Risk factors for episodes of back pain in emerging adults. A systematic review

Abstract

Background and Objective The transition from adolescence to adulthood is a sensitive period in life for health outcomes, including back pain. The objective was to synthesize evidence on risk factors for new episodes of back pain in emerging adults (18–29 years). Methods The protocol was registered in PROSPERO (CRD42016046635). We searched Medline; EMBASE; AMED and other databases up to September 2018 for prospective cohort studies that estimated the association between risk factor(s) and self‐reported back pain. Risk factors could be measured before or during the age range 18–29 years, and back pain could be measured during or after this age range, with at least 12 months between assessments. Risk factors assessed in ≥3 studies were summarized. Risk of bias was assessed using a 6‐item checklist. Results Forty‐nine studies were included with more than 150 different risk factors studied. Nine studies had low risk of bias, 26 had moderate and 14 had high risk of bias. Age, sex, height, body mass index (BMI), smoking, physical activity level, a history of back pain, job satisfaction and structural imaging findings were investigated in three or more studies. History of back pain was the only risk factor consistently associated with back pain after adjustment (nine studies). Conclusion There is moderate quality evidence that a history of back pain is a risk factor for back pain. There are inconsistent associations for age, sex, height, BMI, smoking and activity level. No associations were found between job satisfaction and structural imaging findings and back pain. Significance Emerging adulthood is a transitional period of life with changes in life style, potentially influencing future musculoskeletal health. This systematic review included 49 articles evaluating more than 150 potential risk factors for back pain, one of the most prevalent musculoskeletal disorders. No consistent results were found for life style factors such as physical activity level or BMI, both highlighted as important risk factors in previous literature. Importantly, a previous episode of back pain was a consistent risk factor for a new episode of back pain across several studies, and further investigation of risk factors for the first back pain episode is needed.

Consultation prevalence among children, adolescents and young adults with pain conditions: A description of age‐ and gender differences

“…This emphasises not only the individual suffering but also the high healthcare burden for society. These individuals also have an increased risk of later persistent pain (Beltramini et al, ; Hassett et al, ; Hestbaek, Leboeuf‐Yde, & Kyvik, ; Hestbaek, Leboeuf‐Yde, Kyvik, & Manniche, ; Jones, Silman, Power, & Macfarlane, ; Oiestad et al, ) and health impairments (Hoftun et al, ; Huguet & Miro, ; Kamper et al, ; Roth‐Isigkeit et al, ), as well as difficulties with school performance (Grimby‐Ekman et al, ; Groenewald et al, ; O'Sullivan, Beales, Smith, & Straker, ; Petersen, Hagglof, & Bergstrom, ).…”

Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs

“…19 Other significant risk factors associated with LBP include smoking and occupational hazards such as heavy lifting and poor posture. 20,21 However, prevalence estimates of LBP in older adults vastly differ due to the lack of a standard definition of LBP and variations in sampling and experimental methods as reported by clinical and administrative studies. 22 Authors of these studies also provide limited information regarding location and severity of pain, as well as LBP-induced limitations on normal functioning.…”

Prevalence of Hip or Groin Pain in Adolescents: A Systematic Review and Meta‐Analysis

“…when it is associated with a sports‐related injury), it may also become chronic and persistent 2 . Previous research on musculoskeletal pain in adolescence, which has primarily focused on back pain, 2,3 has shown that pain during adolescence is an important predictor of future pain 4–6 . It can negatively impact everyday activities such as school attendance, 7 sleep, 7 social functioning, 8 withdrawal from social and sports activities, 8,9 and reduced physical activity, 10 which in itself is a risk factor for obesity and diabetes 11…”