Risk Factors for Disabling and Nondisabling Neck Pain in a Large Cohort of Adolescents.

OBJECTIVES: Neck pain is extremely common and represents a substantial economic burden to our society. We aimed to investigate risk factors for nondisabling and disabling neck pain in a large cohort of Italian adolescents with a cross-sectional study. DESIGN: Six thousand two hundred eighty-one students (14-19 yrs old) answered an online questionnaire, investigating the following: anthropometric data, lifestyle-related items, neck pain frequency and intensity, need for medical examination, and several risk factors. Students who had to give up social activities because of neck complaints constituted the disabling neck pain group. RESULTS: Our findings revealed that sex, age, sports practice, hours of sleep, and family history were risk factors ( P < 0.001) for neck pain in our cohort. Moreover, disabling neck pain group experienced neck pain more frequently ( P < 0.001) and with higher levels of pain ( P < 0.001) compared with the nondisabling group. The number of hours of sleep was the only risk factor that showed a trend to differ comparing the disabling neck pain group with the nondisabling neck pain one ( P = 0.057). CONCLUSIONS: Different risk factors for neck pain were detected in a very large cohort of adolescents. This study may pave the way for future prospective studies and for the development of preventive strategies for neck pain in adolescents. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Identify different risk factors for neck pain in adolescents; (2) Determine the differences between adolescents with nondisabling neck pain and disabling neck pain; and (3) Recognize that most risk factors for disabling neck pain are still unknown, but insufficient sleep quantity could potentially contribute to the development of this condition. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Lower back pain in young climbers: a retrospective cross-sectional study.

Objective: The popularity of sport climbing has been growing since its inclusion in the Olympic Games program, which led to more people practicing it on recreational, amateur, and professional levels. Strenuous climbing training sessions and competitions might lead to frequent and serious musculoskeletal injuries and complaints among competitive climbers. This study aimed to investigate the prevalence of low back pain (LBP) and to explore the influence of various risk factors on LBP in adolescent climbers. Methods: The sample included 180 competitive climbers (46.6% males) aged 13-19 years competing in under-16 (48.3%) or under-20 categories. Data collection was carried out using the Nordic Musculoskeletal Questionnaire (NMQ) and the Graded Chronic Pain Scale (GCPS). Results: A total of 74.4% of the entire sample of participants (male = 75%; female = 74%) reported lower back complaints throughout the past twelve months, and only 15.5% during the last seven days. A major part of complaints was classified as low intensity-low disability (Grade I, 62.8%; male = 72.6%; female = 54.2%). Under-20 competitors reported a small but significantly higher percentage of almost all NMQ measures compared to under-16 athletes. Conclusions: This study found a relatively high prevalence of LBP, although complaints were of limited severity and did not affect climbers' regular training practice. Moreover, climbers did not differ in LBP prevalence according to sex, while climbers from the older age group reported higher complaints and seeking medical attention than younger climbers. Future studies should prospectively monitor the influence of climbing on LBP in youth climbers.

Lifetime Prevalence of Nonspecific Low Back Pain in Adolescents: A Cross-sectional Epidemiologic Survey.

BACKGROUND: Many nonconclusive studies have been conducted on low back pain (LBP) in adolescents and associated factors. OBJECTIVE: The aim was to assess the lifetime prevalence and associated factors of LBP in adolescents. MATERIALS AND METHODS: A questionnaire was administered in high school students (14-19-yr-old participants) in Veneto region (Italy). The self-administered, structured questionnaire included anthropometric data; psychologic factors and lifestyle; presence, intensity, and family history of LBP; referral to professional health care for LBP; and a short version of the International Physical Activity Questionnaire. RESULTS: A total of 6281 adolescents were recruited; 5204 questionnaires were included in the final analysis. A total of 2549 (48.98%) students reported one or more LBP episodes and 723 (13.89%) reported nonspecific disabling lumbar pain (i.e., no underlying pathology); 1040 (41.11%) subjects with LBP consulted a healthcare professional. A significant association emerged for LBP with sex (female), positive family history, time spent sitting or using electronic devices, sleep deprivation (<5 hrs/night), and low level of physical activity. CONCLUSION: In a large sample of adolescents, LBP lifetime prevalence is high and often associated with disabling pain and sedentary lifestyle, requiring professional care. These findings may support the development of prevention and treatment strategies of LBP in adolescents, reducing the risk of developing chronic pain.

Healthcare service use in adolescents with non-specific musculoskeletal pain.

AIM: To estimate occurrence of non-specific musculoskeletal pain in a wide population sample of Italian adolescents, and to investigate their use of healthcare services (seeking of medical attention, referral for diagnostic tests and treatment use). METHODS: We investigated 7542 high-school adolescents (aged between 12 and 16 years) by a structured questionnaire and consisting of personal data, presence of pain, health provider consulted, referral for diagnostic tests and compliance with the prescribed treatments. RESULTS: In 3399 (45.1%) reported musculoskeletal pain (the most affected sites being the spine and knees), 2525 (74.2%) of whom had sought medical attention. Of the 2525 subjects who had sought healthcare, 1061 (42.0%) had consulted more than one health provider, 2410 (95.4%) had been referred for diagnostic tests, and some form of treatment had been recommended for 2445 (96.8%), but only 1694 (69.2%) had complied with prescribed therapies. The most important factors linked to health seeking behaviour were pain intensity, pain lasting longer than 3 months, injury, interruption to or absence of physical activity and localization in the spine and knee. CONCLUSION: Non-specific musculoskeletal pain is a frequent event in Italian adolescents and that a large number of these subjects consult a healthcare service.

Prevalence of nonspecific low back pain in schoolchildren aged between 13 and 15 years.

AIM: To investigate the annual (2005) prevalence of nonspecific low back pain (LBP), defined as lumbago not attributed to recognizable, known specific pathology, in a population of adolescents. METHODS: We investigated 7542 school teenagers with a structured questionnaire consisting of demographic and anthropometric items, psychosocial factors and life style, presence and intensity of LBP, family history of LBP, and questions about whether the teenager had been referred to a physician for this problem. Univariate (t-test, Mann-Whitney U-test and chi-square test) and multivariate analyses (logistic regression) were performed. RESULTS: A total of 1180 (20.5%) teenagers reported one or more episodes of LBP, of whom 900 (76.3%) had consulted a health provider. A significantly greater percentage of LBP was found in the students who practised aerobics and swimming compared to the other sports. The search for risk factors in the whole population revealed no associations between LBP and the investigated anthropometrics or lifestyle items, whereas a significant association was found for gender (to be female), positive family history of LBP and absence of sports activity. CONCLUSIONS: Our study shows that nonspecific LBP is a frequent event in teenagers, particularly in females, sedentary children and those with a family history of LBP.