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Spinal Pain and Co-occurrence with Stress and General Well-being Among Young Adolescents

By |December 26, 2018|Pediatrics|

Spinal Pain and Co-occurrence with Stress and General Well-being Among Young Adolescents: A Study Within the Danish National Birth Cohort

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SOURCE:   European Journal of Pediatrics 2017 (Jun); 176 (6): 807–814

Sandra Elkjær Stallknecht & Katrine Strandberg-Larsen & Lise Hestbæk & Anne-Marie Nybo Andersen

Department of Public Health, Section of Social Medicine,
University of Copenhagen,
Øster Farimagsgade 5, 1014, Copenhagen, Denmark.


This study aims to describe the patterns in low back, mid back, and neck pain complaints in young adolescents from the Danish National Birth Cohort (DNBC) and to investigate the co-occurrence of spinal pain and stress and general well-being, respectively. Cross-sectional data from the 11-year follow-up of DNBC were used. As part of a web-based survey, a total of 45,371 young adolescents between 10 and 14 years old completed the Young Spine Questionnaire, the Stress in Children Questionnaire, and a one-item question on general well-being. Associations between spinal pain and, respectively, stress and general well-being were estimated by means of multiple logistic regression models. Almost one fifth of boys and one quarter of girls reported spinal pain. Compared with adolescents who reported no stress, adolescents reporting medium and high values of stress had odds ratios (OR) of 2.19 (95% CI 2.08-2.30) and 4.73 (95% CI 4.28-5.23), respectively, of reporting spinal pain (adjusted for age, gender, and maternal education). Adolescents who reported poor general well-being had an OR of 2.50 (95% CI 2.31-2.72) for reporting spinal pain compared to adolescents with good general well-being.

CONCLUSION:   Spinal pain in childhood and adolescence is strongly associated with spinal pain and generalized pain in adulthood. [2, 7, 11]. Therefore, it is of great importance to seek to treat and prevent spinal pain in children both to prevent discomfort for the child but also to reduce the individual and social costs of spinal pain in adulthood. If spinal pain among children and adolescents involves psychosocial well-being, then treatment as well as preventive initiatives might include psychosocial approaches, e.g., psycho education and development of appropriate coping strategies.

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The Association Between Psychological and Social Factors and Spinal Pain in Adolescents

By |November 29, 2018|Pediatrics, Spinal Pain|

The Association Between Psychological and Social Factors and Spinal Pain in Adolescents

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SOURCE:   Eur J Pediatr. 2018 (Nov 21) [Epub]

Sarah Batley & Ellen Aartun & Eleanor Boyle & Jan Hartvigsen & Paula J. Stern & Lise Hestbæk

Graduate Studies,
Canadian Memorial Chiropractic College,
6100 Leslie Street,
Toronto, M2H 3J1, Canada.


Spinal pain, back pain, and/or neck pain begins early in life and is strongly associated with spinal pain in adulthood. Understanding the relationship between psychological and social factors and adolescent spinal pain may be important in both the prevention and treatment of spinal pain in this age group. We aimed to determine if psychological and social factors were associated with spinal pain in a cross-sectional study of a school-based cohort of 1279 Danish adolescents aged 11–13, who were categorized into “any” and “substantial” spinal pain.

“Substantial spinal pain” was defined as a lifetime frequency of “sometimes” or “often” and a pain intensity of at least two on the revised Faces Pain Scale. Logistic regression analyses, stratified by sex, were conducted for single and all variables together. Eighty-six percent of participants reported “any spinal pain” and 28% reported “substantial spinal pain”. Frequency of psychological and social factors was significantly higher in those with spinal pain compared to those without. As the frequency of psychological and social factors increased, the odds of both “any spinal pain” and “substantial spinal pain” also increased.

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Referred Pain from Myofascial Trigger Points in Head and Neck-shoulder Muscles Reproduces Head Pain Features in Children With Chronic Tension type Headache

By |October 21, 2018|Headache, Myofascial Disorder, Pediatrics|

Referred Pain from Myofascial Trigger Points in Head and Neck-shoulder Muscles Reproduces Head Pain Features in Children With Chronic Tension type Headache

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SOURCE:   J Headache Pain. 2011 (Feb); 12 (1): 35–43

César Fernández-de-las-Peñas, Daniel M. Fernández-Mayoralas, Ricardo Ortega-Santiago, Silvia Ambite-Quesada, Domingo Palacios-Ceña and Juan A. Pareja

Department of Physical Therapy,
Occupational Therapy,
Rehabilitation and Physical Medicine,
Facultad de Ciencias de la Salud,
Universidad Rey Juan Carlos,
Avenida de Atenas s/n,
28922 Alcorcón, Madrid



Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children’s condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured.

The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

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Chiropractic or Osteopathic Manipulation for Children in the United States

By |July 11, 2018|Pediatrics|

Chiropractic or Osteopathic Manipulation for Children in the United States: An Analysis of Data from the 2007 National Health Interview Survey

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SOURCE:   J Altern Complement Med. 2012 (Apr); 18 (4): 347–353

Harrison Ndetan, MSc, MPH, DrPH, Marion Willard Evans, Jr., DC, PhD, MCHES, Cheryl Hawk, DC, PhD, and Clark Walker, BS, MPH

Cheryl Hawk, DC, PhD
Logan College of Chiropractic
Chesterfield, MO 63017


OBJECTIVES:   The aim of this study was to describe use of chiropractic and/or osteopathic manipulation by children in the United States along with the specific health conditions for which they sought care.

METHODS:   The study was a secondary data analysis of the National Health Interview Survey 2007, Child Alternative Medicine file as well as the Child Core Sample. National population estimates were generated for reported use of chiropractic or osteopathic manipulation (C/OM) by children for specific health conditions. Odds ratios (OR) and 95% confidence intervals (CI) were generated from binary logistic regression models that assessed the likelihood that children of specific characteristics would use this therapy.

RESULTS:   National estimates indicated that 2.3 million children (2.3%) in the United States had used C/OM in 2007. C/OM was the most common complementary and alternative medicine procedure. Children aged 12–18 years were more likely to have seen these providers than were younger age groups (OR=3.4 [95% CI, 2.1–5.5]). Homeopathy (1.2%), massage (1.0), and naturopathy (0.3%) were the next most common procedures. The most common complaints were back and neck pain. Other conditions for which children were seen included other musculoskeletal conditions, sinusitis, allergies, and nonmigraine headaches. Racial categories did not differ significantly regarding use of manipulation, but those children with both mother and father in the household were more likely to have used this form of care (OR=1.7 [95% CI, 1.1–2.6]).

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Infant Demographic Profile and Parent Report of Treatment Outcomes at a Chiropractic Clinic in the UK

By |April 25, 2018|Pediatrics|

Infant Demographic Profile and Parent Report of Treatment Outcomes at a Chiropractic Clinic in the UK:
An Observational Study

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SOURCE:   J Clinical Chiropractic Pediatrics 2017 (Jan); 17 (1): 1398–1404

Johanna M. Jaskulski, MChiro and Joyce E. Miller, BS, DC, PhD

Private practice.
ProChiro Baesweiler,
Nordrhein-Westfalen, Deutschland


Background:   Children, particularly infants, commonly present to chiropractors. Few studies have concentrated on the demographic profile of infants as well as clinical changes reported by parents of infants under chiropractic care.

Objectives:   To identify the demographic profile of infants presenting to a chiropractic clinic and to investigate any change of infant symptoms and maternal feelings following an episode of chiropractic care.

Setting:   This health care observation study was performed at a chiropractic teaching clinic on the south coast of England.

Subjects/Patients:   The study included all mother-infant dyads who presented to the clinic between August 2011 and June 2015 and could read and write English and who consented to complete the forms. Exclusion criteria were mothers of infants older than one year of age at presentation.

Methods:   All mothers were asked to complete two questionnaires at the initial visit and two follow-up questionnaires at discharge. Data collected were sociodemographic characteristics along with questions asking for graded responses regarding the daily amount of irritable behavior in their child, level of distress the mother feels with her child’s behavior, restfulness of infant sleep during the week and difficulty to console the child when crying as well as to the clinical experience provided. Additionally, the validated Edinburgh Postnatal Depression Scale (EPDS) was used as a report of the mother’s feelings.

Results:   413 mothers completed the intake questionnaires. 197 (48%) mothers completed the discharge questionnaires. At intake, 50.3% (n=182) of the patients were four weeks of age or younger. The presenting complaint appeared before the age of two weeks in 79.1% (n=161) of the cases. 30.2% (n=160) presented with colic/crying and 22.9% (n=121) with a feeding related complaint. The modal length of an episode of care was two weeks. Over the course of treatment, average maternal distress levels reduced by 48%. Mean amount of irritability reduced by 31%; mean restfulness of sleep improved by 27% and mean difficulty to console reduced by 38% in the infant. The median EPDS score dropped by 50% over the time of care. 96.3% of parents rated 8–10 satisfaction with care on a scale of 1–10.

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Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood

By |April 3, 2018|Pediatrics|

Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood

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SOURCE:   JAMA Pediatrics 2018 (Apr 2) [Epub]

Edward Mitre, MD; Apryl Susi, MS; Laura E. Kropp, MPH

Department of Microbiology and Immunology,
F. Edward Hébert School of Medicine,
Uniformed Services University of the Health Sciences,
Bethesda, Maryland


A new Study reports:
Infants who are given antacids like Zantac or Pepcid
are more likely to develop childhood allergies


FROM:   TIME Magazine ~ April 2, 2018 ~ FULL TEXT

Infants who are given antacids like Zantac or Pepcid are more likely to develop childhood allergies, perhaps because these drugs may alter their gut bacteria, a new large study suggests.

Early use of antibiotics also raised the chances of allergies in the study of nearly 800,000 children.

Researchers combed the health records of kids born between 2001 and 2013 and covered by Tricare, an insurance program for active duty and retired military personnel and their families. A surprising 9 percent of the babies received antacids, reflecting the popularity of treating reflux in infancy.

Over four years, more than half of all the children developed allergies to foods or medications, rashes, asthma, hay fever or other allergic diseases. The study couldn’t prove causes, but the connection with antacids and antibiotics was striking.

For children who received an antacid during their first six months, the chances of developing a food allergy doubled; the chances of developing a severe allergic reaction called anaphylaxis or hay fever were about 50 percent higher. For babies who received antibiotics, the chances doubled for asthma and were at least 50 percent higher for hay fever and anaphylaxis.

The results were published Monday in JAMA Pediatrics.

      The Abstract:

Importance   Allergic diseases are prevalent in childhood. Early exposure to medications that can alter the microbiome, including acid-suppressive medications and antibiotics, may influence the likelihood of allergy.

Objective   To determine whether there is an association between the use of acid-suppressive medications or antibiotics in the first 6 months of infancy and development of allergic diseases in early childhood.

Design, Setting, and Participants   A retrospective cohort study was conducted in 792,130 children who were Department of Defense TRICARE beneficiaries with a birth medical record in the Military Health System database between October 1, 2001, and September 30, 2013, with continued enrollment from within 35 days of birth until at least age 1 year. Children who had an initial birth stay of greater than 7 days or were diagnosed with any of the outcome allergic conditions within the first 6 months of life were excluded from the study. Data analysis was performed from April 15, 2015, to January 4, 2018.

Exposures   Exposures were defined as having any dispensed prescription for a histamine-2 receptor antagonist (H2RA), proton pump inhibitor (PPI), or antibiotic.

Main Outcomes and Measures   The main outcome was allergic disease, defined as the presence of food allergy, anaphylaxis, asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis, urticaria, contact dermatitis, medication allergy, or other allergy.

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