Non-specific low back pain in children and adolescents: risk factors

Abstract

IntroductionBackache in children and adolescents has traditionally been considered a rare and serious condition, causing one to suspect an organic, infectious, inflammatory or neoplastic origin. Several surveys, however, have revealed a high prevalence of backache, and particularly of lumbar pain, in these age groups, indeed sometimes similar to that reported for adults. The purpose of this article is to review the recent literature, published since 1992 [6], on this topic. Epidemiological dataThe prevalence of back pain in children varies according to the age of the population studied and, particularly, according to the methodology of the studies themselves, viz.:1. Cross-sectional studies by means of a questionnaire, with or without the participation of an investigator, looking at subjective morbidity [4,5,8,9,13,18,26,35,41,48,50,59,62,64,69]. 2. Cross-sectional studies based on physical examination of the subjects, to evaluate the measurable morbidity [4,13,35,48,50,69]. 3. Longitudinal studies (cohort studies) to measure the yearly incidence of spinal pain [12,15].Moreover, studies differ in terms of the definition of backache selected (any localisation of spinal pain versus pain limited to the lumbar area, radicular pain), and also according to the type of prevalence studied (lifetime prevalence or point prevalence of back pain). Several approaches are used in evaluating the intensity of pain: relapsing or permanent pain, need for medical care, or disability due to pain. Furthermore, in studying risk factors, it is important from a methodological point of view to distinguish cross-sectional studies without either a control group or multiple analysis of variance [2, 9, 13, 18, 22, Abstract Low back pain (LBP) among children and adolescents has become the subject of an increasing amount of literature over the last 15 years. This topic, which was considered almost insignificant less than two decades ago, was the focus of a recent international meeting organised in Grenoble (France) in March 1999. This review paper is the result of an literature update search performed by members of three groups which have been active in this field for many years. Current epidemiological data on LBP is summarized as well as the role of the major risk factors according to studies published in the principal peer reviewed journals interested in the topic.Key words Non-specific low back pain · Schoolchildren · Risk factors · Epidemiology Eur Spine J (1999) 8 : 429-438 REVIEW

Spinal alignment in low back pain patients and age-related side effects: a multivariate cross-sectional analysis of video rasterstereography back shape reconstruction data

“…These results were probably Independent variables entered together, discriminant coefficients C0.50 in italics Eur Spine J (2013) 22:1979-1985 1983 not affected by age-related side effects, although significance failed by 1.6 % for the comparison of controls and younger patients in a univariate analysis (Table 5). This result was in line with findings that revealed frontal plane asymmetries as risk factor for the development of low back pain [1,2]. In terms of our rasterstereography spinal form assessment, sagittal plane spine shape parameters could not be exposed clearly by multivariate factor analysis procedures as LBP indicating variables, but in discriminant analyses sagittal plane parameters were extracted as variables being able to separate controls from LBP patients of different age (Table 4).…”

“…Using video rasterstereography and multivariate analysis procedures, we found low back pain-associated spine shape parameters in the frontal plane, which was consistent with findings considering frontal plane asymmetries to be risk factors for the development of low back pain [1,2]. Parameters of the sagittal plane were extracted as being associated with low back pain, too.…”

“…Especially, frontal plane spinal asymmetries were identified to be a risk factor for low back pain syndromes [2]. When the most predictive factor for the development of low back pain-earlier back pain periods-could be controlled statistically, a flatter lumbar lordosis angle could be identified as a risk factor [1]; mathematical modeling studies reported a tendency for a flatter lordosis angle in chronic low back pain patients, too [11].…”

Back posture education in elementary schoolchildren: a 2-year follow-up study

“…These study findings may be important since a review on risk factors related to back pain at young age indicated that sitting is the most common factor associated with back pain reports in youngsters [1]. Furthermore, at adolescent age youngsters typically adopt stooping postures, which may result in pressure on the anterior aspects of the vertebral growth plates [32].…”

“…During this transition period, stooping postures are frequently adopted for whatever reason (feelings of shame for the changing body or imitations in conscious of being ''cool''), which may result in pressure on the anterior aspects of the vertebral growth plates [32]. As a final aspect, the mounting back pain reporting around the growth spurt [1] justifies research on the stability of early intervention effects in youngsters at secondary school age.…”