European Spine Journal

, Volume 14, Issue 6, pp 595–598 | Cite as

Anthropometric measurements and growth as predictors of low-back pain: a cohort study of children followed up from the age of 11 to 22 years

  • Mikko S. Poussa
  • Markku M. Heliövaara
  • Jorma T. Seitsamo
  • Mauno H. Könönen
  • Kirsti A. Hurmerinta
  • Maunu J. NissinenEmail author
Original Article


Body height is an alleged risk factor for low-back pain (LBP) in adulthood, but its importance is obscure during childhood and adolescence. We studied growth for its association with the incidence of LBP in a population study of 430 children who were examined five times: at the age 11,12,13,14 and 22 years. Body height and weight and the degrees of trunk asymmetry, thoracic kyphosis and lumbar lordosis were measured at every examination. The history of LBP was obtained by a structured questionnaire at the ages of 14 and 22 years. The incidence of LBP was defined as pain, which occurred on eight or more days during the past year among those 338 children who had been free from LBP until 14 years of age. Growth of body height between 11 years and 14 years of age predicted the incidence of LBP. Adjusted for sex, the odds ratio (with 95% confidence interval) per an increment of one SD (4.3 cm) was 1.32 (1.06–1.65), the P value for trend being 0.03. Growth after 14 years of age was inversely related to the incidence of LBP, but the association did not reach statistical significance (P for trend = 0.06). Other anthropometric measurements or their changes were not found to predict LBP. Our results are not compatible with the old myth that spinal growth actually contributes to LBP. But abundant growth in early adolescence may be a risk factor for subsequent LBP.


Adolescence Anthropometry Growth Low-back pain Spinal posture 


  1. 1.
    Balaguè F, Dutoit G, Waldburger M (1988) Low back pain in schoolchildren. Scand J Rehabil Med 20:175–179Google Scholar
  2. 2.
    Fairbank J, Pynsent P, van Poortvliet J, Phillips H (1984) Influence of anthropometric factors and joint laxity in the incidence of adolescent back pain. Spine 9:461–464Google Scholar
  3. 3.
    Hakala P, Rimpelä A, Salminen J,Virtanen S, Rimpelä M (2002) Back, neck and shoulder pain in Finnish adolescents: national cross sectional surveys. Br Med J 325:743Google Scholar
  4. 4.
    Heliövaara M, Mäkelä M, Knekt P, Impivaara O, Aromaa A (1991) Determinants of sciatica and low-back pain. Spine 16:608–14Google Scholar
  5. 5.
    Lindqvist C, Signell H, Wasz-Höckert C (1962) Synpunkter på hållningsfel hos barn (in swedish). Finska Läkaresällskapets Handlingar 106:146–157Google Scholar
  6. 6.
    Nissinen M (1995) Spinal posture during pubertal growth. Acta Pediatr 84:308–312Google Scholar
  7. 7.
    Nissinen M, Heliövaara M, Seitsamo J, Alaranta H, Poussa M (1994) Anthropometric measurements and the incidence of low-back pain in a cohort of pubertal children. Spine 19:1367–1370PubMedGoogle Scholar
  8. 8.
    Nissinen MJ, Heliövaara MM, Seitsamo JT, Könönen MH, Hurmerinta KA, Poussa MS (2000) Development of trunk asymmetry in a cohort of children ages 11 to 22 years. Spine 25:570–74Google Scholar
  9. 9.
    Nissinen M, Heliövaara M, Seitsamo J, Poussa M (1993) Trunk asymmetry, posture, growth and risk of scoliosis. A three-year follow-up study of finnish prepubertal school children. Spine 18:8–13Google Scholar
  10. 10.
    Nissinen M, Heliövaara M, Ylikoski M, Poussa M (1993) Trunk asymmetry and screening for scoliosis: a longitudinal cohort study of puberal school children. Acta Pediatr 82:77–82Google Scholar
  11. 11.
    Poussa M, Heliövaara M, Seitsamo J, Könönen M, Hurmerinta K, Nissinen M (2005) Development of spinal posture in a cohort of children from the age of 11 to 22 years. Eur Spine J (in press)Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Mikko S. Poussa
    • 1
  • Markku M. Heliövaara
    • 2
  • Jorma T. Seitsamo
    • 3
  • Mauno H. Könönen
    • 4
  • Kirsti A. Hurmerinta
    • 5
  • Maunu J. Nissinen
    • 6
    Email author
  1. 1.The Orthopaedic Hospital of The Invalid FoundationHelsinkiFinland
  2. 2.National Public Health InstituteHelsinkiFinland
  3. 3.Occupational Health InstituteHelsinkiFinland
  4. 4.Institute of DentistryUniversity of HelsinkiHelsinkiFinland
  5. 5.Institute of DentistryUniversity of HelsinkiHelsinkiFinland
  6. 6.Kanta-Häme Central HospitalRiihimäkiFinland

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