A systematic review of the incidence and prevalence of low back pain in children

Abstract

Objectives: To identify what is known about the prevalence and incidence of low back pain (LBP) in children and to assess the quality of the methods employed to find this information.Data source: The entire holdings of Medline, Cinahl, Amed, Embase, Psycinfo, Australian Medical Index, and the Cochrane Database of Systematic Reviews and Registry of Randomized Controlled Clinical Trials up to September 2008.Methods: Inclusion criteria were cross-sectional, retrospective or prospective studies, published in English, participants aged 7–18 years, studies reporting data that includes information about the age of onset of LBP, prevalence and/or incidence of LBP. Studies were assessed for quality according to nine pre-defined criteria.Results: Thirty-five studies were included in the review. Lifetime prevalence was most widely studied. There was considerable variation in the definition of LBP and recall periods for reporting of LBP. Age specific data indicates that LBP is not uncommon in children less than 10 years. Lifetime prevalence of LBP gradually increases from age 7 to 12 years (lifetime prevalence 1% at 7 years to 17% at 12 years). This is followed by a steep increase in lifetime prevalence from 12–15 years (from a maximum lifetime prevalence of 17% at 12 years to 53% at 15 years), with a continued increase in lifetime prevalence of LBP until the late teens.Discussion/Conclusion: The incidence and prevalence of LBP in children has been widely studied. Inconsistency in definition of LBP and pre-defined recall periods, along with a range of other variations in data collection methods, probably affect the reported prevalence rates. Standardisation of best methods is essential for confident pooling of future studies.