Baseline musculoskeletal pain and impaired sleep related to school pressure influence the development of musculoskeletal pain in N = 107 adolescents in a 5-year longitudinal study

  • C. Rolli SalathéEmail author
  • W. Kälin
  • S. Zilse
  • A. Elfering
Original Article



This longitudinal study followed 10- to 13-year-old adolescents for 5 years to investigate the effects of juvenile musculoskeletal (MSK) pain and psychosocial risk factors on future pain. We further predicted that increased MSK pain at follow-up would be positively related to current school pressure at follow-up and negatively related to current sleep quality. Sleep quality was tested as a potential mediator of the link between school pressure and MSK pain at follow-up after controlling for baseline MSK pain.


The baseline sample comprised 189 adolescents, and 5-year follow-up resulted in 107 15- to 18-year-old adolescents who had completed mandatory education. Adolescents responded to an online questionnaire about psychosocial stressors, MSK pain, school achievement and leisure activities. A longitudinal hierarchic linear regression including all significant baseline predictors was run to assess their impact on MSK pain 5 years later. Mediation analysis was used to investigate sleep quality as a potential mediator of the relationship between school pressure and MSK pain at follow-up.


Baseline MSK pain predicted MSK pain over a time lag of 5 years (ß = .26, p = .02). The relationship between follow-up school pressure and current MSK pain was mediated by sleep quality at follow-up (B = .17, SEB = .07, 95% CI .06–.34) when baseline MSK pain was controlled.


Juvenile MSK pain predicts MSK pain in adolescence. A psychosocial mediation model including school pressure and sleep impairments has the potential to explain MSK pain mechanisms in adolescents.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.


Musculoskeletal pain Longitudinal analysis Adolescents Psychosocial risk factors Sleep quality School characteristics 



We would like to thank Cordula Erne, M.Sc., for her support and Charlotte Holzer, M.Sc., and Manuela Luterbacher, M.Sc., for their work and support to this study.

Compliance with ethical standards

Conflict of interest

None of the authors has a potential conflict of interest.

Supplementary material

586_2019_6211_MOESM1_ESM.pptx (281 kb)
Supplementary material 1 (PPTX 280 kb)


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Copyright information

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

Authors and Affiliations

  1. 1.Department of Psychology, Institute for PsychologyUniversity of BernBernSwitzerland
  2. 2.National Centre of Competence in Research, Affective Sciences, CISAUniversity of GenevaGenevaSwitzerland

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