Abstract
BackgroundThe key to a better understanding of the immense problem of spinal pain seems to be to investigate its development in adolescents. Based on the data of Spine Day 2012 (an annual action day where Swiss school children were examined by chiropractors on a voluntary basis for back problems), the aim of the present study was to gain systematic epidemiologic data on adolescent spinal pain in Switzerland and to explore risk factors per gender and per spinal area.MethodData (questionnaires and physical examinations) of 836 school children were descriptively analyzed for prevalence, recurrence and severity of spinal pain. Of those, 434 data sets were included in risk factor analysis. Using logistic regression analysis, psycho-social parameters (presence of parental back pain, parental smoking, media consumption, type of school bag) and physical parameters (trunk symmetry, posture, mobility, coordination, BMI) were analyzed per gender and per spinal area.ResultsPrevalence of spinal pain was higher for female gender in all areas apart from the neck. With age, a steep increase in prevalence was observed for low back pain (LBP) and for multiple pain sites. The increasing impact of spinal pain on quality of life with age was reflected in an increase in recurrence, but not in severity of spinal pain. Besides age and gender, parental back pain (Odds ratio (OR)=3.26, p=0.011) and trunk asymmetry (OR=3.36, p=0.027) emerged as risk factors for spinal pain in girls. Parental smoking seemed to increase the risk for both genders (boys: OR=2.39, p=0.020; girls: OR=2.19, p=0.051). Risk factor analysis per spinal area resulted in trunk asymmetry as risk factor for LBP (OR=3.15, p=0.015), while parental smoking increased the risk for thoracic spinal pain (TSP) (OR=2.83, p=0.036) and neck pain (OR=2.23, p=0.038). The risk for TSP was further enhanced by a higher BMI (OR=1.15, p=0.027).ConclusionThis study supports the view of adolescent spinal pain as a bio-psycho-social problem that should be investigated per spinal area, age and gender. The role of trunk asymmetry and passive smoking as risk factors as well as the association between BMI and TSP should be further investigated, preferably in prospective studies.
Highlights
The key to a better understanding of the immense problem of spinal pain seems to be to investigate its development in adolescents
A steep increase in prevalence was observed for low back pain (LBP) and for multiple pain sites
Risk factor analysis per spinal area resulted in trunk asymmetry as risk factor for LBP (OR=3.15, p=0.015), while parental smoking increased the risk for thoracic spinal pain (TSP) (OR=2.83, p=0.036) and neck pain (OR=2.23, p=0.038)
Summary
The key to a better understanding of the immense problem of spinal pain seems to be to investigate its development in adolescents. The majority of studies state that adolescent spinal pain is an important public health issue and that the focus of research, prevention and treatment in this area should be changed from the adult to the young population [5]. Research into adolescent spinal pain can roughly be divided into three main sub-areas, namely epidemiological studies focusing on prevalence, studies on (psycho-social and physical) risk factors and longitudinal studies that focus on the course or on prevention/treatment of spinal pain throughout adolescence. A detailed assessment of spinal pain in terms of location was recommended by recent studies [4,8,9]. In order to make the various studies on spinal pain comparable, standardization of definition of adolescent back pain by assessing recurrence and severity was recommended [10]
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