Pubertal development and growth are prospectively associated with spinal pain in young people (CHAMPS study-DK)
To examine the prospective associations of pubertal development and linear growth with spinal pain frequency and duration in children.
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.
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.
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.
KeywordsPuberty Growth and development Body height Risk factors Back pain
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.
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.
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