Low Back Pain In Adolescents Research Articles

The Impact of Physical Activity on Adolescent Low Back Pain: A Systematic Review.

Background: The relationship between physical activity and low back pain (LBP) in adolescents is complex, with conflicting evidence on whether activity is protective or a risk factor. The COVID-19 pandemic has introduced new challenges, increasing sedentary behaviors among adolescents. This systematic review updates the evidence on the association between physical activity and LBP in this population, focusing on the impact of the pandemic. Methods: A systematic search of PubMed, Cochrane Library, Web of Science, Medline, and SCOPUS identified observational studies published between January 2011 and December 2023. This review focused on adolescents aged 10 to 19 years, examining the effects of various physical activity levels and types on LBP incidence. Quality assessment was conducted using the ROBINS-I tool. Results: Twelve studies were included, with a total of 78,850 adolescents. The findings suggest a U-shaped relationship between physical activity and LBP, where low and high activity levels increase LBP risk, while moderate activity appears protective. The pandemic exacerbated LBP prevalence, likely due to increased sedentary behavior. Gender differences were noted, with females more likely to report LBP, particularly related to sports participation. Conclusions: Moderate physical activity may protect against LBP in adolescents, whereas both inactivity and excessive activity heighten risk. The pandemic's impact highlights the need for balanced physical activity to prevent LBP. Further research should explore the long-term effects of these changes.

The Prevalence of Spondylolysis and the Diagnostic Sensitivity of Radiography in Adolescent Low Back Pain

ABSTRACT Introduction The aims of this retrospective chart review were to determine the prevalence of radiographically positive spondylolysis based on the historical “gold standard” of single photon emission computed tomography (SPECT) and to evaluate the sensitivity of radiographs in detecting spondylolysis relative to SPECT scans in adolescent athletes presenting with low back pain (LBP). Our secondary outcome measure included an assessment of the variable prevalence of spondylolysis in different athletic subpopulations. Methods Radiographs and SPECT scans for patients with LBP were reviewed for the presence of spondylolysis. The sensitivity and specificity of two-view and four-view radiographs compared to SPECT scans were calculated, and the associations between diagnosis of spondylolysis and age, gender, and sport were determined. Results Nine hundred ninety-nine adolescent patients presented with LBP; 405 SPECT scans were performed. Of those, 141 (35%) SPECT scans were positive for spondylolysis. The prevalence rate for spondylolysis in this population who presented with LBP was 14%. Compared to SPECT scans, two-view radiographs were more specific (92.93%) and had a higher negative likelihood ratio (0.81) for spondylolysis than four-view radiographs. Boys were more likely to have a positive SPECT scan compared to girls (adjusted odds ratio, 6.07; 95% confidence interval, 3.00–12.26). Younger age was significantly associated with a spondylolysis diagnosis (adjusted odds ratio, 1.24; 95% confidence interval, 1.09–1.41). Lacrosse, soccer, softball, and volleyball athletes had a significantly lower risk of spondylolysis diagnosis compared to football and gymnastics athletes. Conclusions This research contributes to data regarding the prevalence of spondylolysis in symptomatic, adolescent athletes. Two-view radiographs were more useful screening tests for spondylolysis than four-view radiographs. Younger athletes, boys, and those who participate in certain sports were more likely to have evidence of spondylolysis on SPECT scans.

Lower Back Pain in Adolescents with an Osteopathic Component

Low back pain (LBP) is a common complaint in adolescents and has been increasingly reported in recent years. Affecting roughly 40% of adolescents, it leads to negative overall health, higher incidence of LBP in adulthood, and greater utilization of health care resources over one’s lifetime. LBP in adolescents differs from adult populations due to variations in structural anatomy, which contribute to differing approaches in diagnosis and treatment of this condition. The differential diagnosis of LBP in this population is extremely broad and can be attributed to many underlying etiologic factors. Clinicians must conduct a thorough history and physical examination and consider the appropriate diagnostic testing to accurately diagnose adolescents early on in their conditions to provide the most effectivetreatment. Treatment for this condition ranges from rest and rehabilitation, to oral medications, OMT, bracing, and rarely, surgery. Physicians must also be able to recognize clear risk factors and symptoms for serious underlying pathology that can be causing LBP. This article will focus on diagnosis and treatment of the most common causes of LBP in adolescents.

Low Back Pain in Adolescents: Associations With Demographics, Physical and Psychosocial Factors, and Magnetic Resonance Imaging Features of the Spine.

van den Heuvel, Marleen M. MD, MSca,b; Chiarotto, Alessandro hDa; Oei, Edwin H.G. MD, PhDc; van Middelkoop, Marienke PhDa Author Information

Screen time and low back pain in children and adolescents: a systematic review of Brazilian studies.

To identify and summarize the possible associations between screen time and low back pain in children and adolescents. Systematic searches were performed in five electronic databases (Lilacs, Scielo, Scopus, PubMed and Web of Science) on 01/25/2021, complemented by manual searches in reference lists and on Google Scholar, looking for original scientific articles that included Brazilian observational studies; whose samples had children and/or adolescents aged between 6 and 19 years, without specific clinical conditions, and that presented analyses of associations between indicators of screen time and nonspecific low back pain, based on regression models. Nine cross-sectional studies whose samples had adolescents were included. Of the 18 analyses identified, nine reported risk relationships between the variables of interest. More specifically, risk associations were found in two studies that evaluated adolescents exposed to at least three hours using cell phone or tablet, and watching television per day. Also, instruments, cut-off points adopted, and screen equipment evaluated were diverse. Even though most of the risk associations were borderline from the statistical point of view, we found a higher frequency of risk associations between screen time and non-specific low back pain in adolescents exposed to screen time for at least three hours a day. In addition, further longitudinal studies with samples composed of children should be conducted across the country.

Mckenzie versus William’s Exercise for Non-Specific Low Back Pain in Adolescents: A Comparative Study

Mckenzie versus William’s Exercise for Non-Specific Low Back Pain in Adolescents: A Comparative Study

Prevalence of Low Back Pain and Associated Risk Factors among Saudi Arabian Adolescents: A Cross-Sectional Study.

Low back pain is the most prevalent musculoskeletal condition. Studies on adolescent low back pain are scarce, with no research to determine its prevalence in Saudi Arabia. This study aimed to assess the prevalence and associated risk factors of low back pain in Saudi Arabian adolescents. This cross-sectional study was conducted among Saudi Arabian high school students, which included demographic data, medical and low back pain history. The completed survey by 2000 participants showcased 57.9% of students experiencing low back pain in the last 12 months. This included 31.2% men and 26.7% women. This study found a link between low back pain and age, clinical symptoms of diabetes, heart disease, lung disease, thyroid disease, arthritis, and back surgery, a family history of low back pain, as well as smoking. There is substantial prevalence of low back pain in Saudi Arabian adolescents. This study identified several modifiable and non-modifiable risk factors stemming from adolescent low back pain.

Low-back pain in adolescents with an osteopathic component

Low-back pain (LBP) is a common symptom presenting in adolescents. Most back pain in adolescents is benign and musculoskeletal in nature, due to trauma or congenital anomalies. Other less common causes include infection, inflammatory conditions or neoplasm. A comprehensive history and physical focusing on posture, muscle tenderness, range of motion, muscle strength and neurological function is essential in understanding the cause of low-back pain. Identification of risk factors for low-back pain will help the clinician in managing their patient. Treatment includes rest, avoiding activities that cause pain, physical therapy, osteopathic manipulative treatment, limited use of non-steroidal anti-inflammatory drugs and family and patient education. Assessing for warning signs or red flags of serious causes of LBP is a fundamental part of the clinical assessment. Pain that awakens from sleep, pain lasting longer than 4 weeks, sudden onset pain, systemic findings such as fever or weight loss and abnormal neurological findings should warrant immediate evaluation as these may suggest serious infectious conditions, malignancy or fracture. This article presents a comprehensive review of the epidemiology, relevant anatomy, biomechanics, causes and major risk factors for adolescent low-back pain. A diagnostic algorithm utilizing a step-by-step approach is also introduced to aid the clinician in management of the patient. Finally, the article presents guidelines for management of the adolescent with low-back pain including conservative, pharmacologic, as well as the osteopathic approach to treatment. Evidence-based recommendations on osteopathic approach to treatment has been reviewed from meta-analysis data and randomized controlled trials.

Effect of low back pain on clinical-functional factors and its associated potential risk of chronicity in adolescent dancers of classical ballet: cross-sectional study

BackgroundLow back pain (LBP) is a common symptom in classical ballet dancers, which can limit their daily activities and dance training routines. The purpose of the study was to verify the association and comparison of clinical-functional outcomes (spine flexibility and foot posture) between different levels of intensity low back pain in adolescents of classical ballet and the potential risk of chronicity using the STarT back tool.MethodsCross-sectional study. Participants: 78 adolescent girls who practice classical ballet were evaluated and divided into groups according to level of low back pain: mild (n = 21), moderate (n = 17), and high (n = 20), and a control group (n = 20). Main outcome measures: Pain, flexibility of the spine (thoracic and lumbosacral), risk of chronicity for low back pain, and foot posture were assessed using the visual analogue scale, clinical tests, STarT back screening tool (SBST) questionnaire, and foot posture index (FPI), respectively.ResultsDancers with high-intensity low back pain showed a potential risk of chronicity by the SBST. The spine pain intensity was not different considering thoracic and lumbosacral flexibility in the sagittal plane, but was different with greater supine FPI when compared to control dancers. Mild low back pain was associated with greater supine FPI. The SBST score was associated with higher exposure time–frequency and time of dancing.ConclusionAdolescents of classical ballet with high-intensity low back pain showed a potential risk of chronicity by the SBST. The level of intensity low back pain did not influence the clinical-functional aspects of spine flexibility in the sagittal plane, but the level of intensity moderate pain promoted changes in foot posture (more supinated). The potential risk of chronicity using the SBST was also associated with higher exposure time–frequency and time of dancing, in adolescents of classical ballet.

Association Between Family History of Surgically Treated Low Back Pain and Adolescent Low Back Pain.

Cross-sectional. To study the associations between a family history of surgically treated low back pain (LBP) and adolescent LBP. A family history of LBP is related to adolescent LBP, but whether a family history of back surgery is relevant to adolescent LBP is not known. A subpopulation of the Northern Finland Birth Cohort 1986 was contacted when they were aged between 18 and 19years. The postal questionnaire asked the participants to report their LBP and a relative's (mother, father, sibling) LBP and back surgery, and to provide data on potential covariates. The association between a family history of LBP ("no family history of LBP," "family history of LBP but no surgery," and "family history of LBP and surgery") and adolescent LBP (no LBP, occasional LBP, and frequent LBP) were evaluated using logistic regression analysis with odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for sex, smoking, and psychological distress. Of the 1374 adolescents in the study, 33% reported occasional LBP and 9% frequent LBP. Both the "family history of LBP but no surgery" and "family history of LBP and surgery" categories were associated with frequent LBP (adjusted OR [aOR] 2.09, 95% CI 1.38-3.16; aOR 2.23, 95% CI 1.02-4.90, respectively). Occasional LBP was associated with the "family history of LBP and surgery" category. A subgroup analysis of adolescents with a family history of LBP found no statistically significant associations between family history of back surgery and adolescent LBP. Our findings suggest that adolescents who report a family history of LBP have higher odds of frequent LBP irrespectively of a family history of back surgery.Level of evidence: 4.

Lateral bending differentiates early-stage spondylolysis from nonspecific low back pain in adolescents

BackgroundEarly-stage spondylolysis (ESS) is one of the common causes of acute low back pain (LBP) in adolescents. Although accurate diagnosis of ESS is important for providing appropriate treatment, differentiating ESS from other low back disorders is difficult by physical signs alone. ObjectivesTo elucidate the most common characteristic, namely, motion-provoking LBP, in patients with ESS. DesignRetrospective comparative cohort study. MethodWe included and categorized adolescents (n = 112; age, <18 years) with acute LBP (<1 month) into the ESS (n = 71) and nonspecific LBP (NS-LBP) (n = 41) groups based on magnetic resonance imaging (MRI) findings. Patients were evaluated using a visual analog scale (VAS), Oswestry Disability Index (ODI), and degree of pain using a numerical rating scale (NRS) provoked by hyperextension, hyperflexion, right and left rotations, and lateral bending in standing position.; the value were compared between the 2 groups. A cut-off value of significance was obtained using receiver operating characteristic (ROC) analysis. ResultsThe mean scores for VAS and ODI and NRS of each test were as follows (ESS/NS-LBP): VAS, 6.5/6.0; ODI, 19.7/24.6; hyperextension, 4.1/4.1; hyperflexion, 2.4/3.0; rotation, 2.1/2.2; and lateral bending, 2.9/2.2. The ESS group had a significantly greater number of LBP cases provoked by lateral bending than the NS-LBP group. A cut-off lateral bending of 3.5 yielded a diagnosis of ESS. ConclusionsOur results indicate that lateral bending is the greatest motion-provoking characteristic of LBP in patients with ESS.

Incidence and factors associated with low back pain in adolescents: A prospective study

BackgroundLow back pain (LBP) is a common complaint among children and adolescents and can negatively impact their physical and mental health. Although previous studies investigating the incidence of low back pain (LBP) in children and adolescents have been performed in high income countries, it is unclear whether countries such as Brazil would show similar incidence rates. ObjectiveTo determine the incidence and to identify predictors of new episodes of LBP in high school students. MethodsThis is a 1-year longitudinal study of high school students from public schools in the city of Bauru, Sao Paulo. Collected clinical data were: demographic and socioeconomic factors, information on the use of electronic devices, mental health status (the Strengths and Difficulties Questionnaires), level of habitual physical activity (Baecke Physical Activity Questionnaire), and incidence of LBP (measured with question about LBP in the past 12 months and the Nordic Musculoskeletal Questionnaire). Descriptive analysis and bivariate and multivariate logistic regressions were performed. ResultsThe cumulative incidence of new LBP episodes for the total cohort of 757 high school students was 18.9% (95% CI: 16.2, 21.8). The cumulative incidence was 14.8% (95% CI: 11.7, 18.5) for male students and 24.1% (95% CI: 19.8, 29.9) for female students. Being a female student (OR = 1.78; 95% CI: 1.23, 2.59), sitting posture while using tablet (OR = 4.34; 95% CI: 1.19, 16.60), daily time spent on tablet (OR = 3.21; 95% CI: 1.41, 7.30), daily time spent on mobile phone (OR =1.49; 95% CI: 1.11, 2.00), lying posture while using mobile phone (OR = 1.49; 95% CI: 1.05, 2.12), and mental health status (OR = 2.81; 95% CI: 1.76, 4.48) were identified as predictor variables. ConclusionOur findings showed that one in five high school students reported having a LBP episode over the last year. The predictors found to be associated with low back pain include those related to sex, time and posture while using electronic devices, and mental health status.

Association of sedentary behavior and early engagement in physical activity with low back pain in adolescents: a cross-sectional epidemiological study.

To investigate the association of sedentary behavior and physical activity from childhood to adolescence with prevalence of low back pain in adolescents. In addition, we also explored whether sleep quality influences this association. This is a cross-sectional epidemiological study. Participants (aged 10-17years) were recruited from public and private schools in Brazil. Sedentary behavior and previous and current engagement in physical activity were assessed through questionnaires. Low back pain and sleep quality were assessed by the Nordic questionnaire and Mini-Sleep Questionnaire, respectively. Sex, age, body mass index, abdominal obesity, socioeconomic status and sleep quality were used as potential confounders. Binary logistic regression models were used to generate values of odds ratio(OR) and 95% confidence intervals (95%CI). A total of 1,001 (44,5% boys; n = 446) were included. Overall prevalence of low back pain was 18%, with higher rates among inactive and sedentary participants. Physical inactivity from childhood to adolescence in combination with high sedentary behavior doubled the likelihood of having low back pain (OR = 2.40 [95%CI: 1.38-4.18]), independent of potential confounders. Sleep quality attenuates, but not eliminates, this association (OR = 2.19 [95%CI: 1.25-3.84]). Being inactive from childhood to adolescence in combination with high sedentary behavior is associated with low back pain in adolescents. Sleep quality seems to attenuate, but not eliminate, this association.

Back School Postural Education Program: Comparison of Two Types of Interventions in Improving Ergonomic Knowledge about Postures and Reducing Low Back Pain in Adolescents.

This study aimed to compare the impact of two Back School Postural Education Programs on improving ergonomic knowledge of postures adopted at school and home, as well as on reducing low back pain (LPB) in adolescents. The sample was constituted by 153 students, aged 10–16 years, with 96 (62.7%) girls, divided into 2 intervention groups (GA, GB). Two tests (theoretical and practical) and LBP questionnaire were applied 1 week before and 1 year after the end of the program. In GA, three sessions were performed for each class separately, on theoretical and practical issues, lasting 45 min and at intervals of 1 week, and in GB, only one theoretical session (90 min) was given to all students. Statistically differences on GA were obtained between the values 1 week before and after 1 year of evaluation in both theoretical and practical tests (p ≤ 0.001). In GB, only the values of the practical test present a statistical difference (p ≤ 0.001). GA obtained higher values on both tests after 1 year of follow-up compared with GB (p ≤ 0.001). The number of students with LBP decreased on GA (p ≤ 0.001). The program with longer duration, higher weekly frequency, and more practical and individualized character promotes better effects.

Transforaminal lumbar interbody fusion versus posterolateral fusion for the treatment of low-grade isthmic spondylolisthesis in adults

Background Isthmic spondylolisthesis means slippage of one vertebra relative to the next caudal vertebra as a result of an abnormality in the pars interarticularis. Isthmic spondylolisthesis has three subtypes: subtype A in which there is stress fracture of the pars (spondylolysis), subtype B in which the pars is elongated, and subtype C in which there is acute fracture of the pars. Isthmic spondylolisthesis is the most common cause of low back pain in adolescents. Spinal fusion is the mainstay of the surgical treatment of low-grade isthmic spondylolisthesis. Spinal fusion can be achieved by posterolateral fusion (PLF) or circumferential fusion. The three basic techniques for circumferential fusion include anterior lumbar interbody fusion, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion (TLIF). Patients and methods Fifty patients with low-grade isthmic spondylolisthesis managed with spinal fusion at the Zagazig University Hospital. Patients were divided into two groups: group I included patients managed by TLIF and group II included patients managed by PLF. The mean age of patients was 34.6 years (range: 26–43 years) in group I and 36.8 years (range: 28–46) in group II. Sex distribution was nine males and 16 females in group I and seven males and 18 females in group II. Exclusion criteria included patients with high-grade spondylolisthesis, traumatic spondylolisthesis, degenerative spondylolisthesis, neoplastic spondylolisthesis, patients with acute or chronic infection, and congenital malformation. Results No patients were dropped in the follow-up. In both groups, the mean visual analog scale (VAS) for back pain and leg pain and the Oswestry disability index (ODI) showed statistically significant difference between the values obtained preoperatively and the values obtained at the 1-year follow-up visit. In comparison between both groups for the change in the VAS for back and leg pain and ODI score, group I gave a significant difference regarding the change in the VAS for back pain compared to group II. However, the change in the VAS for leg pain and ODI was not statistically significant. Conclusion Both TLIF and PLF are effective options for the treatment of low-grade isthmic spondylolisthesis in adults. However, TLIF gives better clinical outcome, so it is considered a better option.

Lifetime Prevalence of Nonspecific Low Back Pain in Adolescents: A Cross-sectional Epidemiologic Survey.

Many nonconclusive studies have been conducted on low back pain (LBP) in adolescents and associated factors. The aim was to assess the lifetime prevalence and associated factors of LBP in adolescents. A questionnaire was administered in high school students (14-19-yr-old participants) in Veneto region (Italy). The self-administered, structured questionnaire included anthropometric data; psychologic factors and lifestyle; presence, intensity, and family history of LBP; referral to professional health care for LBP; and a short version of the International Physical Activity Questionnaire. A total of 6281 adolescents were recruited; 5204 questionnaires were included in the final analysis. A total of 2549 (48.98%) students reported one or more LBP episodes and 723 (13.89%) reported nonspecific disabling lumbar pain (i.e., no underlying pathology); 1040 (41.11%) subjects with LBP consulted a healthcare professional. A significant association emerged for LBP with sex (female), positive family history, time spent sitting or using electronic devices, sleep deprivation (<5 hrs/night), and low level of physical activity. In a large sample of adolescents, LBP lifetime prevalence is high and often associated with disabling pain and sedentary lifestyle, requiring professional care. These findings may support the development of prevention and treatment strategies of LBP in adolescents, reducing the risk of developing chronic pain.

Inter-rater Reliability of the McKenzie Method of Mechanical Diagnosis and Therapy for the Provisional Classification of Low Back Pain in Adolescents and Young Adults

ABSTRACT Objective To investigate the inter-rater reliability of Mechanical Diagnosis and Therapy (MDT)-trained Diplomats in classifying adolescents and young adults with lumbar pain. Methods Forty-three participants (mean age 15 ± 2 years) with lumbar pain, with or without lower extremity symptoms, were assessed simultaneously by three MDT Diploma holders and classified into one of three groups: 1) Derangement, 2) Dysfunction, 3) Postural/OTHER. Inter-rater reliability was calculated using the Fleiss kappa statistics with 95% confidence intervals (CI). Analyses were repeated with the younger (11 to 15 years old) and older (16 to 21 years old) age groups. Results There was moderate reliability (Fleiss kappa = 0.50, 95% CI = 0.45 to 0.54) for the entire sample, which was statistically significant (p < 0.001). There was good reliability in older participants (Fleiss kappa = 0.63, 95% CI = 0.57 to 0.70), but poor reliability in younger participants (Fleiss kappa = 0.33, 95% CI = 0.27 to 0.39). There was 100% agreement in classifications among assessors for 70% of participants. Discussion The MDT system has moderate reliability when classifying lumbar pain in adolescents and young adults. Future reliability studies may include a balanced group for classifications or a second session.

Early life chronic inflammatory conditions predict low back pain in adolescence and young adulthood.

Associations between inflammatory conditions and low back pain (LBP) have been found frequently in older populations. However, the nature of these relationships in younger populations is unknown. This study aimed to investigate the associations between early life chronic or recurrent inflammatory conditions and impactful LBP in adolescence and young adulthood. In this longitudinal study, we used data from the Raine Study Gen2 participants at the 1, 2, 3, 5, 8, 10, 14, 17, 20 and 22-year follow-ups (N=2,868). Data were collected on inflammatory conditions from 1 to 22years of age and occurrences of impactful LBP from 14 to 22years of age. Longitudinal and cross-sectional associations between inflammatory conditions and impactful LBP occurrence were examined. Potential dose-response relationships between the number of inflammatory conditions and impactful LBP were also assessed. Logistic regression models were used in the analysis. Participants with respiratory or atopic conditions during childhood had increased odds of future impactful LBP in adolescence and young adulthood (odds ratio (OR) [95% confidence interval (CI)] = 1.29 [1.07, 1.54] and 1.23 [1.02, 1.49], respectively). There were cross-sectional associations between inflammatory conditions including respiratory, skin, musculoskeletal, autoimmune and atopic conditions, with impactful LBP. Participants with two illnesses and three or more illnesses had an increased odds (OR [95% CI] =1.68 [1.30, 2.18] and OR [95% CI] =2.12 [1.54, 2.89], respectively) of reporting impactful LBP. Overall, longitudinal and cross-sectional associations of respiratory and atopic conditions with impactful LBP in adolescence and young adulthood were identified. More evidence is needed to determine whether there is a causal relationship between chronic inflammatory conditions and impactful LBP. Low back pain (LBP) is a prominent and significant health problem and associations between inflammatory conditions and LBP have been found frequently in older populations. We found that children with respiratory or atopic conditions and those with several chronic inflammatory conditions are at increased odds of impactful LBP in adolescence and young adulthood. In clinical practice and future research, there is a need to consider comorbidities also in younger populations.

Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health

ObjectivesTo determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems. MethodsCross‐sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used. ResultsThe overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR = 1.70), daily TV use for more than 3hours (PR = 1.17), use of laptop computer (PR = 1.40), use of the cell phone in the supine position (PR = 1.23), use of the cell phone in semi‐supine position (PR = 1.49), daily cell phone use for more than 3hours (PR = 1.36), use of tablet (PR = 1.67), daily tablet use for more than above 3hours (PR = 1.46), and clinically important mental health problems (PR = 2.62). ConclusionThere is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.

Associação entre diferentes domínios da atividade física e a dor lombar inespecífica em adolescentes

This study aimed to analyze the associations between different domains of physical activity (PA) and nonspecific low back pain in adolescents. A school-based study with adolescents randomly selected from a city in the south Brazil. Analyzed variables were nonspecific low back pain, different domains of PA (commuting to school, participation on physical education classes, participation on classes of sports teams, and the general physical activity level), sex, age, socioeconomic status and living area. 1,455 adolescents (50.9% female) with a mean age of 13.5 (± 2.02) years participated of the study. Low back pain prevalence was 16.1% (95% CI: 14.2-17.9). The non-participation in physical education classes was the only domain of PA to be associated with the presence of low back pain (OR: 2.26; 95% CI: 1.48-3.47). Non-participation in Physical Education classes increases the chance of adolescents presenting nonspecific low back pain.