European Spine Journal

, Volume 25, Issue 9, pp 2809–2821 | Cite as

Multivariable modeling of factors associated with spinal pain in young adolescence

  • Mieke DolphensEmail author
  • Stijn Vansteelandt
  • Barbara Cagnie
  • Andry Vleeming
  • Jo Nijs
  • Guy Vanderstraeten
  • Lieven Danneels
Original Article



To investigate the factors related to the 1-month period prevalence of low back pain (LBP), neck pain (NP) and thoracic spine pain (TSP) in young adolescents, thereby considering potential correlates from the physical, sociodemographic, lifestyle, psychosocial and comorbid pain domains.


In this cross-sectional baseline study, 69 factors potentially associated with spinal pain were assessed among 842 healthy adolescents before pubertal peak growth. With consideration for possible sex differences in associations, multivariable analysis was used to simultaneously evaluate contributions of all variables collected in the five domains.


A significantly higher odds of LBP was shown for having high levels of psychosomatic complaints (odds ratio: 4.4; 95 % confidence interval: 1.6–11.9), a high lumbar lordotic apex, retroversed pelvis, introverted personality, and high levels of negative over positive affect. Associations with a higher prevalence and odds of NP were found for psychosomatic complaints (7.8; 2.5–23.9), TSP in the last month (4.9; 2.2–10.8), backward trunk lean, high levels of negative over positive affect and depressed mood. Having experienced LBP (2.7; 1.3–5.7) or NP (5.5; 2.6–11.8) in the preceding month was associated with a higher odds of TSP, as were low self-esteem, excessive physical activity, sedentarism and not achieving the Fit-norm.


Psychosomatic symptoms and pain comorbidities had the strongest association with 1-month period prevalence of spinal pain in young adolescents, followed by factors from the physical and psychosocial domains. The role that “physical factors” play in non-adult spinal pain may have been underestimated by previous studies.


Adolescent Spinal pain Multivariate analysis Back pain Neck pain 



We are indebted to the pupils, parents and staff of the schools and pupil guidance centers for taking part in this study and to Mr. Roel De Ridder, Ms. Gizem Îrem Güvendik, and Ms. Heidi Bauters for their assistance in data collection.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest. The authors had full control of all primary data. The authors agree to allow the journal to review our data if requested.

Supplementary material

586_2016_4629_MOESM1_ESM.pdf (47 kb)
Supplementary material 1 (PDF 46 kb)
586_2016_4629_MOESM2_ESM.pdf (27 kb)
Supplementary material 2 (PDF 27 kb)


  1. 1.
    Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2163–2196PubMedCrossRefGoogle Scholar
  2. 2.
    Dagenais S, Caro J, Haldeman S (2008) A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J 8:8–20PubMedCrossRefGoogle Scholar
  3. 3.
    Maniadakis N, Gray A (2000) The economic burden of back pain in the UK. Pain 84:95–103PubMedCrossRefGoogle Scholar
  4. 4.
    Borghouts JA, Koes BW, Vondeling H, Bouter LM (1999) Cost-of-illness of neck pain in The Netherlands in 1996. Pain 80:629–636PubMedCrossRefGoogle Scholar
  5. 5.
    Roth-Isigkeit A, Thyen U, Stoven H, Schwarzenberger J, Schmucker P (2005) Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics 115:e152–e162PubMedCrossRefGoogle Scholar
  6. 6.
    Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C (2006) The course of low back pain from adolescence to adulthood: 8-year follow-up of 9600 twins. Spine 31:468–472PubMedCrossRefGoogle 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? A 25-year prospective cohort study of 640 school children. Spine 20:2298–2302PubMedCrossRefGoogle Scholar
  8. 8.
    Siivola SM, Levoska S, Latvala K, Hoskio E, Vanharanta H, Keinänen-Kiukaanniemi S (2004) Predictive factors for neck and shoulder pain: a longitudinal study in young adults. Spine 29:1662–1669PubMedCrossRefGoogle Scholar
  9. 9.
    Jones GT, Watson KD, Silman AJ, Symmons DP, Macfarlane GJ (2003) Predictors of low back pain in British schoolchildren: a population-based prospective cohort study. Pediatrics 111:822–828PubMedCrossRefGoogle Scholar
  10. 10.
    Hanvold TN, Veiersted KB, Waersted M (2010) A prospective study of neck, shoulder, and upper back pain among technical school students entering working life. J Adolesc Health 46:488–494PubMedCrossRefGoogle Scholar
  11. 11.
    Brattberg G (2004) Do pain problems in young school children persist into early adulthood? A 13-year follow-up. Eur J Pain 8:187–199PubMedCrossRefGoogle Scholar
  12. 12.
    Sjolie AN (2004) Persistence and change in nonspecific low back pain among adolescents: a 3-year prospective study. Spine 29:2452–2457PubMedCrossRefGoogle Scholar
  13. 13.
    Ståhl M, Kautiainen H, El-Metwally A, Häkkinen A, Ylinen J, Salminen JJ et al (2008) Non-specific neck pain in schoolchildren: prognosis and risk factors for occurrence and persistence. A 4-year follow-up study. Pain 137:316–322PubMedCrossRefGoogle Scholar
  14. 14.
    Balagué F, Dudler J, Nordin M (2003) Low-back pain in children. Lancet 361:1403–1404PubMedCrossRefGoogle Scholar
  15. 15.
    Briggs AM, Smith AJ, Straker LM, Bragge P (2009) Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord 10:77PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Petersen S, Brulin C, Bergström E (2006) Recurrent pain symptoms in young schoolchildren are often multiple. Pain 121:145–150PubMedCrossRefGoogle Scholar
  17. 17.
    Myrtveit SM, Sivertsen B, Skogen JC, Frostholm L, Stormark KM, Hysing M (2014) Adolescent neck and shoulder pain-the association with depression, physical activity, screen-based activities, and use of health care services. J Adolesc Health 55:366–372PubMedCrossRefGoogle Scholar
  18. 18.
    Murphy S, Buckle P, Stubbs D (2007) A cross-sectional study of self-reported back and neck pain among English schoolchildren and associated physical and psychological risk factors. Appl Ergon 38:797–804PubMedCrossRefGoogle Scholar
  19. 19.
    Watson KD, Papageorgiou AC, Jones GT, Taylor S, Symmons DP, Silman AJ et al (2003) Low back pain in schoolchildren: the role of mechanical and psychosocial factors. Arch Dis Child 88:12–17PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Szpalski M, Gunzburg R, Balagué F, Nordin M, Mélot C (2002) A 2-year prospective longitudinal study on low back pain in primary school children. Eur Spine J 11:459–464PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    O’Sullivan PB, Smith AJ, Beales DJ, Straker LM (2011) Association of biopsychosocial factors with degree of slump in sitting posture and self-report of back pain in adolescents: a cross-sectional study. Phys Ther 91:470–483PubMedCrossRefGoogle Scholar
  22. 22.
    Balagué F, Skovron ML, Nordin M, Dutoit G, Pol LR, Waldburger M (1995) Low back pain in schoolchildren. A study of familial and psychological factors. Spine 20:1265–1270PubMedCrossRefGoogle Scholar
  23. 23.
    El-Metwally A, Mikkelsson M, Ståhl M, Macfarlane GJ, Jones GT, Pulkkinen L et al (2008) Genetic and environmental influences on non-specific low back pain in children: a twin study. Eur Spine J 17:502–508PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Kovacs FM, Gestoso M, Gil del Real MT, López J, Mufraggi N, Méndez JI (2003) Risk factors for non-specific low back pain in schoolchildren and their parents: a population based study. Pain 103:259–268PubMedCrossRefGoogle Scholar
  25. 25.
    Steele S, Grimmer K, Williams M, Gill T (2001) Vertical anthropometric measures and low back pain in adolescents. Physiother Res Int 6:94–105PubMedCrossRefGoogle Scholar
  26. 26.
    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 11–22 years. Eur Spine J 14:595–598PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Rees CS, Smith AJ, O’Sullivan PB, Kendall GE, Straker LM (2011) Back and neck pain are related to mental health problems in adolescence. BMC Public Health 11:382PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Poussa MS, Heliövaara MM, Seitsamo JT, Könönen MH, Hurmerinta KA, Nissinen MJ (2005) Predictors of neck pain: a cohort study of children followed up from the age of 11–22 years. Eur Spine J 14:1033–1036PubMedCrossRefGoogle Scholar
  29. 29.
    Salminen JJ (1984) The adolescent back. A field survey of 370 Finnish school children. Acta Paediatr Scand 73(Suppl 315):1–122CrossRefGoogle Scholar
  30. 30.
    Hertzberg A (1985) Prediction of cervical and low-back pain based on routine school health examinations. A nine- to twelve-year follow-up study. Scand J Prim Health Care 3:247–253PubMedCrossRefGoogle Scholar
  31. 31.
    Shan Z, Deng G, Li J, Li Y, Zhang Y, Zhao Q (2014) How schooling and lifestyle factors effect neck and shoulder pain? A cross-sectional survey of adolescents in China. Spine 39:E276–E283PubMedCrossRefGoogle Scholar
  32. 32.
    Mogensen AM, Gausel AM, Wedderkopp N, Kjaer P, Leboeuf-Yde C (2007) Is active participation in specific sport activities linked with back pain? Scand J Med Sci Sports 17:680–686PubMedCrossRefGoogle Scholar
  33. 33.
    Lynch AM, Kashikar-Zuck S, Goldschneider KR, Jones BA (2006) Psychosocial risks for disability in children with chronic back pain. J Pain 7:244–251PubMedCrossRefGoogle Scholar
  34. 34.
    Feldman ED, Shrier I, Rossignol M, Abenhaim L (2002) Risk factors for the development of neck and upper limb pain in adolescents. Spine 27:523–528CrossRefGoogle Scholar
  35. 35.
    Balagué F, Troussier B, Salminen JJ (1999) Non-specific low back pain in children and adolescents: risk factors. Eur Spine J 8:429–438PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Chen SM, Liu MF, Cook J, Bass S, Lo SK (2009) Sedentary lifestyle as a risk factor for low back pain: a systematic review. Int Arch Occup Environ Health 82:797–806PubMedCrossRefGoogle Scholar
  37. 37.
    Dunn KM, Hestbaek L, Cassidy JD (2013) Low back pain across the life course. Best Pract Res Clin Rheumatol 27:591–600PubMedCrossRefGoogle Scholar
  38. 38.
    Leboeuf-Yde C (2004) Back pain—individual and genetic factors. J Electromyogr Kinesiol 14:129–133PubMedCrossRefGoogle Scholar
  39. 39.
    Hill JJ, Keating JL (2010) Risk factors for the first episode of low back pain in children are infrequently validated across samples and conditions: a systematic review. J Physiother 56:237–244PubMedCrossRefGoogle Scholar
  40. 40.
    Prins Y, Crous L, Louw QA (2008) A systematic review of posture and psychosocial factors as contributors to upper quadrant musculoskeletal pain in children and adolescents. Physiother Theory Pract 24:221–242PubMedCrossRefGoogle Scholar
  41. 41.
    Sitthipornvorakul E, Janwantanakul P, Purepong N, Pensri P, van der Beek AJ (2011) The association between physical activity and neck and low back pain: a systematic review. Eur Spine J 20:677–689PubMedCrossRefGoogle Scholar
  42. 42.
    Pollock CM, Harries RL, Smith AJ, Straker LM, Kendall GE, O’Sullivan PB (2011) Neck/shoulder pain is more strongly related to depressed mood in adolescent girls than in boys. Man Ther 16:246–251PubMedCrossRefGoogle Scholar
  43. 43.
    Gilkey DP, Keefe TJ, Peel JL, Kassab OM, Kennedy CA (2010) Risk factors associated with back pain: a cross-sectional study of 963 college students. J Manip Physiol Ther 33:88–95CrossRefGoogle Scholar
  44. 44.
    Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR (1996) A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 49:1373–1379PubMedCrossRefGoogle Scholar
  45. 45.
    Ståhl M, Mikkelsson M, Kautiainen H, Häkkinen A, Ylinen J, Salminen JJ (2004) Neck pain in adolescence. A 4-year follow-up of pain-free preadolescents. Pain 110:427–431PubMedCrossRefGoogle Scholar
  46. 46.
    Mikkelsson M, Salminen JJ, Kautiainen H (1997) Non-specific musculoskeletal pain in preadolescents. Prevalence and 1-year persistence. Pain 73:29–35PubMedCrossRefGoogle Scholar
  47. 47.
    Hoftun GB, Romundstad PR, Zwart JA, Rygg M (2011) Chronic idiopathic pain in adolescence—high prevalence and disability: the young HUNT Study 2008. Pain 152:2259–2266PubMedCrossRefGoogle Scholar
  48. 48.
    Vikat A, Rimpelä M, Salminen JJ, Rimpelä A, Savolainen A, Virtanen SM (2000) Neck or shoulder pain and low back pain in Finnish adolescents. Scand J Public Health 28:164–173PubMedCrossRefGoogle Scholar
  49. 49.
    Diepenmaat AC, van der Wal MF, de Vet HC, Hirasing RA (2006) Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents. Pediatrics 117:412–416PubMedCrossRefGoogle Scholar
  50. 50.
    Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J et al (2008) The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000–2010 task force on neck pain and its associated disorders. Spine 33:S39–S51PubMedCrossRefGoogle Scholar
  51. 51.
    Fillingim RB, Hastie BA, Ness TJ, Glover TL, Campbell CM, Staud R (2005) Sex-related psychological predictors of baseline pain perception and analgesic responses to pentazocine. Biol Psychol 69:97–112PubMedCrossRefGoogle Scholar
  52. 52.
    Kjaer P, Wedderkopp N, Korsholm L, Leboeuf-Yde C (2011) Prevalence and tracking of back pain from childhood to adolescence. BMC Musculoskelet Disord 12:98PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Brattberg G (1994) The incidence of back pain and headache among Swedish school children. Qual Life Res 3:S27–S31PubMedCrossRefGoogle Scholar
  54. 54.
    Brink Y, Crous LC, Louw QA, Grimmer-Somers K, Schreve K (2009) The association between postural alignment and psychosocial factors to upper quadrant pain in high school students: a prospective study. Man Ther 14:647–653PubMedCrossRefGoogle Scholar
  55. 55.
    Niemi SM, Levoska S, Rekola KE, Keinanen-Kiukaanniemi SM (1997) Neck and shoulder symptoms of high school students and associated psychosocial factors. J Adolesc Health 20:238–242PubMedCrossRefGoogle Scholar
  56. 56.
    Dolphens M, Cagnie B, Vleeming A, Vanderstraeten G, Danneels L (2013) Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading. J Anat 223:629–640PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Brink Y, Louw QA (2013) A systematic review of the relationship between sitting and upper quadrant musculoskeletal pain in children and adolescents. Man Ther 18:281–288PubMedCrossRefGoogle Scholar
  58. 58.
    Dolphens M, Cagnie B, Coorevits P, Vleeming A, Vanderstraeten G, Danneels L (2014) Classification system of the sagittal standing alignment in young adolescent girls. Eur Spine J 23:216–225PubMedCrossRefGoogle Scholar
  59. 59.
    Jeffries LJ, Milanese SF, Grimmer-Somers KA (2007) Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine 32:2630–2637PubMedCrossRefGoogle Scholar
  60. 60.
    LeResche L, Mancl LA, Drangsholt MT, Saunders K, Korff MV (2005) Relationship of pain and symptoms to pubertal development in adolescents. Pain 118:201–209PubMedCrossRefGoogle Scholar
  61. 61.
    Patton GC, Viner R (2007) Pubertal transitions in health. Lancet 369:1130–1139PubMedCrossRefGoogle Scholar
  62. 62.
    Wedderkopp N, Andersen LB, Froberg K, Leboeuf-Yde C (2005) Back pain reporting in young girls appears to be puberty-related. BMC Musculoskelet Disord 6:52PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Malina RM, Bouchard C, Bar-Or O (2004) Growth, maturation, and physical activity. Human Kinetics, ChampaignGoogle Scholar
  64. 64.
    Dolphens M, Cagnie B, Coorevits P, Vanderstraeten G, Cardon G, D’Hooge R et al (2012) Sagittal standing posture and its association with spinal pain: a school-based epidemiological study of 1196 Flemish adolescents before age at peak height velocity. Spine 37:1657–1666PubMedCrossRefGoogle Scholar
  65. 65.
    Staes F, Stappaerts K, Vertommen H, Everaert D, Coppieters M (1999) Reproducibility of a survey questionnaire for the investigation of low back problems in adolescents. Acta Paediatr 88:1269–1273PubMedCrossRefGoogle Scholar
  66. 66.
    Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240–1243PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Cole TJ, Flegal KM, Nicholls D, Jackson AA (2007) Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 335:194PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Dolphens M, Cagnie B, Coorevits P, Vleeming A, Danneels L (2013) Classification system of the normal variation in sagittal standing plane alignment: a study among young adolescent boys. Spine 38:E1003–E1012PubMedCrossRefGoogle Scholar
  69. 69.
    Beighton PH, Grahame R, Bird HA (1999) Hypermobility of joints. Springer, LondonCrossRefGoogle Scholar
  70. 70.
    Mirwald RL, Baxter-Jones AD, Bailey DA, Beunen GP (2002) An assessment of maturity from anthropometric measurements. Med Sci Sports Exerc 34:689–694PubMedCrossRefGoogle Scholar
  71. 71.
    Saskatchewan Childhood Growth and Development (SCGD) Research group. Childhood growth utility programs. University of Saskatchewan, College of Kinesiology, Saskatoon, Saskatchewan, Canada. Accessed 30 March 2013
  72. 72.
    Sherar LB, Mirwald RL, Baxter-Jones AD, Thomis M (2005) Prediction of adult height using maturity-based cumulative height velocity curves. J Pediatr 147:508–514PubMedCrossRefGoogle Scholar
  73. 73.
    Ganzeboom HBG, Treiman DJ (1996) Internationally comparable measures of occupational status for the 1988 International Standard Classification of Occupations. Soc Sci Res 25:201–239CrossRefGoogle Scholar
  74. 74.
    Philippaerts RM, Matton L, Wijndaele K, Balduck AL, De Bourdeaudhuij I, Lefevre J (2006) Validity of a physical activity computer questionnaire in 12- to 18-year-old boys and girls. Int J Sports Med 27:131–136PubMedCrossRefGoogle Scholar
  75. 75.
    Verstraete SJM, Cardon GM, Trost SG, De Bourdeaudhuij IMM (2006) Reliability and validity of a questionnaire to measure usual physical activity in children with and without parental assistance. In: Verstraete SJM. The effectiveness of an intervention promoting physical activity in elementary school children. Dissertation, Ghent UniversityGoogle Scholar
  76. 76.
    Hildebrandt VH, Chorus AMJ, Stubbe JH (2010) Trend report of physical activity and health 2008/2009. TNO Quality of Life, LeidenGoogle Scholar
  77. 77.
    Biddle S, Sallis J, Cavill N (1998) Young and active? Young people and health-enhancing physical activity: evidence and implications. Health Education Authority, LondonGoogle Scholar
  78. 78.
    Harter S (1988) Manual for the Self-Perception Profile for Adolescents. University of Denver, DenverGoogle Scholar
  79. 79.
    Treffers PDA, Goedhart AW, Veerman JW, Van den Bergh BRH, Ackaert L, de Rycke L (2002) Handleiding Competentiebelevingsschaal voor Adolescenten (CBSA) [Manual Self-Perception Profile for Adolescents (SPPA)]. Swets and Zeitlinger, LisseGoogle Scholar
  80. 80.
    Wichstrøm L (1995) Harter’s Self-Perception Profile for Adolescents: reliability, validity, and evaluation of the question format. J Pers Assess 65:100–116PubMedCrossRefGoogle Scholar
  81. 81.
    Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, PrincetonCrossRefGoogle Scholar
  82. 82.
    Franck E, De Raedt R, Barbez C, Rosseel Y (2008) Psychometric properties of the Dutch Rosenberg Self-Esteem Scale. Psychol Belg 48:25–35CrossRefGoogle Scholar
  83. 83.
    Van Dijl H, Wilde G (1982) Handleiding bij de Amsterdamse Biografische Vragenlijst voor Kinderen, ABVK, en de Korte Amsterdamse Biografische vragenlijst voor Kinderen, KABVK [Manual Amsterdam Biographical Questionnaire for Children and Short Amsterdam Biographical Questionnaire for Children]. Van Rossen, AmsterdamGoogle Scholar
  84. 84.
    Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54:1063–1070PubMedCrossRefGoogle Scholar
  85. 85.
    Bradburn NM (1969) The structure of psychological well-being. Aldine, ChicagoGoogle Scholar
  86. 86.
    De Wit CAM (1987) Depressie Vragenlijst voor Kinderen, DVK en KDVK [Depression Questionnaire for Children, DQC and SDQC]. Acco, Amersfoort/LeuvenGoogle Scholar
  87. 87.
    Diener E, Emmons RA, Larsen RJ, Griffin S (1985) The Satisfaction With Life Scale. J Pers Assess 49:71–75PubMedCrossRefGoogle Scholar
  88. 88.
    Pavot W, Diener E, Colvin CR, Sandvik E (1991) Further validation of the Satisfaction with Life Scale: evidence for the cross-method convergence of well-being measures. J Pers Assess 57:149–161PubMedCrossRefGoogle Scholar
  89. 89.
    Ryan RM, Frederick C (1997) On energy, personality, and health: subjective vitality as a dynamic reflection of well-being. J Pers 65:529–565PubMedCrossRefGoogle Scholar
  90. 90.
    Armsden GC, Greenberg MT (1987) The inventory of parent and peer attachment: individual differences and their relationship to psychological well-being in adolescence. J Youth Adolesc 16:427–454PubMedCrossRefGoogle Scholar
  91. 91.
    Noom MJ, Dekovic M, Meeus WH (1999) Autonomy, attachment and psychosocial adjustment during adolescence: a double-edged sword? J Adolesc 22:771–783PubMedCrossRefGoogle Scholar
  92. 92.
    Victoir A (2006) DIGGing into adolescents’ health behaviours: From measurement to targeting. Dissertation, Katholieke Universiteit LeuvenGoogle Scholar
  93. 93.
    Huang J, Breheny P, Ma S (2012) A selective review of group selection in high-dimensional models. Stat Sci 27:481–499CrossRefGoogle Scholar
  94. 94.
    Firth D (1993) Bias reduction of maximum likelihood estimates. Biometrika 80:27–38CrossRefGoogle Scholar
  95. 95.
    Hartvigsen J, Davidsen M, Hestbaek L, Sogaard K, Roos EM (2013) Patterns of musculoskeletal pain in the population: a latent class analysis using a nationally representative interviewer-based survey of 4817 Danes. Eur J Pain 17:452–460PubMedCrossRefGoogle Scholar
  96. 96.
    Beales DJ, Smith AJ, O’Sullivan PB, Straker LM (2012) Low back pain and comorbidity clusters at 17 years of age: a cross-sectional examination of health-related quality of life and specific low back pain impacts. J Adolesc Health 50:509–516PubMedCrossRefGoogle Scholar
  97. 97.
    Chaléat-Valayer E, Mac-Thiong JM, Paquet J, Berthonnaud E, Siani F, Roussouly P (2011) Sagittal spino-pelvic alignment in chronic low back pain. Eur Spine J 20:634–640PubMedPubMedCentralCrossRefGoogle Scholar
  98. 98.
    Jackson RP, McManus AC (1994) Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine 19:1611–1618PubMedCrossRefGoogle Scholar
  99. 99.
    Egger HL, Costello EJ, Erkanli A, Angold A (1999) Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches. J Am Acad Child Adolesc Psychiatry 38:852–860PubMedCrossRefGoogle Scholar
  100. 100.
    Linton SJ (2000) A review of psychological risk factors in back and neck pain. Spine 25:1148–1156PubMedCrossRefGoogle Scholar
  101. 101.
    Pincus T, McCracken LM (2013) Psychological factors and treatment opportunities in low back pain. Best Pract Res Clin Rheumatol 27:625–635PubMedCrossRefGoogle Scholar
  102. 102.
    Power C, Frank J, Hertzman C, Schierhout G, Li L (2001) Predictors of low back pain onset in a prospective British study. Am J Public Health 91:1671–1678PubMedPubMedCentralCrossRefGoogle Scholar
  103. 103.
    Marras WS, Davis KG, Heaney CA, Maronitis AB, Allread WG (2000) The influence of psychosocial stress, gender, and personality on mechanical loading of the lumbar spine. Spine 25:3045–3054PubMedCrossRefGoogle Scholar
  104. 104.
    Hanna T (1988) Somatics: Reawakening the mind’s control of movement, flexibility, and health. Addison-Wesley Publishing Company, RochesterGoogle Scholar
  105. 105.
    Trivedi MH (2004) The link between depression and physical symptoms. Prim Care Companion J Clin Psychiatry 6:S12–S16Google Scholar
  106. 106.
    Von Korff M, Simon G (1996) The relationship between pain and depression. Br J Psychiatry 168:101–108Google Scholar
  107. 107.
    Lu F, Huo Y, Li M, Chen H, Liu F, Wang Y et al (2014) Relationship between personality and gray matter volume in healthy young adults: a voxel-based morphometric study. PLoS One 9:e88763PubMedPubMedCentralCrossRefGoogle Scholar
  108. 108.
    Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC (2007) The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull 133:581–624PubMedCrossRefGoogle Scholar
  109. 109.
    Bair MJ, Robinson RL, Katon W, Kroenke K (2003) Depression and pain comorbidity: a literature review. Arch Intern Med 163:2433–2445PubMedCrossRefGoogle Scholar
  110. 110.
    Staes F, Stappaerts K, Lesaffre E, Vertommen H (2003) Low back pain in Flemish adolescents and the role of perceived social support and effect on the perception of back pain. Acta Paediatr 92:444–451PubMedCrossRefGoogle Scholar
  111. 111.
    Bartlett JW, Carpenter JR, Tilling K, Vansteelandt S (2014) Improving upon the efficiency of complete case analysis when covariates are MNAR. Biostatistics 15:719–730PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Mieke Dolphens
    • 1
    Email author
  • Stijn Vansteelandt
    • 2
  • Barbara Cagnie
    • 1
  • Andry Vleeming
    • 1
    • 3
  • Jo Nijs
    • 4
  • Guy Vanderstraeten
    • 1
    • 5
  • Lieven Danneels
    • 1
  1. 1.Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
  2. 2.Department of Applied Mathematics, Computer Science and Statistics, Faculty of SciencesGhent UniversityGhentBelgium
  3. 3.Department of Anatomy, Center for Excellence in the Neurosciences, Medical FacultyUniversity of New EnglandBiddefordUSA
  4. 4.Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and PhysiotherapyVrije Universiteit BrusselBrusselsBelgium
  5. 5.Department of Physical and Rehabilitation Medicine, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium

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