< Back to previous page


Factors associated with low back pain before pubertal peak growth

Book Contribution - Book Abstract Conference Contribution

Introduction. The multifactorial nature of low back pain (LBP) is well recognized with respect to its causes and associated factors. Explanatory models for LBP built on analyses that are suited to deal with a large number of correlated factors are lacking. Since adult LBP might originate in childhood/adolescence, thorough understanding of idiopathic adolescent LBP is needed. This study provides a comprehensive multivariable approach to explain LBP in young adolescents before pubertal peak growth. It explores which factors from multiple domains are independently associated with LBP, thereby using a novel multivariable analysis method that is well suited to deal with large numbers of correlated factors relative to sample size. Purpose/Aim. To investigate the factors related to the 1-month period prevalence of LBP in young adolescents, thereby considering potential correlates from the physical, sociodemographic, lifestyle, psychosocial and comorbid pain domains. Materials and Methods. A school-based cross-sectional study was conducted of 842 adolescents before pubertal peak growth in Flanders, Belgium. Study participants (girls aged 10.6±0.47 years; boys aged 12.6±0.54 years) underwent physical examination and completed questionnaires to obtain 69 putative (phenotypic) risk factors for LBP. With consideration for potential sex differences in associations, multivariable analysis was used to simultaneously evaluate contributions of all variables collected in the 5 domains of interest.Results. A significantly higher odds of LBP was shown for having high levels of psychosomatic complaints (odds ratio [OR], 4.4; 95% confidence interval [CI]: 1.6-11.9; p=.004; variable importance score (VIS)=0.99), a high lumbar lordotic apex (OR, 0.7; 95% CI, 0.5-1.0; p=.04; VIS=0.85), retroversed pelvis in habitual standing (OR, 0.9; 95% CI, 0.9-1.0; p=.03; VIS=0.71), introverted personality (OR, 0.9; 95% CI, 0.8-1.0; p=.002; VIS=0.93) and high levels of negative over positive affect. All the study variables accounted for 21% of the variance in LBP. Conclusions. Psychosomatic symptoms had the strongest association with 1-month period prevalence of LBP 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. The lifestyle and sociodemographic domains did not turn out to be important in explaining LBP prevalence. A substantial proportion of unexplained variation in LBP was found. As this is a cross-sectional analysis, conclusions regarding temporal or causal relationships between LBP and putative risk factors cannot be made. The results of this study, however, add much to our understanding of the relative importance and predictive ability of (pre-defined groups of) factors associated with LBP in otherwise healthy pre-/early adolescents.
Book: Low Back and Pelvic Girdle Pain, 9th Interdisciplinary world congress, Abstracts
Number of pages: 1
Publication year:2016