Prognosis of non-specific musculoskeletal pain in preadolescents: A prospective 4-year follow-up study till adolescence

Abstract

Musculoskeletal pain is common in children but studies on the outcome and predictive factors for persistence/recurrence of these symptoms are scarce. A baseline cross-sectional survey of 1,756 schoolchildren (mean age 10.8) identified 564 (32.1%) children with musculoskeletal pain. At baseline, these children were evaluated using a structured questionnaire and examined for hypermobility and physical fitness. The children were re-evaluated after one year, and four years (at adolescence) using the same pain questionnaire. At 1-year follow-up, 53.8% (95% CI 48.8-58.8) of the children reported pain persistence (persistent preadolescent musculoskeletal pain). At 4-year follow-up, 63.5% (95% CI 58.7-68.1) of them had musculoskeletal pain. Neck was the site with most persistent/recurrent musculoskeletal pain. Those with persistent preadolescent musculoskeletal pain had approximately three times higher risk of pain recurrence (OR=2.90 [95% CI 1.9-4.4]). In the univariate analysis, female gender, older age group (11+), hypermobility, co-existence of psychosomatic symptoms, having high disability index, and reporting combined musculoskeletal pain at baseline predicted pain recurrence at adolescence. In the multivariate analysis, age, headache, hypermobility and having combined musculoskeletal pain were found as independent predictors. Statistically significant sex interactions were found for age, depressive feelings, waking up during nights and hypermobility. More psychosomatic symptoms predicted pain recurrence in girls than in boys, and hypermobility was a strong predictor in females only. Musculoskeletal pain in preadolescents is not a self-limiting phenomenon and more studies are still warranted to explore its determinants aiming to improve the long-term outcome of these symptoms.

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

“…Insufficient quantity and quality of sleep could well be related to the increased prevalence of musculoskeletal pains. Some early studies suggest that tiredness, difficulties in falling asleep, waking up at night and other sleep problems are risk factors for musculoskeletal pains [10,42,47,52]. A cohort-based, long-term follow-up study among adults showing that sleep disturbances predict hospitalizations for back disorders [21] confirmed earlier observations, although the results may have been confounded by occupational factors.…”

“…The majority of previous findings are, nevertheless, consistent with our results. Among longitudinal studies, daytime tiredness predicted musculoskeletal pains in a 1-year follow-up of 363 children [28], and waking up at night predicted musculoskeletal pains among girls in a 4-year follow-up of the same population [10]. Difficulty in falling asleep increased the risk of low back pain in a 2-year follow-up of 287 children aged 9-12 years [47].…”

Ocorrência de dor lombar e fatores associados em crianças e adolescentes de uma escola privada do sul do Brasil

“…Os valores mais elevados podem ser observados dos 15 aos 17 anos (Tabela 4). Estudiosos parecem estar de acordo sobre a relação entre o aumento das idades e a ocorrência de dor lombar 12,14,16,34,35,36,37,38 . Tendo em vista esses achados sobre as idades iniciais de ocorrência da dor lombar, sugere-se que haja maior atenção em relação à pesquisa, à prevenção e ao tratamento de dor lombar em crianças em jovens, visto que os estudos concluem que sua ocorrência na adolescência é fator de risco para a dor lombar na vida adulta 7 .…”

Multimodal Chiropractic Care of Pain and Disability for a Patient Diagnosed With Benign Joint Hypermobility Syndrome: A Case Report

“…Studies have shown adults and children with BJHS frequently experience arthralgia, with adults also being prone to generalized back pain. [14][15][16][17][18][19][20][21] There are also some studies that suggest BJHS is associated with fibromyalgia, 22,23 and a prospective cohort study concluded that joint hypermobility in adolescence was a risk factor for musculoskeletal pain at the shoulder, knee, and ankle/foot joints. 24 Research on the conservative treatment of BJHS is quite limited, with most high-level studies (randomized controlled trials) focused on knee pain and lowlevel studies (single-group prospective cohort, case series, case reports) focused on the spine or full body pain.…”