Musculoskeletal Pain In Adolescents Research Articles

P095 Association between autism and chronic musculoskeletal pain; a single tertiary adolescent rheumatology centre experience

Abstract Background/Aims Autism is a common neurodevelopmental disorder and can present with atypical sensorimotor function and altered pain response. Evidence suggests that patients with autism have a different processing mechanism which can alter pain perception. Pain evaluation and management is often insufficient in patients with autism. Chronic musculoskeletal pain in adolescents is common and is frequently associated with other co-morbidities. The adolescent musculoskeletal pain service at University College London Hospital uses a multidisciplinary approach to provide treatment and ongoing support for young people with chronic musculoskeletal pain up to the age of 19 years, bridging significant and often stressful life events such as exams and moving away from home. Methods A retrospective review of patient records was conducted between October 2021 and October 2023. New patients attending the adolescent chronic musculoskeletal pain clinic at University College London Hospital were identified and the prevalence of autism was noted. The presence of other co-morbidities and symptoms was also recorded. Statistical analysis was undertaken using GraphPad Prism (Fisher’s exact test) to determine any differences between patients with and without a diagnosis of autism. Results Retrospective data was obtained on 82 new patients aged between 13 and 18 years seen in the adolescent chronic musculoskeletal pain clinic. 28 patients (34%) had a diagnosis of autism. A higher proportion of autistic patients with chronic musculoskeletal pain were male compared to those without autism (36% vs 11%, p = 0.016). More patients with autism reported co-existing mental health difficulties, especially anxiety and depression (68% vs 37%, p = 0.011). Conversely, patients without autism reported a higher incidence of postural orthostatic tachycardia symptoms (POTS) or symptoms of postural dizziness (57% vs 25%, p = 0.009). Other co-morbidities and symptoms were found to be similar between patients with and without autism (headaches 18% vs 39%, abdominal pain 36% vs 54%, fatigue 61% vs 46%, sleep difficulties 68% vs 54%, attention deficit hyperactivity disorder 18% vs 9%). Conclusion This small retrospective study demonstrates that over a third of new patients seen in the adolescent chronic musculoskeletal pain service are autistic. This suggests a possible link between autism and chronic pain but more research is needed to evaluate this and larger studies are required. Patients with chronic musculoskeletal pain and autism were more likely to be male and have mental health difficulties compared to those without autism. The high incidence of mental health difficulties highlights the need for multidisciplinary team working, in particular psychological support. The results of this study have important implications for training and suggest that novel treatment strategies are needed to help advance therapies for chronic musculoskeletal pain in young people with autism. Disclosure E. Williams: None. S. Mavrommatis: None. J. Glanville: None. M. Leandro: None. D. Sen: None. C. Fisher: None.

Academic performance and musculoskeletal pain in adolescents with uncorrected vision problems

BackgroundUndetected vision problems are common in school children, and a prevalence of up to 40% has previously been reported. Uncorrected vision and lack of optimal eye wear can have a significant impact on almost all aspects of everyday life, such as development and learning, academic performance, pain and discomfort, and quality of life. This study aimed to analyze the relationship between uncorrected vision problems, educational outcomes, and musculoskeletal pain symptoms.MethodsA total of 152 school children (15.1 ± 0.8 years, mean ± SD; 40% males) were included in the study. All participants were recruited from a free-of-charge school vision testing program in Kathmandu, Nepal. Academic grades were collected from the school records of the participants’ nationwide final grade examinations. A questionnaire was used to record the use of digital devices, screen time, and associated symptoms, including musculoskeletal pain (Wong-Baker FACES Pain Rating Scales).ResultsA total of 61 children (40%) had uncorrected vision, with a cycloplegic refraction of SER − 0.53 ± 0.52 (mean ± SD). Children with uncorrected vision had significantly more third division grades (26 vs. 9%, p = 0.004) and shoulder pain in general/during screen use (66 vs. 43/40%, p = 0.008/0.003; 2.1/1.9 vs. 1.1/1.0 mean pain score, p = 0.002/0.001) compared with children with normal vision. Sex based subanalyses showed that only girls with uncorrected vision had more third division grades (25 vs. 4%, p = 0.006), and only boys with uncorrected vision had more shoulder pain in general/during screen use (76 vs. 28/31%, p < 0.001; 2.2/2.4 vs. 0.7 mean pain score, p < 0.001), compared with children with normal vision.ConclusionsThe results of this study showed that even small refractive errors may impact educational outcomes and musculoskeletal pain in adolescents. Most of the participating children had low myopia, easily corrected with glasses. This suggests that regular eye examinations are important in school children, and there is a need for raised awareness among parents, and school- and healthcare personnel.

Musculoskeletal Pain Description in Adolescence with Internet Addiction: Community Engagement in Senior High School

Background: Some bad postures resulting from bad habits that had lasted since childhood, especially posture while accessing internet using gadget, might lead to some complications in adolescence.&#x0D; Aim: In this community engagement program, we tried to explore internet addiction and musculoskeletal pain proportions in some students.&#x0D; Material and methods: This is a cross-sectional study conducted in a senior high school at Jonggol, West Java, in February 2023. Students were gathered to have an education class about good posture. Before the education session, we asked the students to explore whether they had internet addiction and musculoskeletal pain by filling out the Indonesian Internet Addiction Diagnostic Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire.&#x0D; Results: Thirty-nine students were involved in this study. As many as 19 (48.7%) students have an internet addiction. More than 50% of the addicted students often have moderate-severe pain in their neck, back and right wrist and reported that the pain interferes with their daily activities.&#x0D; Conclusions: Almost half of students attending posture education class had internet addiction and musculoskeletal pain. A further study with a larger sample size needs to be conducted to show the correlation between internet addiction and musculoskeletal pain in adolescence and other factors that correlate with them.

Family structure and multisite musculoskeletal pain in adolescence: a Northern Finland Birth Cohort 1986 study

BackgroundFamily structure is suggested to be associated with adolescent pain, but evidence on its association with multisite MS pain is sparse. The purpose of this cross-sectional study was to investigate the potential associations between family structure (‘single-parent family’, ‘reconstructed family’, and ‘two-parent family’) and multisite musculoskeletal (MS) pain in adolescence.MethodsThe dataset was based on the 16-year-old Northern Finland Birth Cohort 1986 adolescents with available data on family structure, multisite MS pain, and a potential confounder (n = 5,878). The associations between family structure and multisite MS pain were analyzed with binomial logistic regression and modelled as unadjusted, as the evaluated potential confounder, mother’s educational level, did not meet the criteria for a confounder.ResultsOverall, 13% of the adolescents had a ‘single-parent family’ and 8% a ‘reconstructed family’. Adolescents living in a single-parent family had 36% higher odds of multisite MS pain compared to adolescents from two-parent families (the reference) (Odds Ratio [OR]: 1.36, 95% Confidence Interval [CI]: 1.17 to 1.59). Belonging to a ‘reconstructed family’ was associated with 39% higher odds of multisite MS pain (OR 1.39, 1.14 to 1.69).ConclusionFamily structure may have a role in adolescent multisite MS pain. Future research is needed on causality between family structure and multisite MS pain, to establish if there is a need for targeted support.

Accumulation of health complaints is associated with persistent musculoskeletal pain two years later in adolescents: The Fit Futures study.

There is limited knowledge on the association between different health complaints and the development of persistent musculoskeletal pain in adolescents. The aims of this study were to assess whether specific health complaints, and an accumulation of health complaints, in the first year of upper-secondary school, were associated with persistent musculoskeletal pain 2 years later. We used data from a population-based cohort study (the Fit Futures Study in Norway), including 551 adolescents without persistent musculoskeletal pain at baseline. The outcome was persistent musculoskeletal pain (≥3 months) 2 years after inclusion. The following self-reported health complaints were investigated as individual exposures at baseline: asthma, allergic rhinitis, atopic eczema, headache, abdominal pain and psychological distress. We also investigated the association between the accumulated number of self-reported health complaints and persistent musculoskeletal pain 2 years later. Logistic regression analyses estimated adjusted odds ratios (ORs) with 95% confidence intervals (CIs). At the 2-year follow-up, 13.8% (95% CI [11.2-16.9]) reported persistent musculoskeletal pain. Baseline abdominal pain was associated with persistent musculoskeletal pain 2 years later (OR 2.33, 95% CI [1.29-4.19], p = 0.01). Our analyses showed no statistically significant associations between asthma, allergic rhinitis, atopic eczema, headache or psychological distress and persistent musculoskeletal pain at the 2-year follow-up. For the accumulated number of health complaints, a higher odds of persistent musculoskeletal pain at the 2-year follow-up was observed for each additional health complaint at baseline (OR 1.33, 95% CI [1.07-1.66], p = 0.01). Health care providers might need to take preventive actions in adolescents with abdominal pain and in adolescents with an accumulation of health complaints to prevent development of persistent musculoskeletal pain. The potential multimorbidity perspective of adolescent musculoskeletal pain is an important topic for future research to understand the underlying patterns of persistent pain conditions in adolescents.

Sedentary behavior is associated with musculoskeletal pain in adolescents: A cross sectional study

BackgroundHigh prevalence of back pain has been observed in adolescents. Sedentary behavior (SB) is considered a risk factor for musculoskeletal pain. The association between back pain and SB in the pediatric/adolescent population is not well established. ObjectiveTo investigate the association between SB and low back and neck pain in adolescents according to sex. MethodsThis is a cross-sectional study with children and adolescents aged 10-17 years, randomly recruited from public and private schools in Presidente Prudente, Brazil. All students enrolled in the selected schools were eligible to participate. SB was evaluated by adding the number of hours of use of screen devices, such as television, computer, video game, and smartphone/tablet. To assess neck and low back pain, the Nordic Musculoskeletal Questionnaire was used. Physical activity and socioeconomic status were assessed by the Baecke Questionnaire and the Brazilian Criteria for Economic Classification (ABEP), respectively. Odds ratio (OR) from Binary Logistic Regression in the unadjusted and adjusted model (physical activity, abdominal obesity, and socioeconomic status) showed the relationship between musculoskeletal pain and SB. ResultsA total of 1011 adolescents (557 girls) with a mean ± standard deviation age of 13.2±2.4 years were included. Moderate (OR = 1.80; 95%CI: 1.00, 3.23) and high (OR = 1.91; 95%CI: 1.02, 3.53) SB were associated with neck pain in girls. In boys, moderate SB (OR = 2.75; 95%CI: 1.31, 5.78) were associated with neck pain. Moderate (OR = 2.73; 95%CI: 1.45, 5.02) and high (OR = 2.49; 95%CI: 1.30, 4.76) SB were associated with low back pain only in girls. ConclusionModerate and high SB were associated with neck pain in girls and boys, while moderate and high SB were associated with low back pain only in girls.

Bio-psycho-social characteristics and impact of musculoskeletal pain in one hundred children and adolescents consulting general practice

BackgroundEight percent of all child and adolescent general practice consultations are due to musculoskeletal conditions, with pain as the most frequent symptom. Despite the commonality of musculoskeletal pain, limited knowledge exists about care-seeking children and adolescents with musculoskeletal pain.The purpose of this study was to describe characteristics of children and adolescents consulting their general practitioner with musculoskeletal pain.MethodsThis is a cross-sectional study based on baseline data from the child and adolescent musculoskeletal pain cohort study (ChiBPS), carried out in 17 Danish general practice clinics. Patients aged 8–19 years who had musculoskeletal pain when consulting their general practitioner were recruited. Participants completed a questionnaire on demographics, physical activity, pain impact, psychosocial factors, and expectations of their general practitioner. Descriptive statistics were used to summarize data. Normally distributed continuous data were described using mean and standard deviation while non-normally data were described using median and interquartile range (IQR).ResultsWe included 100 participants (54% female, median age 13 [IQR: 12–16.5 years]). Frequent pain sites limiting activity were knee (56%), back (20%), ankle (19%), and neck (13%). Most participants (63%) consulted their general practitioner due to inability to use their body as usual, due to pain. Median pain duration at consultation was 5 months [IQR: 3 weeks-1 year]. More than a third were often/sometimes nervous (34%), worried or anxious (33%), and took pain medication (33%). Pain impeded ability to participate in sport activities at school (79%) and disturbed spare time activities (88%). Pain also made it difficult to concentrate for 58%, and to fall asleep for 38%. Only 38% expected a pain free long-term future.ConclusionThis study demonstrates the bio-psycho-social impact of musculoskeletal pain in care-seeking children and adolescents. Demographics, pain characteristics, psychosocial characteristics, and physical characteristics should be included in addressing children and adolescents with musculoskeletal pain.Trial registrationThe ChiBPS study was pre-registered before participant recruitment (ClinicalTrials.gov Identifier: NCT03678922) date: 09.20.18.

Low social acceptance among peers increases the risk of persistent musculoskeletal pain in adolescents. Prospective data from the Fit Futures Study

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.

Quality of sleep and musculoskeletal pain in adolescents: observational study

Quality of sleep and musculoskeletal pain in adolescents: observational study

The Onset of Chronic Musculoskeletal Pain in High School Adolescents: Associated Factors and the Role of Symptoms of Central Sensitization.

This study aimed to investigate the association between sociodemographic data, physical activity, depression, anxiety, and stress, sleep, and self-reported symptoms of central sensitization at baseline, in asymptomatic adolescents, and the onset of pain at 6-months follow-up. A total of 252 asymptomatic adolescents were assessed at baseline with an online questionnaire that included sociodemographic data, the Nordic Musculoskeletal Questionnaire; the International Physical Activity Questionnaire for Adolescents; the Depression, Anxiety and Stress Scale for Children; the Basic Scale on Insomnia complaints and Quality of Sleep; and the Central Sensitization Inventory. The same questionnaire was repeated at 6-months follow-up. Of the 231 (91.7%) adolescents who completed the questionnaire at the follow-up, 127 (55.0%) remained asymptomatic and 88 (38.1%) reported a new onset of pain. At the 6-month follow-up, the mean (SD) number of painful body sites was 1.81 (1.04), and the neck region was the most reported (n = 29, 33%). Multivariable analysis showed that being female (OR = 2.34; 95% CI = 1.28-4.27) and reporting more self-reported symptoms of central sensitization (OR = 1.04; 95% CI = 1.01-1.07) were associated with the onset of chronic pain at follow-up. Female sex and self-reported symptoms of central sensitization were considered risk factors for the onset of pain in adolescents but should be further explored in future studies. Considering the increasing prevalence of chronic musculoskeletal pain in adolescents, understanding the factors that may be associated with its new onset may help to better design preventive strategies and thus minimize the appearance of this type of pain in adolescents.

Are psychological symptoms a risk factor for musculoskeletal pain in adolescents?

Adolescent musculoskeletal pain is common and is associated with musculoskeletal pain in adulthood. Psychological symptoms, also common in adolescence, have been shown to be associated with musculoskeletal pain, but the current evidence is mixed and may be dependent on effect modifiers. This study investigated whether adolescents with psychological symptoms (internalizing and externalizing constructs) at age 13 years were at higher odds for musculoskeletal pain at age 17 years and whether the associations were modified by pubertal status and sex. A prospective cohort design examined data on 3865 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC). Associations between baseline (aged 13 years) internalizing and externalizing symptoms and musculoskeletal pain at follow-up (aged 17 years) were investigated using logistic regression producing odds ratios (OR) and 95% confidence intervals (95% CI). In total 43.1% of adolescents reported musculoskeletal pain at follow-up. Externalizing symptoms at baseline increased the odds of musculoskeletal pain (OR 1.68, 95% CI 1.28, 2.20), and internalizing symptoms demonstrated a non-significant increase (OR 1.26, 95% CI 0.98, 1.62). Effect modification analysis showed an increased effect dependent on pubertal status.Conclusion: Adolescents with externalizing symptoms, and to some extent internalizing symptoms, are at increased odds of later musculoskeletal pain. Future research is now required to understand the reasons for these associations.What is Known:• Current evidence regarding the association between internalizing symptoms and externalizing symptoms and future musculoskeletal pain in adolescents is mixed.What is New:• This study found that adolescents with externalizing symptoms, and to some extent internalizing symptoms, are at increased odds for musculoskeletal pain, with an increased influence dependent on pubertal status.• These results are of interest for the development of timely preventative interventions designed to reduce the risk of musculoskeletal pain.

Obesity in Young Adulthood: The Role of Physical Activity Level, Musculoskeletal Pain, and Psychological Distress in Adolescence (The HUNT-Study).

The global obesity epidemic raises long-term health concerns which underline the importance of preventive efforts. We aimed to investigate individual and combined effects of common health problems in adolescence on the probability of obesity in young adulthood. This prospective population-based study included data from participants in the Nord-Trøndelag Health Study in Norway (Young-HUNT1 (1995–1997), age 13–19, baseline) who participated in HUNT3 as young adults 11 years later (age 23–31). Exposure variables at baseline included self-reported physical activity, musculoskeletal pain, and psychological distress. We examined associations between exposure variables and the main outcome of obesity in young adulthood (BMI ≥ 30 kg/m2) using univariate and multiple logistic regression, stratified by sex. Probabilities of obesity for given combinations of the exposure variables were visualized in risk matrixes. The study sample consisted of 1859 participants (43.6% boys). Higher probabilities of obesity in young adulthood were found across combinations of lower physical activity levels and presence of musculoskeletal pain in adolescence. Additional adverse effects of psychological distress were low. Proactive intervention strategies to promote physical activity and facilitate sports participation for all adolescents, whilst addressing musculoskeletal pain and its potential individual causes, could prove helpful to prevent development of obesity in young adulthood.

Chronic idiopathic musculoskeletal pain in youth: a qualitative study

BackgroundChronic musculoskeletal pain (MSP) is frequent in adolescents and has major medical and social consequences. In many cases, when no cause has been clearly established, this pain may be considered to be chronic idiopathic MSP. Our study seeks to identify general criteria for this type of pain through the experience of professionals from tertiary care centers with expertise in pediatric and adolescent chronic MSP.MethodsCross-sectional multicenter qualitative study. Semi-structured interviews of 25 professionals at a rheumatology reference center and in its network for pain management, including diverse specialists and professions. Interpretative Phenomenological Analysis is used to explore the data.ResultsThis approach led us to identify 10 themes organized around three superordinate themes covering different stages of the diagnostic process: 1) the medical pain history up to the consultation at the reference center; 2) the professional’s subjective feelings about the clinical presentation; 3) from the clinical examination to diagnosis and treatment of chronic idiopathic MSP. The main elements guiding this diagnosis do not come from the physical examination but from the medical history and the professionals’ subjective feelings, that is, their clinical judgment. The professionals’ impression of uneasiness and frustration, induced by patients and their parents, is of major importance.ConclusionThe principal elements guiding the diagnosis of chronic idiopathic MSP do not come primarily from the physical examination but rather from the pain history and the health professional’s subjective feelings. Our results suggest that the concept of Juvenile Fibromyalgia (JFM) does not appear to cover all situations of chronic idiopathic MSP in adolescence. A constellation of non-organic criteria enables diagnosis of the latter; these criteria should be validated to avoid medical nomadism and multiple investigations and to shorten the interval until patients receive optimal pain management.Clinical trial registrationclinicaltrials.gov, NCT03171792, https://clinicaltrials.gov/ct2/show/NCT03171792?term=LACHAL&cntry=FR&city=paris&rank=1

Baseline musculoskeletal pain and impaired sleep related to school pressure influence the development of musculoskeletal pain in N = 107 adolescents in a 5-year longitudinal study.

This longitudinal study followed 10- to 13-year-old adolescents for 5years to investigate the effects of juvenile musculoskeletal (MSK) pain and psychosocial risk factors on future pain. We further predicted that increased MSK pain at follow-up would be positively related to current school pressure at follow-up and negatively related to current sleep quality. Sleep quality was tested as a potential mediator of the link between school pressure and MSK pain at follow-up after controlling for baseline MSK pain. The baseline sample comprised 189 adolescents, and 5-year follow-up resulted in 107 15- to 18-year-old adolescents who had completed mandatory education. Adolescents responded to an online questionnaire about psychosocial stressors, MSK pain, school achievement and leisure activities. A longitudinal hierarchic linear regression including all significant baseline predictors was run to assess their impact on MSK pain 5years later. Mediation analysis was used to investigate sleep quality as a potential mediator of the relationship between school pressure and MSK pain at follow-up. Baseline MSK pain predicted MSK pain over a time lag of 5years (ß = .26, p = .02). The relationship between follow-up school pressure and current MSK pain was mediated by sleep quality at follow-up (B = .17, SEB = .07, 95% CI .06-.34) when baseline MSK pain was controlled. Juvenile MSK pain predicts MSK pain in adolescence. A psychosocial mediation model including school pressure and sleep impairments has the potential to explain MSK pain mechanisms in adolescents. These slides can be retrieved under Electronic Supplementary Material.

Graded exposure treatment for adolescents with chronic pain (GET Living): Protocol for a randomized controlled trial enhanced with single case experimental design

Chronic musculoskeletal pain in adolescence is a significant public health concern with 3–5% of adolescents suffering from significant pain-related disability. Pain-related fear and avoidance of activities has been found to have a significant influence on pain outcomes in children and adolescents and is a risk factor for less favorable response to treatment. To address this need, we developed graded exposure treatment for youth with chronic pain (GET Living). We describe the rationale, design, and implementation of a two-group randomized controlled trial (RCT) enhanced with single-case experimental design (SCED) methodology with a sample of 74 adolescents with chronic musculosketal pain and their parent caregivers. GET Living includes education, behavioral exposures, and parent intervention jointly delivered by pain psychology and physical therapy providers. The multidisciplinary pain management control group includes pain psychology delivered education and pain self-management skills training (e.g., relaxation, cognitive skills) and separate physical therapy. Assessments include brief daily diaries (baseline to discharge, 7-days at 3-month and 6-month follow-up), comprehensive in-person evaluations at baseline and discharge, and questionnaire across all time points (baseline, discharge, 3-month and 6-month follow-up). Primary outcome is pain-related fear avoidance. Secondary outcome is functional disability. We also outline all additional outcomes, exploratory outcomes, covariates, and implementation measures. The objective is to offer a mechanism-based, targeted intervention to youth with musculoskeletal pain to enhance likelihood of return to function.

Poor prognosis of child and adolescent musculoskeletal pain: a systematic literature review

ObjectivesTo identify baseline patient characteristics that are (1) associated with a poor outcome on follow-up regardless of which treatment was provided (prognosis) or (2) associated with a successful outcome to...

Not engaged in education, employment or training (NEET) in an Arctic sociocultural context: the NAAHS cohort study

ObjectivesThe purpose of the study is to explore the prevalence and predictors of not engaged in education, employment or training (NEET) status in a multicultural young adult population in Northern...

Child and adolescent musculoskeletal pain (CAM-Pain) feasibility study: testing a method of identifying, recruiting and collecting data from children and adolescents who consult about a musculoskeletal condition in UK general practice

ObjectivesTest a method of identifying, recruiting and collecting data from children and adolescents who consult their general practitioner about a musculoskeletal condition.DesignProspective cohort feasibility study.Setting13 general practices in West Midlands...

Multisite musculoskeletal pain in adolescence as a predictor of medical and social welfare benefits in young adulthood: The Norwegian Arctic Adolescent Health Cohort Study.

Pain in adolescence is associated with mental health problems, the main reason for work disability in young adults. This study explores the relationship between multisite musculoskeletal pain in adolescence and later medical (sickness and medical rehabilitation benefits) and social welfare benefits, adjusted for sociodemographic, adolescent psychosocial and mental health problems. Data were obtained by linkage between the National Insurance Registry (2003-11) and the Norwegian Arctic Adolescent Health Study, a school-based survey in North Norway (2003-05), accepted by 3987 fifteen- to sixteen-year-olds (68% of the total population). The start of the follow-up time was July 1st of the corresponding year the participants responded to the health study. Musculoskeletal pain was measured by the number of musculoskeletal pain sites. We found a positive linear relationship between adolescent musculoskeletal pain sites and the occurrence of medical and social welfare benefits in young adulthood (p≤0.001). Adolescent musculoskeletal pain was a significant predictor of sickness (p<0.001) and social welfare benefits in females (p=0.036), when adjusted for adolescent psychosocial and mental health problems. The most important adolescent psychosocial predictors were externalizing problems, less parental involvement and adverse life events. Adolescent multisite musculoskeletal pain was found to be an important predictor of later sickness and social welfare benefit receipt from adolescence to young adulthood. Adolescents with multisite musculoskeletal pain are at substantially increased risk of health and social difficulties into young adulthood. Identification and interventions for these adolescent problems could alleviate this risk and be a sound socioeconomic investment.

Multisite musculoskeletal pain in adolescence and later mental health disorders: a population-based registry study of Norwegian youth: the NAAHS cohort study

ObjectivesTo examine the association between multisite musculoskeletal pain in adolescence and mental health disorders in young adulthood.Design and settingData were obtained from a linkage between the Norwegian Patient Registry (2008–2012)...