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Spinal pain and co-occurrence with stress and general well-being among young adolescents: a study within the Danish National Birth Cohort


This study aims to describe the patterns in low back, mid back, and neck pain complaints in young adolescents from the Danish National Birth Cohort (DNBC) and to investigate the co-occurrence of spinal pain and stress and general well-being, respectively. Cross-sectional data from the 11-year follow-up of DNBC were used. As part of a web-based survey, a total of 45,371 young adolescents between 10 and 14 years old completed the Young Spine Questionnaire, the Stress in Children Questionnaire, and a one-item question on general well-being. Associations between spinal pain and, respectively, stress and general well-being were estimated by means of multiple logistic regression models. Almost one fifth of boys and one quarter of girls reported spinal pain. Compared with adolescents who reported no stress, adolescents reporting medium and high values of stress had odds ratios (OR) of 2.19 (95% CI 2.08–2.30) and 4.73 (95% CI 4.28–5.23), respectively, of reporting spinal pain (adjusted for age, gender, and maternal education). Adolescents who reported poor general well-being had an OR of 2.50 (95% CI 2.31–2.72) for reporting spinal pain compared to adolescents with good general well-being.

Conclusion: Spinal pain is a common complaint among young adolescents and co-occurs with stress and poor general well-being. The mutual dependency between the factors remained to be explained.

What is Known:
The prevalence of spinal pain increases rapidly during childhood and adolescence, but different measurement instruments result in great variation in the estimates of spinal pain in children and adolescents.
Some studies have shown that different psychosocial measures are associated with spinal pain in children and adolescents.
What is New:
Spinal pain, as measured by the newly developed and validated Young Spine Questionnaire, is a common complaint in young adolescents aged 10–14 years.
Spinal pain in young adolescents co-occurs with stress and poor general well-being.

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Fig. 1
Fig. 2



Danish National Birth Cohort


Odds ratio


The revised version of the Faces Pain Scale


Standard deviation


Strengths and Difficulties Questionnaire


Stress in Children


Young Spine Questionnaire

95% CI:

95% confidence intervals


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The Danish National Research Foundation established the Danish Epidemiology Science Centre, where the Danish National Birth Cohort was initiated. The cohort is furthermore a result of a major grant from this foundation. Additional support for the DNBC is obtained from the Pharmacy Foundation, the Egmont Foundation, the March Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation. The DNBC 11-year follow-up was supported by grants from the Danish Council for Independent Research (DFF) and the Lundbeck Foundation.

Author information




Sandra Elkjær Stallknecht: Ms. Stallknecht analyzed the data and wrote the first draft of the manuscript.

Katrine Strandberg-Larsen: Ms. Strandberg-Larsen made substantial contributions to conception and design as well as analysis and interpretation of data, and reviewed and revised the manuscript.

Lise Hestbæk: Ms. Hestbæk developed the Young Spine Questionnaire, made substantial contributions to interpretation of results, and reviewed and revised the manuscript.

Anne-Marie Nybo Andersen: Ms. Andersen made substantial contributions to interpretation of results and reviewed and revised the manuscript.

All authors conceptualized and designed this study. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Sandra Elkjær Stallknecht.

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This particular work was supported by the University of Copenhagen, the Danish Council for Independent Research (DFF), and the Lundbeck Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all mothers included in the study and children were invited to the study through an invitation to the mother.

Additional information

Communicated by Communicated by Mario Bianchetti

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Stallknecht, S.E., Strandberg-Larsen, K., Hestbæk, L. et al. Spinal pain and co-occurrence with stress and general well-being among young adolescents: a study within the Danish National Birth Cohort. Eur J Pediatr 176, 807–814 (2017).

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  • Back pain
  • Lumbar pain
  • Thoracic pain
  • Neck pain
  • School children