European J Pediatrics 2022 (Apr); 181 (4): 1727–1736
Jeffrey J. Hébert, Amber M. Beynon, Bobby L. Jones, Chinchin Wang, Ian Shrier, Jan Hartvigsen, Charlotte Leboeuf-Yde, Lise Hestbæk, Michael S. Swain, Tina Junge, Claudia Franz & Niels Wedderkopp
University of New Brunswick,
Fredericton, New Brunswick, Canada.
This study aimed to investigate the trajectories of spinal pain frequency from 6 to 17 years of age and describe the prevalence and frequency of spinal pain and related diagnoses in children following different pain trajectories.
First through fifth-grade students from 13 primary schools were followed for 5.5 years. Occurrences of spinal pain were reported weekly via text messages. Children reporting spinal pain were physically evaluated and classified using International Classification of Disease criteria.
Trajectories of spinal pain frequency were modeled from age 6 to 17 years with latent class growth analysis. We included data from 1,556 children (52.4% female, mean (SD) baseline age = 9.1 (1.9) years) and identified 10,554 weeks of spinal pain in 329,756 weeks of observation. Sixty-three percent of children reported one or more occurrences of spinal pain.
We identified five trajectories of spinal pain frequency. Half the children (49.8%) were classified as members of a “no pain” trajectory. The remaining children followed
“rare, increasing” (14.5%),
“moderate, increasing” (6.5%), or
“early-onset, decreasing” (1.3%) spinal pain trajectories.
The most common diagnoses in all trajectory groups were non-specific (e.g., “back pain”). Tissue-specific diagnoses (e.g., muscle strain) were less common and pathologies (e.g., fracture) were rare.
Conclusion: From childhood through adolescence, spinal pain was common and followed heterogeneous courses comprising stable, increasing, and early-onset trajectories. These findings accord with recommendations from adult back pain guidelines that most children with spinal pain can be reassured that they do not have a serious disease and encouraged to stay active.
Keywords: Diagnosis; Life course; Low back pain; Neck pain; Pediatric; Prevalence; Prognosis; Trajectory.
What is Known:
What is New:
Spinal pain imposes a large burden on individuals and society.
Although many people first experience the condition in childhood, little is known about the developmental trajectories of spinal pain from childhood to adolescence.
Data from 1,556 children and 329,756 participant weeks showed five unique spinal pain trajectories from 6 to 17 years: most children rarely reported spinal pain, while one in five followed increasing or early-onset trajectories.
Most pain occurrences were non-specific; pathological diagnoses were rare.