain is not favourable and treatment seems to offer greater reductions in pain compared to a “wait-and-see” approach. The purpose of this study was to describe the determinants of care-seeking behaviour among adolescents with current knee pain and investigate what types of treatment are initiated.MethodsAn online questionnaire was forwarded to 2,846 adolescents aged 15–19 in four upper secondary schools. The questionnaire contained questions on age, gender, height, weight, currently painful body regions, frequency of knee pain, health-related quality of life measured by the EuroQol 5-dimensions, sports participation and if they had sought medical care. Adolescents who reported current knee pain at least monthly or more frequently were telephoned. The adolescents were asked about pain duration, onset of knee pain (traumatic or insidious) and if they were currently being treated for their knee pain.Results504 adolescents currently reported at least monthly knee pain. 59% of these had sought medical care and 18% were currently under medical treatment . A longer pain duration and higher pain severity increased the odds of seeking medical care. Females with traumatic onset of knee pain were more likely to have sought medical care than females with insidious onset of knee pain. Females with traumatic onset of knee pain and increased pain severity were more likely to be undergoing medical treatment. The most frequently reported treatments were the combination of exercises and orthotics (68% of those undergoing medical treatment).ConclusionFemales with insidious onset of knee pain do not seek medical care as often as those with traumatic onset and adolescents of both genders with insidious onset are less likely to be under medical treatment. These findings are important as knee pain with insidious onset has similar consequences as knee pain with traumatic onset regarding pain severity, pain duration and reductions in health-related quality of life.

Exercise during school hours when added to patient education improves outcome for 2 years in adolescent patellofemoral pain: a cluster randomised trial

“…Recruiting from a population-based cohort is very relevant for adolescents, as those with an insidious onset of knee pain (such as PFP) are less likely to contact their GPs compared with adolescents with knee pain of traumatic onset 1. This suggests that the study results have a very high external validity and are generalisable to the adolescent population between 15 and 19 years.…”

Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013

“… PFP is common in young adolescents, with a high point prevalence of PFP in adolescents between 12 and 17 years of age 8. There are no data regarding the prevalence or incidence in other populations, except in military personnel1 where the annual incidence in men is 3.8% and in women is 6.5%, with a prevalence of 12% in men and 15% in women 1…”

Risk factors for patellofemoral pain: a systematic review and meta-analysis

“…PFP is a common pathology in both adolescents2 and adults,3 with prevalence in the general population reported as 22.7% 4. However, the factors associated with PFP development and the incidence of the condition across a variety of populations remains under-evaluated due to limited prospective data and the homogeneity of studied populations 4 5.…”