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European Spine Journal

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01-02-2016 | Original Article

Accumulation of psychosocial and lifestyle factors and risk of low back pain in adolescence: a cohort study

Authors: Paula Mikkonen, Eveliina Heikkala, Markus Paananen, Jouko Remes, Simo Taimela, Juha Auvinen, Jaro Karppinen

Published in: European Spine Journal | Issue 2/2016

Abstract

Purpose

Low back pain (LBP) is common already in adolescence, and many risk indicators including both psychosocial and lifestyle factors have been recognized. Our purpose was to assess whether the co-occurrence of psychosocial (externalizing and internalizing) problems and lifestyle factors (leisure time physical activity, sedentary behaviour, sleep, smoking, and overweight/obesity) associate with LBP at 16 years cross-sectionally or with new LBP at 18-year follow-up.

Methods

The study population, drawn from the Northern Finland Birth Cohort 1986, consisted of 1625 participants (712 boys and 913 girls) who completed a questionnaire on potential explanatory factors at 16 years and on LBP at 16 and 18 years. The outcome measure was ‘reporting LBP’ or ‘consultation for LBP’ during the past 6 months. Latent Class Analysis (LCA) was utilized to study the co-occurrence of the explanatory factors.

Results

Among both genders, four clusters were found. Externalizing behaviour problems were associated with ‘reporting LBP’ (RR 1.5, boys 1.4, girls) and ‘consultation for LBP’ (RR 1.6 for both genders) at baseline among both genders. In addition, the cluster of multiple risk behaviours was associated with both ‘reporting LBP’ (RR 1.3) and ‘consultation for LBP’ (RR 2.5) and the obese cluster with ‘consultation for LBP’ (RR 1.7) among girls. Externalizing behaviour problems at 16 years predicted ‘consultation for LBP’ at 18 years among girls (RR 3.6).

Conclusions

Our results stress the role of psychosocial factors in reporting and seeking care for adolescent LBP.

Balagué F, Troussier B, Salminen JJ (1999) Non-specific low back pain in children and adolescents: risk factors. Eur Spine J 8:429–438PubMedPubMedCentralCrossRef

Jones MA, Stratton G, Reilly T, Unnithan VB (2004) A school-based survey of recurrent non-specific low-back pain prevalence and consequences in children. Health Educ Res 19:284–289PubMedCrossRef

Jones GT, Macfarlane GJ (2005) Epidemiology of low back pain in children and adolescents. Arch Dis Child 90:312–316PubMedPubMedCentralCrossRef

Wedderkopp N, Kjaer P, Hestbaek L, Korsholm L, Leboeuf-Yde C (2009) High-level physical activity in childhood seems to protect against low back pain in early adolescence. Spine J 9:134–141PubMedCrossRef

Jeffries LJ, Milanese SF, Grimmer-Somers KA (2007) Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine 32:2630–2637PubMedCrossRef

Leboeuf-Yde C, Kyvik KO (1998) At what age does low back pain become a common problem? A study of 29,424 individuals aged 12–41 years. Spine 23:228–234PubMedCrossRef

Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C (2006) The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine 31:468–472PubMedCrossRef

Watson KD, Papageorgiou AC, Jones GT et al (2002) Low back pain in schoolchildren: Occurrence and characteristics. Pain 97:87–92PubMedCrossRef

Bejia I, Abid N, Ben Salem K et al (2005) Low back pain in a cohort of 622 Tunisian schoolchildren and adolescents: an epidemiological study. Eur Spine J 14:331–336PubMedPubMedCentralCrossRef

10.

Harreby M, Nygaard B, Jessen T et al (1999) Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study. Eur Spine J 8:444–450PubMedPubMedCentralCrossRef

11.

Jones GT, Watson KD, Silman AJ, Symmons DP, Macfarlane GJ (2003) Predictors of low back pain in British schoolchildren: a population-based prospective cohort study. Pediatrics 111:822–828PubMedCrossRef

12.

Mikkonen P, Leino-Arjas P, Remes J, Zitting P, Taimela S, Karppinen J (2008) Is smoking a risk factor for low back pain in adolescents? A prospective cohort study. Spine 33:527–532PubMedCrossRef

13.

Heikkala E, Remes J, Paananen M, Taimela S, Auvinen J, Karppinen J (2014) Accumulation of lifestyle and psychosocial problems and persistence of adverse lifestyle over two-year follow-up among Finnish adolescents. BMC Public Health 14:542PubMedPubMedCentralCrossRef

14.

Mikkonen P, Laitinen J, Remes J et al (2013) Association between overweight and low back pain. A population-based prospective cohort study of adolescents. Spine 38:1026–1033PubMedCrossRef

15.

Auvinen J, Tammelin T, Taimela S et al (2010) Is insufficient quantity and quality of sleep a risk factor for neck, shoulder, and low back pain? A longitudinal study in adolescents. Eur Spine J 19:641–649PubMedPubMedCentralCrossRef

16.

Tammelin T, Ekelund U, Remes J, Nayha S (2007) Physical activity and sedentary behaviors among Finnish youth. Med Sci Sports Exerc 39:1067–1074PubMedCrossRef

17.

Hurtig T, Taanila A, Ebeling H, Miettunen J, Moilanen I (2005) Attention and behavioural problems of Finnish adolescents may be related to the family environment. Eur Child Adolesc Psychiatry 14:471–478PubMedCrossRef

18.

Auvinen J, Tammelin T, Taimela S, Zitting P, Karppinen J (2008) Associations of physical activity and inactivity with low back pain in adolescents. Scand J Med Sci Sports 18:188–194PubMedCrossRef

19.

Paananen MV, Auvinen JP, Taimela SP et al (2010) Psychosocial, mechanical, and metabolic factors in adolescents’ musculoskeletal pain in multiple locations: A cross-sectional study. Eur J Pain 14:395–401PubMedCrossRef

20.

Tiira AH, Paananen MV, Taimela SP, Zitting PJ, Järvelin MR, Karppinen JI (2012) Determinants of adolescent health care use for low back pain. Eur J Pain 16:1467–1476PubMedCrossRef

21.

Collins LM, Lanza ST (2010) Latent class and latent transitions analysis: with applications in the social, behavioral, and health sciences. Wiley, New York

22.

Lazarsfeld PF, Henry NW (1968) Latent Structure Analysis. Houghton Mifflin, Boston

23.

Achenbach TM, Rescorla LA (2001) Manual for the ASEBA school-age forms and profiles. University of Vermont, Research Center for Children, Youth and Families, Burlington

24.

Carskadon MA, Harvey K, Duke P, Anders TF, Litt IF, Dement WC (1980) Pubertal changes in daytime sleepiness. Sleep 2:453–460PubMed

25.

Carskadon MA, Acebo C, Seifer R (2001) Extended nights, sleep loss, and recovery sleep in adolescents. Arch Ital Biol 139:301–312PubMed

26.

Magidson J, Vermunt JK (2002) A nontechnical introduction to latent class models. DMA Research Council Journal (http://www.statisticalinnovations.com/articles/Icmodels2.pdf)

27.

Nylund KL, Asparouhov T, Muthén BO (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal 14:535–569CrossRef

28.

Vermunt JK, Magidson J (2004) Latent class analysis. In: Lewis-Beck M, Bryman A, Liao TF (eds) The sage encyclopedia of social sciences research methods. Sage Publications, California, pp 549–553

29.

Erne C, Elfering A (2011) Low back pain at school: unique risk deriving from unsatisfactory grade in maths and school-type recommendation. Eur Spine J 20:2126–2133PubMedPubMedCentralCrossRef

30.

Mustard CA, Kalcevich C, Frank JW, Boyle M (2005) Childhood and early adult predictors of risk of incident back pain: Ontario Child Health Study 2001 follow-up. Am J Epidemiol 162:779–786PubMedCrossRef

31.

Kekkonen VK, Kivimäki P, Valtonen H et al (2015) Psychosocial problems in adolescents associate with frequent health care use. Fam Pract. doi:10.1093/fampra/cmu090 PubMed

32.

Watson KD, Papageorgiou AC, Jones GT et al (2003) Low back pain in schoolchildren: the role of mechanical and psychosocial factors. Arch Dis Child 88:12–17PubMedPubMedCentralCrossRef

33.

Schuit AJ, van Loon AJ, Tijhuis M, Ocké M (2002) Clustering of lifestyle risk factors in a general adult population. Prev Med 35:219–224PubMedCrossRef

34.

Mistry R, McCarthy WJ, Yancey AK, Lu Y, Patel M (2009) Resilience and patterns of health risk behaviors in California adolescents. Prev Med 48:291–297PubMedPubMedCentralCrossRef

35.

Leech RM, McNaughton SA, Timperio A (2014) The clustering of diet, physical activity and sedentary behavior in children and adolescents: a review. Int J Behav Nutr Phys Act 11:4PubMedPubMedCentralCrossRef

Title: Accumulation of psychosocial and lifestyle factors and risk of low back pain in adolescence: a cohort study
Authors: Paula Mikkonen
Eveliina Heikkala
Markus Paananen
Jouko Remes
Simo Taimela
Juha Auvinen
Jaro Karppinen
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 2/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4065-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Accumulation of psychosocial and lifestyle factors and risk of low back pain in adolescence: a cohort study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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