Advertisement

European Spine Journal

, Volume 13, Issue 8, pp 663–679 | Cite as

Low back pain prevention’s effects in schoolchildren. What is the evidence?

  • Greet Cardon
  • F. Balagué
Review

Abstract

Given the high prevalence rates of back pain, as early as in childhood, there has been a call for early preventive interventions. To determine which interventions are used to prevent back problems in school-children, as well as what the evidence is for their utility, the literature was searched to locate all investigations that used subjects under the age of 18 and not seeking treatment. Included investigations were specifically designed as an intervention for low back pain (LBP) prevention. Additionally, a literature search was performed for modifiable risk factors for LBP in schoolchildren. The literature-update search was performed within the scope of the “COST Action B13” of the European Commission, approved for the development of European guidelines for the management of LBP. It was concluded that intervention studies in school-children focusing on back-pain prevention are promising but too limited to formulate evidence-based guidelines. On the other hand, since the literature shows that back-pain reports about schoolchildren are mainly associated with psychosocial factors, the scope for LBP prevention in schoolchildren may be limited. However, schoolchildren are receptive to back-care-related knowledge and postural habits, which may play a preventive role for back pain in adulthood. Further studies with a follow-up into adulthood are needed to evaluate the long-term effect of early interventions and the possible detrimental effect of spinal loading at young age.

Keywords

Non-specific low back pain Prevention Risk factors Schoolchildren 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Adams M, Mannion A, Dolan P (1999) Personal risk factors for first-time low back pain. Spine 24: 2497–2505PubMedCrossRefGoogle Scholar
  2. 2.
    Balagué F, Dutoit G, Waldburger M (1988) Low back pain in schoolchildren. Scand J Rehab 20: 175–179Google Scholar
  3. 3.
    Balagué F, Skovron ML, Nordin M, Dutoit G, Pol LR, Waldburger M (1995) Low back pain in schoolchildren — A study of familial and psychological factors. Spine 20: 1265–1270PubMedGoogle Scholar
  4. 4.
    Balagué F, Nordin M, Dutoit G, Waldburger M (1996) Primary prevention, education, and low back pain among school children. Bull Hosp Jt Dis 55: 130–134PubMedGoogle Scholar
  5. 5.
    Balagué F, Troussier B, Salminen JJ (1999) Non-specific low back pain in children and adolescents: risk factors. Eur Spine J 8: 429–438PubMedCrossRefGoogle Scholar
  6. 6.
    Balagué F, Dudler J, Nordin M (2003) Low-back pain in children. Lancet 361: 1403–1404PubMedCrossRefGoogle Scholar
  7. 7.
    Brattberg G (1994) The incidence of back pain and headache among Swedish school children. Qual Life Res 3: S27–31PubMedCrossRefGoogle Scholar
  8. 8.
    Burton K (1996) Low back pain in children and adolescents: to treat or not. Bull Hosp Jt Dis 3: 127–129Google Scholar
  9. 9.
    Burton AK, Clarke RD, McClune TD, Tillotson KM (1996) The natural history of low back pain in adolescents. Spine 21: 2323–2328PubMedCrossRefGoogle Scholar
  10. 10.
    Cardon G, Balagué F (2004) Backpacks and spinal disorders in school children. Europa Medicophysica 40: 15–21PubMedGoogle Scholar
  11. 11.
    Cardon G, De Bourdeaudhuij I, De Clercq D (2001) Back care education in elementary school: a pilot study investigating the complementary role of the class teacher. Patient Educ Couns 45: 219–226PubMedCrossRefGoogle Scholar
  12. 12.
    Cardon G, De Bourdeaudhuij I, De Clercq D (2002) Back education in elementary school: knowledge and perceptions of pupils, parents and teachers. J Sch Health 72: 100–106PubMedGoogle Scholar
  13. 13.
    Cardon GM, De Clercq DL, De Bourdeaudhuij IM (2002) Back education efficacy in elementary schoolchildren: a 1-year follow-up study. Spine 27: 299–305PubMedCrossRefGoogle Scholar
  14. 14.
    Cardon G, De Bourdeaudhuij I, De Clercq D, Philippaerts R, Verstraete S, Geldhof E (2004) The significance of physical fitness and physical activity for self-reported back and neck pain in elementary schoolchildren. Pediatr Exerc Sci 16: 1–11Google Scholar
  15. 15.
    Chometon E, Braize C, Levy A (1999) A primary educational prevention program for low back pain in Saint-Etienne primary schools. In: Troussier B, Phelip X (eds) Le dos de l’enfant et de l’adolescent et la prévention des lombalgies (The backs of children and teenagers and the prevention of backache). Actes Masson, Paris, pp 242–245Google Scholar
  16. 16.
    Duggleby T, Kumar S (1997) Epidemiology of juvenile low back pain: a review. Disabil Rehabil 19: 505–512PubMedGoogle Scholar
  17. 17.
    Ebbehoj NE, Hansen FR, Harreby MS, Lassen CF (2002) Low back pain in children and adolescents. Prevalence, risk factors and prevention. Ugeskr Laeger 164: 755–758PubMedGoogle Scholar
  18. 18.
    European Commission COST B13 Management Committee (2002) European guidelines for the management of low back pain. Acta Orthop Scand [Suppl 305]73: 20–25 (www.backpaineurope.org)Google Scholar
  19. 19.
    Feingold AJ, Jacobs K (2002) The effect of education on backpack wearing and posture in a middle school population. Work 18: 287–294PubMedGoogle Scholar
  20. 20.
    Feldman DE, Rossignol M, Shrier L, Abenhaim L (1999) Smoking: a risk factor for development of low back pain in adolescents. Spine 24: 2492–2496PubMedCrossRefGoogle Scholar
  21. 21.
    Feldman DE, Shrier I, Rossignol M, Abenhaim L (2001) Risk factors for the development of low back pain in adolescence. Am J Epidemiol 154: 30–36PubMedCrossRefGoogle Scholar
  22. 22.
    Feldman DE, Shrier I, Rossignol M, Abenhaim L (2002) Work is a risk factor for adolescent musculoskeletal pain. J Occup Environ Med 44: 956–961PubMedCrossRefGoogle Scholar
  23. 23.
    Goldberg MS, Scott SC, Mayo NE (2000) A review of the association between cigarette smoking and the development of non-specific back pain and related outcomes. Spine 25: 995–1014PubMedCrossRefGoogle Scholar
  24. 24.
    Goodgold S, Corcoran M, Gamache D, Gillis J, Guerin J, Coyle JQ (2002) Backpack use in children. Pediatr Phys Ther 14: 122–131PubMedCrossRefGoogle Scholar
  25. 25.
    Goubert L, Crombez G, De Bourdeaudhuij I (2004) Low back pain, disability and back pain myths in a community sample: prevalence and interrelationships. Eur J Pain 8: 385–394PubMedCrossRefGoogle Scholar
  26. 26.
    Grimmer K, Williams M (2000) Gender-age environmental associates of adolescent low back pain. Appl Ergon 31: 343–360PubMedCrossRefGoogle Scholar
  27. 27.
    Gunzburg R, Balagué F, Nordin M, Szpalski M, Duyck D, Bull D, Mélot C (1999) Low back pain in a population of school children. Eur Spine J 8: 439–443PubMedCrossRefGoogle Scholar
  28. 28.
    Harreby M, Neergaard K, Hesselsoe G, Kjer J (1995) Are radiologic changes in the thoracic and lumbar spine of adolescents risk factors for low back pain in adults? Spine 20: 2298–2302PubMedCrossRefGoogle Scholar
  29. 29.
    Harreby M, Nygaard B, Jessen T, Larsen E, Storr-Paulsen A, Lindahl A, Fisker I, Laegaard E (1999) Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study. Eur Spine J 8: 444–450PubMedCrossRefGoogle Scholar
  30. 30.
    Hopf C, Schrot C, Rompe JD, Bodem F (1996) [No upright sitting position due to alternative school furniture]. Z Orthop Ihre Grenzgeb 134: Oa22–25PubMedCrossRefGoogle Scholar
  31. 31.
    Hutchinson MR (1999) Low back pain in elite rhythmic gymnasts. Med Sci Sports Exerc 31: 1686–1688PubMedCrossRefGoogle Scholar
  32. 32.
    Iyer SR (2001) Schoolchildren and backpacks. J Sch Health 71: 88PubMedGoogle Scholar
  33. 33.
    Johnson J, Deshpande C (2000) Health education and physical education: disciplines preparing students as productive, healthy citizens for the challenges of the 21st century. J Sch Health 70: 66–68PubMedCrossRefGoogle Scholar
  34. 34.
    Jones GT, Watson KD, Silman AJ, Symmons DPM, Macfarlane GJ (2003) Predictors of low back pain in British schoolchildren: a population-based prospective cohort study. Pediatrics 111: 822–828PubMedCrossRefGoogle Scholar
  35. 35.
    Knusel O, Jelk W (1994) [Pezzi-balls and ergonomic furniture in the classroom. Results of a prospective longitudinal study]. Schweiz Rundsch Med Prax 83: 407–413PubMedGoogle Scholar
  36. 36.
    Kohl HW, Fulton JE, Caspersen CJ (2000) Assessment of physical activity among children and adolescents: a review and synthesis. Prev Med 31 [Suppl]: 54–76CrossRefGoogle Scholar
  37. 37.
    Korovessis P, Koureas GK, Papazisis Z (2004) Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents. J Spinal Disord Tech 17: 33–40PubMedCrossRefGoogle Scholar
  38. 38.
    Kovacs FM, Gestoso M, del Real MTG, Lopez J, Mufraggi N, Mendez JI (2003) Risk factors for non-specific low back pain in schoolchildren and their parents: a population based study. Pain 103: 259–268PubMedCrossRefGoogle Scholar
  39. 39.
    Kristjansdottir G (1996) Prevalence of self-reported back pain in school children: a study of sociodemographic differences. Eur J Pediatr 155: 984–986PubMedCrossRefGoogle Scholar
  40. 40.
    Kristjansdottir G, Rhee H (2002) Risk factors of back pain frequency in schoolchildren: a search for explanations to a public health problem. Acta Paediatr 91: 849–854PubMedCrossRefGoogle Scholar
  41. 41.
    Kujala UM, Taimela S, Erkintalo M, Salminen JJ, Kaprio J (1996) Low back pain in adolescent athletes. Med Sci Sports Exerc 28: 165–170PubMedGoogle Scholar
  42. 42.
    Kujala UM, Taimela S, Viljanen T (1999) Leisure physical activity and various pain symptoms among adolescents. Br J Sports Med 33: 325–328PubMedCrossRefGoogle Scholar
  43. 43.
    Lake JK, Power C, Cole TJ (2000) Back pain and obesity in the 1985 British birth cohort: cause or effect? J Clin Epidemiol 53: 245–250PubMedCrossRefGoogle Scholar
  44. 44.
    Lebkowski WJ (1997) Back pain in teenagers and young adults (abstract). Pol Merkuriusz Lek 2(8): 111–112Google Scholar
  45. 45.
    Leboeuf-Yde C, Kyvik KO (1998) At what age does low back pain become a common problem? Spine 23: 228–234PubMedCrossRefGoogle Scholar
  46. 46.
    Lee JH, Hoshino Y, Nakamura K, Kariya Y, Saita K, Ito K (1999) Trunk muscle weakness as a risk factor for low back pain. A 5-year prospective study. Spine 24: 54–57PubMedCrossRefGoogle Scholar
  47. 47.
    Mackenzie WG, Sampath JS, Kruse RW, Sheir-Neiss GJ (2003) Backpacks in children. Clin Orthop 409: 78–84PubMedCrossRefGoogle Scholar
  48. 48.
    McMeeken J, Tully E, Stillman B, Nattrass C, Bygott IL, Story I (2001) The experience of back pain in young Australians. Man Ther 6: 213–220PubMedCrossRefGoogle Scholar
  49. 49.
    Mendez FJ, Gomez-Conesa A (2001) Postural hygiene program to prevent low back pain. Spine 26: 1280–1286PubMedCrossRefGoogle Scholar
  50. 50.
    Merati G, Negrini S, Sarchi P, Mauro F, Veicsteinas A (2001) Cardio-respiratory adjustments and cost of locomotion in school children during backpack walking (the Italian backpack study). Eur J Appl Physiol 85: 41–48PubMedCrossRefGoogle Scholar
  51. 51.
    Negrini S, Carabalona R (2002) Backpacks on! Schoolchildren’s perceptions of load, associations with back pain and factors determining the load. Spine 27: 187–195PubMedCrossRefGoogle Scholar
  52. 52.
    Newcomer K, Sinaki M (1996) Low back pain and its relationship to back strength and physical activity in children. Acta Paediatr 85: 1433–1439PubMedCrossRefGoogle Scholar
  53. 53.
    Ogon M, Riedl-Huter C, Sterzinger W, Krismer M, Spratt KF, Wimmer C (2001) Radiologic abnormalities and low back pain in elite skiers. Clin Orthop 151–162Google Scholar
  54. 54.
    Phelip X (1999) Why the back of the child? Eur Spine J 8: 426–428PubMedCrossRefGoogle Scholar
  55. 55.
    Power C, Frank J, Hertzman C, Schierhout G, Li L (2001) Predictors of low back pain onset in a prospective British study. Am J Public Health 91: 1671–1678PubMedCrossRefGoogle Scholar
  56. 56.
    Robertson HC, Lee V (1990) Effects of back care lessons on sitting and lifting by primary students. Aust J Physiother 36: 245–248Google Scholar
  57. 57.
    Rozenberg S, Bourgeois P (1999) Are children also fated to develop back pain? Rev Rhum 66: 365–366Google Scholar
  58. 58.
    Salminen JJ (1984) The adolescent back. A field survey of 370 school-children. Acta Paediatr Scand 73 [Suppl]: 1–122CrossRefGoogle Scholar
  59. 59.
    Salminen JJ, Pentti J, Terho P (1992) Low back pain and disability in 14-year-old schoolchildren. Acta Paediatr 81: 1035–1039PubMedCrossRefGoogle Scholar
  60. 60.
    Salminen JJ, Erkintalo M, Laine M, Pentti J (1995) Low back pain in the young. A prospective 3-year follow-up study of subjects with and without low back pain. Spine 20: 2101–2108PubMedCrossRefGoogle Scholar
  61. 61.
    Salminen JJ, Erkintalo MO, Pentti J, Oksanen A, Kormano MJ (1999) Recurrent low back pain and early disc degeneration in the young. Spine 24: 1316–1321PubMedCrossRefGoogle Scholar
  62. 62.
    Sheir-Neiss GI, Kruse RW, Rahman T, Jacobson LP, Pelli JA (2003) The association of backpack use and back pain in adolescents. Spine 28: 922–930PubMedCrossRefGoogle Scholar
  63. 63.
    Sheldon MR (1994) Lifting instruction to children in an elementary school. J Orthop Sports Phys Ther 19: 105–110PubMedGoogle Scholar
  64. 64.
    Sjolie AN (2002) Psychosocial correlates of low-back pain in adolescents. Eur Spine J 582–588Google Scholar
  65. 65.
    Sjolie AN, Ljunggren AE (2001) The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents. Spine 26: 2629–2636PubMedCrossRefGoogle Scholar
  66. 66.
    Spence SM, Jensen GM, Shepard KF (1984) Comparison of methods of teaching children proper lifting techniques. Phys Ther 64: 1055–1061PubMedGoogle Scholar
  67. 67.
    Staes F, Stappaerts K, Lesaffre E, Vertommen H (2003) Low back pain in Flemish adolescents and the role of perceived social support and effect on the perception of back pain. Acta Paediatr 92: 444–451PubMedGoogle Scholar
  68. 68.
    Storr-Paulsen A (2002) The body-consciousness in school — a back pain school. Ugeskr Laeger 165: 37–41PubMedGoogle Scholar
  69. 69.
    Szpalski M, Gunzburg R, Balagué F, Nordin M, Melot C (2002) A 2-year prospective longitudinal study on low back pain in primary school children. Eur Spine J 11: 459–464PubMedCrossRefGoogle Scholar
  70. 70.
    Taimela S, Kujala UM, Salminen JJ, Viljanen T (1997) The prevalence of low back pain among children and adolescents. A nationwide, cohort-based questionnaire survey in Finland. Spine 22: 1132–1136PubMedCrossRefGoogle Scholar
  71. 71.
    van Gent C, Dols J, de Rover C, Sing R, de Vet H (2003) The weight of school-bags and the occurrence of neck, shoulder and back pain in young adolescents. Spine 28: 916–921PubMedCrossRefGoogle Scholar
  72. 72.
    Vicas-Kunse P (1992) Educating our children: the pilot school program. Occup Med 7: 173–177PubMedGoogle Scholar
  73. 73.
    Viry P, Creveuil C, Marcelli C (1999) Nonspecific back pain in children — a search for associated factors in 14-year-old schoolchildren. Rev Rhum 66: 381–388Google Scholar
  74. 74.
    Watson KD, Papageorgiou AC, Jones GT, Taylor S, Symmons DP, Silman AJ, Macfarlane GJ (2003) Low back pain in schoolchildren: the role of mechanical and psychosocial factors. Arch Dis Child 88: 12–17PubMedCrossRefGoogle Scholar
  75. 75.
    Wedderkopp N, Leboeuf-Yde, Andersen LB, Froberg K, Hansen HS (2003) Back pain in children. No association with objectively measured level of physical activity. Spine 28: 2019–2024PubMedCrossRefGoogle Scholar
  76. 76.
    Widhe T (2001) Spine: posture, mobility and pain. A longitudinal study from childhood to adolescence. Eur.Spine J. 10: 118–123PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of Movement and Sports SciencesGhent UniversityGentBelgium
  2. 2.Department of Rheumatology, Physical Medicine and RehabilitationHopital CantonalFribourgSwitzerland

Personalised recommendations