30 % of all Danish children aged 11- 14 years suffer from moderate spinal pain. The pain is more common among girls than boys and worsens as the children age. Furthermore, there is a clear social gradient in the occurrence of spinal pain, according to new research carried out by researchers from the University of Copenhagen, the University of Southern Denmark and NIKKB.
Spinal pain is a significant problem for many children and adolescents and should be taken seriously for several reasons. Increasingly, evidence points to spinal pain originating around the age of 11 to 14 years and increasing as the children grow older and reach adult level around the age of 18. Adolescents who suffer from spinal pain at the age of 18 risk that the spinal pain becomes chronic. Several epidemiological studies have characterised a previous history of spinal pain as the most important indicator of spinal pain later in life.
Children and adolescents with spinal pain experience increased healthcare utilisation, absenteeism or impairment in school as well as restrictions in their physical activity. At the same time, children with spinal pain often experience other physical and mental health issues, and family and social factors are presumed to be important for health and pain experiences in childhood.
The study includes data from 46,726 children from the Danish National Birth Cohort. The children answered a questionnaire about spinal pain (neck, mid spinal, low spinal), when they were 11 years old, and the researchers classified the pain according to severity. In addition, the researchers identified socio-demographic data on the children and their parents and used statistic models to compute a possible connection between spinal pain and social factors.
According to the study, children who reported spinal pain most often reported neck pain. Moderate and severe spinal pain occurs more often among girls than among boys (14 % v. 9,8 %) and the occurrence increases as the children grow older.
It is likely that some of the underlying mechanisms which can trigger spinal pain are found in the child’s family environment and that they influence the child’s vulnerability and well-being. It could be the parents’ behaviour in connection with pain, chronic pain, the parents’ mental health and behavioural problems, e.g. depression anxiety or use of drugs, or other psychosocial and lifestyle factors. These factors might influence psychological symptoms in the child, e.g. sleep problems, feeling low, nervousness, general well-being and loneliness; all factors that have related to spinal pain in children before.
Children in less educated and low-income families were more likely to report severe spinal pain compared to children from high status families.
Children who grow up in disadvantaged families are predisposed to health adversities and have a larger likelihood of experiencing spinal pain compared to children in well-off families. The same is true for children without biological siblings and children in separated families; children in this group report moderate and severe spinal pain more often.
The research was carried out by Anne Cathrine Jørgensen (University of Copenhagen), Lise Hestbæk (University of Southern Denmark, NIKKB), Per Kragh Andersen (University of Copenhagen) and Anne-Marie Nybo Andersen (University of Copenhagen)
Epidemiology of spinal pain in children: a study within the Danish National Birth Cohort. Joergensen, A.C., Hestbaek, L., Andersen, P.K. et al. Eur J Pediatr (2019) https://link.springer.com/article/10.1007%2Fs00431-019-03326-7