European Spine Journal

, 17:1441 | Cite as

Low back pain in childhood and adolescence: a cross-sectional study in Niigata City

  • Tsuyoshi Sato
  • Takui Ito
  • Toru Hirano
  • Osamu Morita
  • Ren Kikuchi
  • Naoto Endo
  • Naohito Tanabe
Original Article

Abstract

A cross-sectional study targeted a total of 43,630 pupils in Niigata City, Japan was performed. The objective was to clarify the present incidence of low back pain (LBP) in childhood and adolescence in Japan. It has recently been recognized that LBP in childhood and adolescence is also as common a problem as that for adults and most of these studies have been conducted in Europe, however, none have so far been made in Japan. A questionnaire survey was conducted using 43,630 pupils, including all elementary school students from the fourth to sixth grade (21,893 pupils) and all junior high students from the first to third year (21,737 pupils) in Niigata City (population of 785,067) to examine the point prevalence of LBP, the lifetime prevalence, the gender differences, the age of first onset of LBP in third year of junior high school students, the duration, the presence of recurrent LBP or not, the trigger of LBP, and the influences of sports and physical activities. In addition, the severity of LBP was divided into three levels (level 1: no limitation in any activity; level 2: necessary to refrain from participating in sports and physical activities, and level 3: necessary to be absent from school) in order to examine the factors that contribute to severe LBP. The validity rate was 79.8% and the valid response rate was 98.8%. The point prevalence was 10.2% (52.3% male and 47.7% female) and the lifetime prevalence was 28.8% (48.5% male and 51.5% female). Both increased as the grade level increased and in third year of junior high school students, a point prevalence was seen in 15.2% while a lifetime prevalence was observed in 42.5%. About 90% of these students experienced first-time LBP during the first and third year of junior high school. Regarding the duration of LBP, 66.7% experienced it for less than 1 week, while 86.1% suffered from it for less than 1 month. The recurrence rate was 60.5%. Regarding the triggers of LBP, 23.7% of them reported the influence of sports and exercise such as club activities and physical education, 13.5% reported trauma, while 55.6% reported no specific triggers associated with their LBP. The severity of LBP included 81.9% at level 1, 13.9% at level 2 and 4.2% at level 3. It was revealed that LBP in childhood and adolescence is also a common complaint in Japan, and these findings are similar to previous studies conducted in Europe. LBP increased as the grade level increased and it appeared that the point and lifetime prevalence in adolescence are close to the same levels as those seen in the adulthood and there was a tendency to have more severe LBP in both cases who experienced pain for more than 1 month and those with recurrent LBP.

Keywords

Low back pain Childhood Adolescence Cross-sectional study Japan 

References

  1. 1.
    Anderson LB, Wedderkopp N, Leboeuf-Yde C (2006) Association between back pain and physical fitness in adolescents. Spine 31:1740–1744. doi:10.1097/01.brs.0000224186.68017.e0 CrossRefGoogle Scholar
  2. 2.
    Balagué F, Dutoit G, Waldburger M (1988) Low back pain in schoolchildren. An epidemiological study. Scand J Rehabil Med 20:175–179PubMedGoogle Scholar
  3. 3.
    Balagué F, Skovron ML, Nordin M, Dutoti 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, Troussier B, Salminen JJ (1999) Non-specific low back pain in children and adolescents: risk factors. Eur Spine J 8:429–438. doi:10.1007/s005860050201 PubMedCrossRefGoogle Scholar
  5. 5.
    Burton AK, Clarke RD, McClune TD, Tillotson KM (1996) The natural history of low back pain in adolescents. Spine 21:2323–2328. doi:10.1097/00007632-199610150-00004 PubMedCrossRefGoogle Scholar
  6. 6.
    Cardon G, Balagué F (2004) Low back pain prevention’s effects in schoolchildren. What is the evidence? Eur Spine J 13:663–679. doi:10.1007/s00586-004-0749-6 PubMedCrossRefGoogle Scholar
  7. 7.
    Harreby M, Neergaard K, Hesselsøe G, Kjer J (1995) Are radiologic changes in the thoracic and lumbar spine of adolescents risk factors for low back pain in adults? Spine 20:2298–2302. doi:10.1097/00007632-199511000-00007 PubMedCrossRefGoogle Scholar
  8. 8.
    Harreby M, Nygaard B, Jessen T, Larsen E, Storr-Paulsen A, Lindahl A et al (1999) Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study. Eur Spine J 8:444–450. doi:10.1007/s005860050203 PubMedCrossRefGoogle Scholar
  9. 9.
    Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche CM (2006) The course of low back pain from adolescence to adulthood. Eight-year follow-up of 9600 twins. Spine 31:468–472. doi:10.1097/01.brs.0000199958.04073.d9 PubMedCrossRefGoogle Scholar
  10. 10.
    Jones GT, Macfarlane GJ (2005) Epidemiology of low back pain in children and adolescents. Arch Dis Child 90:312–316. doi:10.1136/adc.2004.056812 PubMedCrossRefGoogle Scholar
  11. 11.
    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 19:284–289. doi:10.1093/her/cyg025 PubMedCrossRefGoogle Scholar
  12. 12.
    Kelsey JK, White AA (1985) Epidemiology and impact of low back pain. Spine 5:133–142. doi:10.1097/00007632-198003000-00007 CrossRefGoogle Scholar
  13. 13.
    Leboeuf-Yde C, Kyvik KO (1998) At what age dose low back pain become a common problem? A study of 29, 424 individuals aged 12–41 years. Spine 23:228–234. doi:10.1097/00007632-199801150-00015 PubMedCrossRefGoogle Scholar
  14. 14.
    Limon S, Valinsky LJ, Ben-Shalom Y (2004) Children at risk. risk factors for low back pain in the elementary school environment. Spine 29:697–702. doi:10.1097/01.BRS.0000116695.09697.22 PubMedCrossRefGoogle Scholar
  15. 15.
    McCormic A (1995) Morbidity statistics from general practice: fourth national study 1991–1992/a study carried out by the Royal College of General Practitioners, the Office of Population Censuses and Surveys, and the Department of Health. HMSO, LondonGoogle Scholar
  16. 16.
    Nachemson AL (1976) The lumbar spine: an orthopaedic challenge. Spine 1:59–71. doi:10.1097/00007632-197603000-00009 CrossRefGoogle Scholar
  17. 17.
    Poussa MS, Heliövaara MM, Seitsamo JT, Könönen MH, Hurmerinta KA, Nissinen MJ (2005) 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. Eur Spine J 14:595–598. doi:10.1007/s00586-004-0872-4 PubMedCrossRefGoogle Scholar
  18. 18.
    Salminen JJ, Pentti J, Terho P (1992) Low back pain and disability in 14-year-old schoolchiidren. Acta Paediatr 81:1035–1039. doi:10.1111/j.1651-2227.1992.tb12170.x PubMedCrossRefGoogle Scholar
  19. 19.
    Salminen JJ, Erkintalo M, Laine M, Pentti J (1995) Low back pain in the young. A prospective three-year follow-up study of subjects with and without low back pain. Spine 20:2101–2108. doi:10.1097/00007632-199510000-00006 PubMedCrossRefGoogle Scholar
  20. 20.
    Szpalski M, Gunzburg R, Balagué Nordin M, Mélot C (2002) A 2-year prospective longitudinal study on low back pain in primary school children. Eur Spine J 11:459–464. doi:10.1007/s00586-002-0385-y PubMedCrossRefGoogle Scholar
  21. 21.
    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 22:1132–1136. doi:10.1097/00007632-199705150-00013 PubMedCrossRefGoogle Scholar
  22. 22.
    Tertti MO, Salminen JJ, Paajanen HE, Terho PH, Kormano MJ (1991) Low-back pain and disk degeneration in children: a case-control mr imaging study. Radiology 180:503–507PubMedGoogle Scholar
  23. 23.
    Turner PG, Green JH, Galasko CS (1989) Back pain in childhood. Spine 14:812–814. doi:10.1097/00007632-198908000-00007 PubMedCrossRefGoogle Scholar
  24. 24.
    Walker BF (2000) The prevalence of low back pain: a systemic review of the literature from 1966 to 1998. J Spinal Disord 13:205–217. doi:10.1097/00002517-200006000-00003 PubMedCrossRefGoogle Scholar
  25. 25.
    Walsh K, Cruddas M, Coggon D (1992) Low back pain in eight areas of Britain. J Epidemiol Community Health 46:227–230PubMedCrossRefGoogle Scholar
  26. 26.
    Watson KD, Papageorgiou AC, Jones GT, Taylor S, Symmons DPM, Silman AJ et al (2002) Low back pain in schoolchildren: occurrence and characteristics. Pain 97:87–92. doi:10.1016/S0304-3959(02)00008-8 PubMedCrossRefGoogle Scholar
  27. 27.
    Watson KD, Papageorgiou AC, Jones GT, Taylor S, Symmons DPM, Silman AJ et al (2003) Low back pain in schoolchildren: the role of mechanical and psychosocial factors. Arch Dis Child 88:12–17. doi:10.1136/adc.88.1.12 PubMedCrossRefGoogle Scholar
  28. 28.
    Widhe T (2001) Spine: posture, mobility and pain. A longitudinal study from childhood to adolescence. Eur Spine J 10:118–123. doi:10.1007/s005860000230 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Tsuyoshi Sato
    • 1
    • 2
  • Takui Ito
    • 1
  • Toru Hirano
    • 1
  • Osamu Morita
    • 1
  • Ren Kikuchi
    • 1
  • Naoto Endo
    • 1
  • Naohito Tanabe
    • 3
  1. 1.Division of Orthopedic Surgery, Department of Regenerative and Transplant MedicineNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Department of Orthopedic SurgeryNiigata Prefectural Shibata HospitalShibataJapan
  3. 3.Division of Health Promotion, Department of Public HealthNiigata University Graduate School of Medical and Dental SciencesNiigataJapan

Personalised recommendations