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Pubertal development and growth are prospectively associated with spinal pain in young people (CHAMPS study-DK)

  • Jeffrey J. HebertEmail author
  • Charlotte Leboeuf-Yde
  • Claudia Franz
  • Arnaud Lardon
  • Lise Hestbæk
  • Neil Manson
  • Niels Wedderkopp
Original Article

Abstract

Purpose

To examine the prospective associations of pubertal development and linear growth with spinal pain frequency and duration in children.

Methods

We recruited students from 10 public primary schools. Over 42 months, pubertal development was assessed four times and categorized according to Tanner stages 1–5, and height was measured on seven occasions. Occurrences of spinal pain were reported weekly via text messaging. We constructed variables for spinal pain duration (total weeks with pain) and frequency (number of episodes). Potential associations between pubertal development and growth were examined with generalized estimating equations and reported with incident rate ratios (IRRs). All models were adjusted for potential confounders.

Results

Data from 1021 children (53% female; mean [SD] age = 9.4 [1.4] years), with median participation duration of 39 months, were included. Advancing pubertal development was associated with increased spinal pain duration (IRR [95% CI] = 1.90 [1.45, 2.49] to 5.78 [4.03, 8.29]) and frequency of pain episodes (IRR [95% CI] = 1.32 [1.07, 1.65] to 2.99 [2.24, 3.98]). Similar associations were observed for each 1-cm change in height in 6 months with spinal pain duration (IRR [95% CI] = 1.19 [1.15, 1.23]) and frequency (IRR [95% CI] = 1.14 [1.11, 1.17]). The relations between pubertal development and spinal pain, as well as growth and spinal pain, were largely independent.

Conclusions

In young people, pubertal development and linear growth are likely to be independent risk factors for the development of spinal pain. Pubertal development demonstrates evidence of dose–response in its relationship with spinal pain. This knowledge may assist healthcare providers with clinical decision-making when caring for pediatric patients.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Puberty Growth and development Body height Risk factors Back pain 

Notes

Acknowledgements

The authors gratefully acknowledge the valuable work of numerous students who assisted with data collection in the CHAMPS study-DK. We also thank the participating children, their parents, and teachers in the schools involved in the project. We are grateful for the cooperation with The Svendborg Project, Sport Study Sydfyn, and the Municipality of Svendborg. Finally, we wish to acknowledge members of the CHAMPS study-DK not listed as co-authors in this paper: E. Jespersen, M. Heidemann, and C.T. Rexen.

Funding

The TRYG Foundation, University College Lillebaelt, University of Southern Denmark, The Nordea Foundation, The IMK foundation, The Region of Southern Denmark, The Egmont Foundation, The A.J. Andersen Foundation, The Danish Rheumatism Association, Østifternes Foundation, Brd. Hartmann’s Foundation, TEAM Denmark, The Danish Chiropractor Foundation, and The Nordic Institute of Chiropractic and Clinical Biomechanics. The funding sources played no role in the design, conduct, or reporting of this study.

Conlict of interest

Prof. Hebert receives salary support from the Canadian Chiropractic Research Foundation and the New Brunswick Health Research Foundation. The authors declare no additional conflicts of interest.

Supplementary material

586_2019_5905_MOESM1_ESM.pptx (845 kb)
Supplementary material 1 (PPTX 845 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of KinesiologyUniversity of New BrunswickFrederictonCanada
  2. 2.School of Psychology and Exercise ScienceMurdoch UniversityMurdochAustralia
  3. 3.Institute for Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
  4. 4.Private PracticeHaderslevDenmark
  5. 5.Danish Agency for Patient ComplaintsAarhusDenmark
  6. 6.Institut Franco-Européen de ChiropraxieIvry sur SeineFrance
  7. 7.CIAMSUniversité Paris-Sud, Université Paris-SaclayOrsay CedexFrance
  8. 8.CIAMSUniversité d’OrléansOrléansFrance
  9. 9.Nordic Institute of Chiropractic and Clinical BiomechanicsOdenseDenmark
  10. 10.Canada East Spine CentreSaint JohnCanada
  11. 11.Department of Orthopaedic SurgerySaint John Regional HospitalSaint JohnCanada
  12. 12.Department of Orthopaedic SurgeryDalhousie UniversityHalifaxCanada
  13. 13.Orthopedic DepartmentHospital of Southwestern JutlandEsbjergDenmark
  14. 14.Department of Regional Health ResearchUniversity of Southern DenmarkEsbjergDenmark

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