European Spine Journal

, Volume 24, Issue 3, pp 474–481 | Cite as

Body mass index is associated with low back pain in childhood and adolescence: a birth cohort study with a 6-year follow-up in Niigata City, Japan

  • Atsuki SanoEmail author
  • Toru Hirano
  • Kei Watanabe
  • Naoto Endo
  • Takui Ito
  • Naohito Tanabe
Original Article



To investigate the successive change of low back pain (LBP) prevalence in childhood and adolescence and to examine the associations between LBP and extracurricular sports activities (ECSA) or body mass index (BMI) using a 6-year birth cohort study.


LBP reports of a grade (4,597 pupils at the beginning) were tracked over 6 years (between the ages of 9 and 14 years old), and anonymous questionnaires were distributed to them yearly. After grading the severity of the LBP into three levels and noting the transitions of the point and the lifetime prevalence of LBP, associations between point prevalence of LBP and BMI or ECSA were evaluated.


The point prevalence of LBP had a tendency to become significantly higher as the pupils got older until they became 13 years old. The lifetime prevalence of LBP significantly increased as they got older yearly. As for the severity of LBP among students with a lifetime prevalence, the rate of more severe LBP (levels 2 and 3) increased as they got older. Significant positive associations were recognized between BMI and point prevalence of LBP in every years old (p < 0.05) and between ECSA and point prevalence of LBP at 11 (p = 0.001) and 14 years old (p < 0.001).


The point and lifetime prevalence of LBP and the rate of more severe LBP increased as the pupils got older. BMI may be associated with LBP in childhood and adolescence.


Body mass index Low back pain Birth cohort study Childhood low back pain Adolescent low back pain 



We would like to sincerely thank the members of the Niigata City board of education, school teachers, and others associated with the elementary schools and junior high schools in Niigata City for their valuable cooperation in making this study possible.

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Atsuki Sano
    • 1
    Email author
  • Toru Hirano
    • 1
  • Kei Watanabe
    • 1
  • Naoto Endo
    • 1
  • Takui Ito
    • 2
  • Naohito Tanabe
    • 3
  1. 1.Department of Orthopaedic SurgeryNiigata University Medical and Dental General HospitalNiigata CityJapan
  2. 2.Department of Orthopaedic SurgeryNiigata City General HospitalNiigataJapan
  3. 3.Department of Health and NutritionUniversity of Niigata PrefectureNiigataJapan

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