The Natural History of Low Back Pain in Adolescents

Burton, Kim; Clarke, Robert D.; McClune, Tim; Tillotson, K. M.

doi:10.1097/00007632-199610150-00004

Cited by 403 publications

(328 citation statements)

References 20 publications

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“…In the current study, boys reported experiencing more LBP than did girls. These results, although reported by others [8,29], are not in accordance with the majority of previous studies, which document a higher prevalence of subjectively experienced LBP among females [3,18]. Differences in case-definitions used might be a possible explanation for such inconsistency, but also subtle differences in age and nature of the study samples.…”

Section: Discussioncontrasting

confidence: 87%

Genetic and environmental influences on non-specific low back pain in children: a twin study

et al. 2008

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Aggregation of low back symptoms in families of children with low back pain (LBP) has been described. However, this may be due to genetic factors or common exposure to environmental factors. The aim of this study was to evaluate the relative contribution of genetic and environmental factors to childhood LBP by comparing the pairwise similarity of LBP in pairs of monozygotic (MZ) and dizygotic (DZ) twin children. Data was collected from 1995 to 1998 from a national sample of Finnish 11-year-old twins born between 1984 and 1987. This study sample constituted of 1,790 twin pairs: 610 MZ pairs, 598 same-sex DZ pairs, 582 opposite-sex DZ pairs. LBP pain was determined by using a validated pain questionnaire designed to assess musculoskeletal pains during the preceding 3 months. The outcome measure, LBP, was considered in three categories: none, once a month and at least once a week. Twin similarity in the report of LBP was quantified by correlations. Variance components for genetic and environmental factors were estimated by using biometric structural equation modelling techniques. The prevalence of LBP at least once a month was 15.7%, and at least once a week was 6.6%. The prevalence of frequent LBP in boys was significantly higher than that in girls (P = 0.04). In both genders, there were no differences in LBP reporting by zygosity (P [ 0.2). There were no statistically significant differences between polychoric correlations in male MZ and DZ pairs and between polychoric correlations in female MZ and DZ pairs, suggesting little genetic influence. Results obtained from the best-fitting genetic model suggests that, of the total variance in LBP, 41% (95% CI 34-48) could be attributed to shared environmental factors within families; and 59% (52-66) to unique (unshared) environmental factors. Our results suggest that genetic factors play, at most, a minor role in LBP in children; instead, symptoms seem to be related to a mixture of shared and unshared environmental factors. This study underscore the need for further highquality research, preferably prospective studies, to identify important modifiable risk factors in order to guide interventions that may prevent LBP in childhood.

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Section: Discussioncontrasting

confidence: 87%

Genetic and environmental influences on non-specific low back pain in children: a twin study

et al. 2008

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“…The study findings indicated that the intervention resulted in increased back posture knowledge, improved postural behavior during material handling and while sitting during lesson time. Additionally, the intervention did not result in increased fear avoidance beliefs or augmented back pain prevalence, which may be a negative consequence of attention for back-related topics [3,4].…”

Section: Introductionmentioning

confidence: 99%

Back posture education in elementary schoolchildren: a 2-year follow-up study

et al. 2006

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Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13-14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters' lifestyles. At 2-year followup, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 ± 0.8 years) and 101 controls (mean age 13.2 ± 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fearavoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on selfreports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year postintervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential.

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“…Keywords Adolescents Á Low-back pain Á Physical activity Á Prevention Á Health promotion Background Low-back pain (LBP) is frequent among schoolchildren [1][2][3][4][5][6][7][8]. The occurrence increases with age, especially in the early teen-years [1, 2, 9, 10] so that, by age 14-17, 11-71% will have experienced at least one episode of LBP [1][2][3][4][5][9][10][11].…”

mentioning

confidence: 99%

“…The occurrence increases with age, especially in the early teen-years [1, 2, 9, 10] so that, by age 14-17, 11-71% will have experienced at least one episode of LBP [1][2][3][4][5][9][10][11]. Recurrent LBP during childhood seems to occur among 5-19% of all children [4,5,9], and LBP in childhood may be a forerunner of LPB in adult life [12].…”

mentioning

confidence: 99%

Physical activity and low-back pain in schoolchildren

Skoffer

Foldspang²

2008

Eur Spine J

112

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Design of the experiment is to study the crosssectional sample with retrospective information. The objective is to identify the types of physical activity associated with the decreased occurrence of low-back pain (LBP) in schoolchildren. Physical activity may be hypothesized to possess a potential for LBP prevention. The possible connection between LBP and specific sports activities is however sparsely documented. A total of 546, 15-to 16-year-old schoolchildren filled a questionnaire on current physical activities and LBP occurrence and severity. In multiple logistic regressions, the association of LBP with exposure variables was corrected for body height and weight (data from school health service files) and for anthropometric and school furniture parameters. More than half of the children reported pain or discomfort in the low-back region during the preceding 3 months, and 1/4 experienced a decreased functioning or need of care because of LBP. LBP correlated with physical inactivity, e.g. time spent on homework and hours watching TV or video, and with a series of sports activities, e.g. jogging, handball playing and gymnastics. Among sports activities, only swimming and the number of hours per week participating in soccer were associated with a decreased LBP prevalence. With the exception of swimming and soccer, the types of sport reported by this schoolchild population do not offer themselves for consideration as tools for LBP prevention. Based on the associations found with indicators of physical inactivity, attempts to motivate the children to increase their general physical activity level should be considered for trial.

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The Natural History of Low Back Pain in Adolescents

Abstract: Back pain in adolescents is common; it increases with age and is recurrent, but in general does not deteriorate with time. Much of the symptomatology may be considered a normal life experience, probably unrelated to adult disabling trouble.

Cited by 403 publications

References 20 publications

Genetic and environmental influences on non-specific low back pain in children: a twin study

Genetic and environmental influences on non-specific low back pain in children: a twin study

Back posture education in elementary schoolchildren: a 2-year follow-up study

Physical activity and low-back pain in schoolchildren

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