Is Smoking a Risk Factor for Low Back Pain in Adolescents?: A Prospective Cohort Study

Mikkonen, Paula; Leino-Arjas, Päivi; Remes, Jouko; Zitting, Paavo; Taimela, Simo; Karppinen, Jaro

doi:10.1097/brs.0b013e3181657d3c

Cited by 96 publications

(78 citation statements)

References 29 publications

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“…Furthermore, the questionnaire did not specifically differentiate menstruation pain from other types of LBP among girls, which may partly explain the higher prevalence of ''reporting LBP'' among girls. The selection bias of this subpopulation has previously been analyzed by Mikkonen et al [29]. Those who responded at 18 years had somewhat healthier lifestyles, were more likely to live in two-parent families and girls were more likely to be slimmer and non-smokers at 16 years compared to those who did not participate in the follow-up study at 18 years [29].…”

Section: Discussionmentioning

confidence: 95%

“…The etiology of adolescent NP, SP and LBP still remains largely unclear. Some lifestyle factors may associate with these pains, such as smoking [29,31,38], high level of physical activity [2,3,19,25,33,42] and a great deal of sitting [2,3,11,42]. In addition, psychosocial symptoms [9,11,18,23] and obesity [5,32] have also been suggested to increase the risk of LBP in adolescence.…”

Section: Introductionmentioning

confidence: 99%

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Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents

et al. 2009

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The quantity and quality of adolescents' sleep may have changed due to new technologies. At the same time, the prevalence of neck, shoulder and low back pain has increased. However, only a few studies have investigated insufficient quantity and quality of sleep as possible risk factors for musculoskeletal pain among adolescents. The aim of the study was to assess whether insufficient quantity and quality of sleep are risk factors for neck (NP), shoulder (SP) and low back pain (LBP). A 2-year followup survey among adolescents aged 15-19 years was (2001)(2002)(2003) carried out in a subcohort of the Northern Finland Birth Cohort 1986 (n = 1,773). The outcome measures were 6-month period prevalences of NP, SP and LBP. The quantity and quality of sleep were categorized into sufficient, intermediate or insufficient, based on average hours spent sleeping, and whether or not the subject suffered from nightmares, tiredness and sleeping problems. The odds ratios (OR) and 95% confidence intervals (CI) for having musculoskeletal pain were obtained through logistic regression analysis, adjusted for previously suggested risk factors and finally adjusted for specific pain status at 16 years. The 6-month period prevalences of neck, shoulder and low back pain were higher at the age of 18 than at 16 years. Insufficient quantity or quality of sleep at 16 years predicted NP in both girls (OR 4.4; CI 2.2-9.0) and boys (2.2; 1.2-4.1). Similarly, insufficient sleep at 16 years predicted LBP in both girls (2.9; 1.7-5.2) and boys (2.4; 1.3-4.5), but SP only in girls (2.3; 1.2-4.4). After adjustment for pain status, insufficient sleep at 16 years predicted significantly only NP (3.2; 1.5-6.7) and LBP (2.4; 1.3-4.3) in girls. Insufficient sleep quantity or quality was an independent risk factor for NP and LBP among girls. Future studies should test whether interventions aimed at improving sleep characteristics are effective in the prevention and treatment of musculoskeletal pain.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents

et al. 2009

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“…Smoking is related to poorer functional outcomes, independent of the nature or severity of injury [22]. It is an independent risk factor across a variety of populations and conditions [5,26,30,42], but specifically associated with delayed healing and recurrence of pain in shoulder [6], back [29], neck [14], and multiple other exercise-related injuries [2]. It has deleterious effects on peak bone mass [8], bone mineral density [43], bone healing [28], and wound healing [4,25] as well as many other general complications [41].…”

Section: Discussionmentioning

confidence: 99%

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Teyhen¹,

Shaffer

Butler

et al. 2015

Clinical Orthopaedics &Amp; Related Research

105

119

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Background Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness. Findings from this population may also be useful as hypothesis-generating work for particular civilian settings such as law enforcement officers (SWAT teams), firefighters (smoke jumpers), or others in physically demanding professions.Questions/purposes The purposes of this study were (1) to examine whether using baseline measures of self-report and physical performance can identify musculoskeletal injury risk; and (2) to determine whether a combination of predictors would enhance the accuracy for determining future musculoskeletal injury risk in US Army Rangers. Methods Our study was a planned secondary analysis from a prospective cohort examining how baseline factors predict musculoskeletal injury. Baseline predictors associated with musculoskeletal injury were collected using surveys and physical performance measures. Army Physical Fitness Test (consisting of a 2-mile run and 2 minutes of sit-ups and push-ups). A total of 320 Rangers were invited to enroll and 211 participated (66%). Occurrence of musculoskeletal injury was tracked for 1 year using monthly injury surveillance surveys, medical record reviews, and a query of the Department of Defense healthcare utilization database. Injury surveillance data were available on 100% of the subjects. Receiver operator characteristic curves and accuracy statistics were calculated to identify predictors of interest. A logistic regression equation was then calculated to find the most pertinent set of predictors. Of the 188 Rangers (age, 23.3 ± 3.7 years; body mass index, 26.0 ± 2.4 kg/m 2 ) remaining in the cohort, 85 (45.2%) sustained a musculoskeletal injury of interest. Results Smoking, prior surgery, recurrent prior musculoskeletal injury, limited-duty days in the prior year for musculoskeletal injury, asymmetrical ankle dorsiflexion, pain with Functional Movement Screen clearing tests, and decreased performance on the 2-mile run and 2-minute situp test were associated with increased injury risk. Presenting with one or fewer predictors resulted in a sensitivity of 0.90 (95% confidence interval [CI], 0.83-0.95), and having three or more predictors resulted in a specificity of 0.98 (95% CI, 0.93-0.99). The combined factors that contribute to the final multivariable logistic regression equation yielded an odds ratio of 4.3 (95% CI, 2.0-9.2), relative risk of 1.9 (95% CI, 1.4-2.6), and an area under the curve of 0.64. Conclusions Multiple factors (musculoskeletal injury history, smoking, pain provocation, movement tests, and lower scores on physical performance measures) were associated with individuals at risk for musculoskeletal injury. The summation of the number of risk factors produced a highly sensitive (one or less factor) and specific (three o...

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“…In spite of the fact that most regular smokers are adults, similar to the alcohol use, smoking among adolescents has also been a major concern because it poses many health hazards. Sufficient evidence has demonstrated that cigarette smoking during adolescence produces significant negative somatic health outcomes among young people, including cough and phlegm production, respiratory illness, low back pain (Mikkonen et al 2008), decreased physical fitness, and increased risk of causing many chronic diseases (U.S. Department of Health and Human Services 2012). Meanwhile, evidence is emerging that smoking is related with various developmental and mental health disorders that effect young people.…”

Section: Health and Social Problemsmentioning

confidence: 99%

Socioeconomic inequalities in alcohol use of adolescents: the differences between China and Finland

Yang

Wang

Tynjälä

et al. 2012

Int J Public Health

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Is Smoking a Risk Factor for Low Back Pain in Adolescents?: A Prospective Cohort Study

Abstract: Regular smoking in adolescence was associated with LBP in young adults. Pack-years of smoking showed an exposure-response relationship among girls.

Cited by 96 publications

References 29 publications

Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents

Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Socioeconomic inequalities in alcohol use of adolescents: the differences between China and Finland

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