Abstract
BackgroundMusculoskeletal pain has a high prevalence in adolescence and causes huge consequences for the individuals and the society. Little knowledge exists on social risk factors for musculoskeletal pain in adolescents. This study aimed to investigate if low social acceptance among peers during the first year of upper secondary school was associated with persistent and severe persistent musculoskeletal pain 2 years later and if psychological distress modified this association.MethodsLongitudinal data from the Norwegian Fit Futures Study was used. Students in the first year of upper secondary school answered an electronic questionnaire, covering health status, pain, social acceptance among peers, and psychological distress. Persistent musculoskeletal pain was measured 2 years later. Multiple logistic regression analyses and moderation analyses were conducted adjusting for sex and chronic diseases. Main analyses were conducted on participants without persistent musculoskeletal pain at baseline, and secondary analyses were conducted on all participants with and without persistent musculoskeletal pain at baseline.ResultsOf 775 participants (52% females), 556 (71.7%) were pain-free at baseline and included in the main analyses. Significant associations between low social acceptance among peers and persistent musculoskeletal pain 2 years later were found in crude (Odds ratio (OR) = 1.8, 95%CI [1.0–3.1]) and adjusted analyses (OR = 1.8, 95%CI [1.0–3.2]). No statistically significant effect modification of psychological distress (p = 0.89) on this association was found. A significant association between low social acceptance and persistent musculoskeletal pain was found in adjusted secondary analyses of all the students (n = 692) (OR = 1.6, 95%CI [1.0–2.3]).ConclusionsOur results indicate that low social acceptance among peers increases the risk of future persistent musculoskeletal pain in adolescents. Thus, interventions strengthening adolescent’s social arenas may be helpful to prevent persistent musculoskeletal pain.Trial registrationRetrospective registered at clinicaltrials.org NCT04526522.
Highlights
Musculoskeletal pain has a high prevalence in adolescence and causes huge consequences for the individuals and the society
More adolescents lost to follow-up did not know their parent’s educational level
No differences were found in social acceptance data, nor psychological distress in participants lost to follow-up than those who remained in the study (Additional file 2)
Summary
Musculoskeletal pain has a high prevalence in adolescence and causes huge consequences for the individuals and the society. Little knowledge exists on social risk factors for musculoskeletal pain in adolescents. Identifying modifiable risk factors are necessary to develop effective interventions aiming to prevent future persistent MSK pain. Several studies have investigated risk factors for persistent MSK pain in adolescents [6, 7]. Objectively measured BMI, and persistent MSK pain were measured at baseline and used to describe the study sample. A two-year incidence rate of new cases with persistent MSK pain at follow-up was calculated. The two-year incidence was calculated by dividing the number of participants who developed a new episode of persistent MSK pain at follow-up by the number of participants at risk at baseline (study sample). Independent sample t-test was used to compare normally distributed pairs of continuous data, and categorical variables were compared using the chi-square test
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