The prevalence and impacts of low back pain, as well as associated factors in Chinese female adolescents — The International Society for the Study of the Lumbar Spine
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The prevalence and impacts of low back pain, as well as associated factors in Chinese female adolescents (#1210)

Arnold Wong 1 , Nicole Chung 2 , Grace Lee 3 , Rowena Au 3 , Athena Yeung 3 , Henrik Lauridsen 4 , Lise Hestbaek 4
  1. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
  2. Diocesan Girls' School, Hong Kong SAR, China
  3. Good Hope School, Hong Kong SAR, China
  4. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark

INTRODUCTION

Although prior studies revealed high prevalence of low back pain (LBP) among adolescents, little is known regarding the impact of LBP on various aspects of adolescents. The objectives of the current study were to determine the prevalence of LBP, its impact, and factors associated with a high prevalence of LBP among Chinese female adolescents.

 

METHODS

An online survey was distributed to secondary school students (aged 11-18 years) in two girls’ schools who obtained parents’ consent for their study participation. The survey comprised four parts: (1) a modified Nordic Musculoskeletal Questionnaire; (2) KIDSCREEN; (3) Rosenberg Self-esteem Scale, and (4) Pediatric Daytime Sleepiness Scale (PDSS). KIDSCREEN evaluated the health-related quality of life (HRQOL) of teenagers, while Rosenberg Self-esteem Scale and PDSS assessed adolescents’ self-esteem and daytime sleepiness, respectively. The lifetime prevalence of LBP, the 12-month prevalence of LBP and chronic LBP (CLBP) that lasted for at least 3 months in the last 12 months were calculated. Characteristics of adolescents with and without LBP/CLBP were compared by separate independent t-tests. Factors associated with LBP/CLBP were analyzed by separate stepwise logistic regression models. The significance level was set at 0.05.

 

RESULTS
229 participants completed the survey (mean age: 14.5+1.7 years; 53.3% response rate). The lifetime prevalence of LBP was 27.5%, while the 12-month prevalence of LBP and CLBP were 25.8% and 5.2%, respectively. Adolescents with LBP reported significantly poorer HRQOL (KIDSCREEN: 34.9 vs 38.6), more daytime sleepiness (PDSS: 26.4 vs 24.1) and greater pain-related interferences of recreational activity (3.6/10 vs 2.6/10) than non-LBP counterparts. Similarly, adolescents with CLBP had significantly poorer HRQOL, more daytime sleepiness, and more pain-related interferences of daily activities (3.8/10 vs 2.8/10) or recreational activities (4.7/10 vs 2.7/10) than non-CLBP students. Laptop/desktop usage for >3 hours per weekday, age > 15 years, and an additional painful region in the last 12 months were all significantly associated with a higher 12-months prevalence of LBP with odds ratios (OR) above 2. Interestingly, only an additional painful region in the last 12 months was significantly related to a higher prevalence of CLBP (OR=1.23).

  

DISCUSSION

Both LBP and CLBP not only are prevalent among Chinese adolescents but also adversely impact multiple aspects of their lives. While older age is a non-modifiable risk factor for LBP, both sedentary lifestyle and multi-site pain may be modified to lower the risk of LBP/CLBP occurrence. Since LBP in adolescence is a well-known risk factor for LBP in adulthood, early interventions (including education) are warranted to alleviate LBP in adolescents.

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