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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KEYWORDS:   Back pain; Lumbar pain; Neck pain; School children; Thoracic pain

What is Known:

  • The prevalence of spinal pain increases rapidly during childhood and adolescence, but different measurement instruments result in great variation in the estimates of spinal pain in children and adolescents.

  • Some studies have shown that different psychosocial measures are associated with spinal pain in children and adolescents.

What is New:

  • Spinal pain, as measured by the newly developed and validated Young Spine Questionnaire, is a common complaint in young adolescents
    aged 10–14 years.

  • Spinal pain in young adolescents co-occurs with stress and poor general well-being.

From the Full-Text Article:


Low back pain is a public health concern as it is the leading cause of years lived with disability, while neck pain ranks fourth [29], and spinal pain has enormous costs to both the individual and society due to disability pensions and treatment costs. [19] Spinal pain often presents early in life and the prevalence increases rapidly during adolescence to reach adult levels at the age of 18 years. [7, 14] A meta-analysis from 2013 found a point prevalence of low back pain of 12% among adolescents aged 9–18 years, whereas the 12-month prevalence was 34%. [3] However, the included studies showed great variation in the estimates of the prevalence. Estimates from the Nordic countries showed a weekly occurrence of spinal pain around 20% [28], and a small Danish study showed a lifetime prevalence of spinal pain of 86% in a population of adolescents aged 11–13 years with neck pain being the most prevalent. [1] However, little is known about pattern of spinal pain among adolescents.

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