Adolescent Back Pain

Introduction

The World Health Organization describes adolescence as “young people between the ages of 10 and 19 years”[1]. This definition is further divided into early adolescence (10-14 years old) to late adolescence (15-19 years old) by the United Nations Population Fund [2]. Adolescent back pain has been reported to be as common as that of adult populations [3] [4] [5] and has been attributed to a number of factors such as gender [6], age [7], sitting for long periods [8], working at computers [9], school seating [10] and psychological factors [11].


Epidemiology


There has been a high prevalence of low back pain (LBP) in adolescents demonstrated in a number of epidemiological studies (Pellisé, Balagué, Rajmil et al, 2009). Estimates of the prevalence of back pain in children adolescents vary greatly, ranging from 30%-70% (Balagué, Troussier and Salminen, 1999; Wedderkopp, Leboeuf-Yde, Andersen et al, 2001) The study by Jeffries et al (2007) found a life time prevalence ranging from 4.7% to 74.4% for spinal or back pain and 7% to 72% for LBP. These ranges depend on the age of the participants and the methodological differences, in particular the definition of back pain used (Jones and Macfarlane, 2005).
This level of prevalence raises concerns due to the link between LBP in adolescents and chronic LBP in adulthood (Hestbaek, Leboeuf-Yde, Kyvik et al, 2006). A history of symptoms has been found to be the strongest predictor of future LBP (Papageorgiu, Croft, Thomas et al, 1996) and an early onset in life linked to chronicity (Brattberg, 1994; Harreby et al, 1995). It has been found that the occurrence of back pain in adolescents increases with age, in particular in the years of early teens (Jeffries et al, 2007).
Growth and development of males and females is remarkably similar up to approximately the age of 10 (Brundtland, Liestol and Wallace, 1975). Above the age of 10, as a result of puberty, the growth patterns of males and females deviate considerably (66). By at least the age of 18 or 19 years, puberty is considered to have ceased (Jeffries et al, 2007). With the potential influence of puberty related growth on the incidence of adolescent back pain (Feldman, 2001) it is imperative that the range of pubertal ages are taken into consideration in epidemiological studies (Jeffries et al, 2007).

References

  1. ↑ Who.int. WHO | Adolescent health [Internet]. 2015 [cited 9 January 2015]. Available from: http://www.who.int/topics/adolescent_health/en/
  2. ↑ Unfpa.org. UNFPA - United Nations Population Fund | State of World Population 2003 [Internet]. 2003 [cited 12 January 2015]. Available from: http://www.unfpa.org/publications/state-world-population-2003
  3. ↑ Jones G, Macfarlane G. Epidemiology of low back pain in children and adolescents. Archives of Disease in Childhood. 2005;90(3):312-316.
  4. ↑ Burton A, Clarke R, McClune T, Tillotson K. The Natural History of Low Back Pain in Adolescents. Spine. 1996;21(20):2323-2328.
  5. ↑ Harreby M, Neergaard K, Hesselsôe G, Kjer J. Are Radiologic Changes in the Thoracic and Lumbar Spine of Adolescents Risk Factors for Low Back Pain in Adults?. Spine. 1995;20(21):2298-2302.
  6. ↑ Grimmer K, Nyland L, Milanese S. Longitudinal investigation of low back pain in Australian adolescents: a five-year study. Physiother Res Int. 2006;11(3):161-172.
  7. ↑ Jeffries L, Milanese S, Grimmer-Somers K. Epidemiology of Adolescent Spinal Pain. Spine. 2007;32(23):2630-2637.
  8. ↑ Grimmer K, Williams M. Gender-age environmental associates of adolescent low back pain. Applied Ergonomics. 2000;31(4):343-360.
  9. ↑ Hakala P, Rimpela A, Saarni L, Salminen J. Frequent computer-related activities increase the risk of neck-shoulder and low back pain in adolescents. The European Journal of Public Health. 2005;16(5):536-541.
  10. ↑ Troussiere B, Tesniere C, Fauconnier J, Grison J, Juvin R, Phelip X. Comparative study of two different kinds of school furniture among children. Ergonomics. 1999;42(3):516-526.
  11. ↑ Astfalck R, O'Sullivan P, Straker L, Smith A. A detailed characterisation of pain, disability, physical and psychological features of a small group of adolescents with non-specific chronic low back pain. Manual Therapy. 2010;15(3):240-247.




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