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The one month period prevalence of LBP in the study population was The individual five day average loads ranged from 1. There was no relation however between average load carried and the likelihood of reporting LBP table 1. However, LBP was not significantly associated with either the type of bag carried or the method of carrying data not shown. The median average load was 9. However, there was no significant relation between percentage body weight carried and the likelihood of reporting LBP.
Indeed the lowest risk was reported among those carrying the highest percentage body weight. On analysis of the relation between each of the 17 individual sporting activities and the reporting of LBP, positive relations were only observed for roller blading OR 1. Furthermore, no associations were observed between amount of sedentary activity that is, watching television, using computers and LBP table 3.
Table 4 shows the relation between psychosocial factors and LBP. Strong associations were observed between LBP and the reporting of other somatic symptoms. After adjusting for age and gender, children reporting troublesome headaches for more than three days in the past month had a threefold higher odds of reporting LBP than those not reporting this symptom.
Similar results were found for troublesome abdominal pain, sore throats, and high levels of daytime tiredness table 5. The positively associated factors from the univariate analysis were entered into a multivariate model to identify those that were independently associated with LBP table 6. Six factors were found to be independently associated with LBP conduct problems, emotional problems, troublesome headaches, troublesome sore throats, daytime tiredness, and having a part time job.
Hereafter, the prevalence of LBP was assessed in the whole study population according to the number of exposures reported in the highest category.
Risk of low back pain in relation to positive associations univariate using a multivariate model. This is the largest population based study which has assessed the association between both mechanical and psychosocial factors, and LBP at early ages.
The two main findings of this survey were that mechanical factors were not associated with the reporting of childhood LBP whereas there were strong associations with emotional problems, conduct problems, and other common childhood complaints. It is therefore unlikely that bias resulting from non-participation had an effect on the observed results.
However, there are potential weaknesses. It could be argued that the outcome measure used one month period prevalence of LBP would include some relatively minor low back pain. However, we were concerned as to how accurately the children weighed their bags over the five day period, and therefore the bags were measured on the first day by the investigators bags as a validity check.
Height and weight measurements for the calculation of BMI were taken by the investigators using calibrated instruments and standardised procedures. Only a longitudinal prospective study could investigate the relative contribution of mechanical and psychosocial factors in the aetiology of LBP. Thus from the present results we cannot directly assess whether mechanical load exposure has been altered as a consequence of LBP experience.
However, we were able to examine the hypothesis that those with the highest mechanical exposures were particularly healthy children—that is, those with high mechanical exposures who had experienced LBP and reduced their exposure a variation of the healthy worker effect We also cannot tell whether psychosocial and somatic factors are a consequence or cause of LBP in schoolchildren.
However, LBP studies among adults have suggested that psychological distress is a predictor of future onset rather than merely a consequence.
Previous studies have also failed to establish a relation between LBP in children and anthropometric parameters such as BMI. The evidence in this area is sparse although several studies which have considered such an association have observed relations between heavy mechanical load and LBP. The present study also observed a modest relation between the prevalence of self reported LBP and high sports activity.
On univariate analysis, the negative behavioural dimensions were all strongly associated with the reporting of LBP while the positive behavioural dimension was not. This is in agreement with a previous study which found that adverse psychological factors were positively associated with the reporting of LBP in schoolchildren. These findings reflect those of a study conducted in Finland among schoolchildren, which found that children with widespread pain reported more emotional and behavioural problems than those without pain, and showed that tiredness during the day was a risk factor for the persistence of pain.
Somatic complaints such as headaches, stomach aches, and musculoskeletal pain have also previously been associated with emotional, disruptive, anxiety, and depressive disorders in a population of children aged 9—16 years. Furthermore, the findings suggest co-morbidity between LBP and other frequently occurring common childhood complaints.
Both stomach aches and headaches are known to coexist in adults and children, 20 although the reason for this remains unknown.
However, our results suggest that this could be a manifestation of somatisation. The findings from our population study among children suggest that psychosocial rather than mechanical factors are important in reporting LBP among children.
Further, LBP is most common among children reporting other frequent childhood symptoms and may be a marker of somatisation. Although our data do not provide support for mechanical load being a short term risk factor for LBP, we cannot exclude deleterious longer term effects, highlighting the need for long term follow up studies of populations such as this. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Community child health, public health, and epidemiology. Low back pain in schoolchildren: Linked Articles Request Permissions. Study population The survey area as a whole is mixed in terms of sociodemographic characteristics and includes both rural and urban communities.
Survey procedure In schools which agreed to participate, data were collected between November and July to coincide with the British school year. Pain status The questionnaire had been assessed in a pilot study and was found to be both reliable and comprehensible.
Definition of low back pain according to preshaded manikin. Figure 1 Definition of low back pain according to preshaded manikin. View inline View popup. Table 6 Risk of low back pain in relation to positive associations univariate using a multivariate model. Prevalence of LBP by number of significant risk factors. Figure 2 Prevalence of LBP by number of significant risk factors. The prevalence of low back pain among children and adolescents: Spine ; Backpack as a daily load for schoolchildren.
Lancet ; Back pain in schoolchildren: Scand J Rehab Med ; Grimmer K , Williams M. Gender-age environmental associates of adolescent low back pain. Appl Ergon ; Nonspecific back pain in children: Rev Rhum Engl Ed ; Somatic complaints and psychopathology in children and adolescents: Brattberg G , Wickman V. Prevalence of back pain and headache in Swedish schoolchildren:
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