Prevalence and associated characteristics of recurrent non-specific low back pain in Zimbabwean adolescents: a cross-sectional study

BMC Musculoskeletal Disorders

Nirmala Naidoo¹  Matthew Chiwaridzo² 

[1] Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Faculty of Health Sciences, Cape Town, South Africa;Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe

关键词: Recurrent non-specific low back pain;    Point prevalence;    Non-specific low back pain;    Lifetime prevalence;    Adolescents;   

Others  :  1091890
DOI  :  10.1186/1471-2474-15-381

 received in 2014-07-25, accepted in 2014-10-28,  发布年份 2014

【 摘 要 】

Background

Until recently, non-specific low back pain (NSLBP) in adolescents was considered a rare phenomenon unlike in adults. The last two decades has shown an increasing amount of research highlighting the prevalence in this age group. Recent studies estimate lifetime prevalence at 7%-80%, point prevalence at 10%-15%, and prevalence of recurrent NSLBP at 13%-36%. In Zimbabwe, there is dearth of literature on the magnitude of the problem in adolescents. Therefore, the aims of the study were to determine the prevalence (lifetime, point, recurrent) and the nature of recurrent NSLBP reported by adolescents in secondary schools.

Methods

A cross-sectional study was conducted using a questionnaire. A cluster sample of 544 adolescents (age 13–19 years) randomly derived from government schools participated in the study. Lifetime prevalence, point prevalence and prevalence of recurrent NSLBP were presented as percentages of the total population. Exact 95% confidence intervals were given. Chi-square test was used to evaluate the effect of gender and age on prevalence.

Results

The students’ response rate was 97.8%. The lifetime prevalence was 42.9% [95% confidence interval = 40.8-44.6] with no significant difference between sexes [χ² (1) =0.006, p = 0.94]. However, NSLBP peaked earlier in female students (13.9 years) than in male students (15 years) [t (226) = 4.21, p < 0.001]. About 10% of the adolescents reported having an episode of NSLBP on the day of the survey. However, female students (14.2%) were more affected on the day [χ² (1) =11.2, p < 0.001]. Twenty-nine percent of the adolescents experienced recurrent NSLBP with 78% experiencing at least three episodes in the last 12 months. On average, recurrent NSLBP reported was mild in intensity (4.8 ± 1.9) on the visual analogue scale (VAS) and short in duration. Recurrent NSLBP was associated with sciatica in 20.9% of adolescents.

Conclusions

NSLBP is a common occurrence among Zimbabwean adolescents in secondary schools. It increases with chronological age and is recurrent in the minority of adolescents. Although much of the symptomatology may be considered benign, the existence of recurrent NSLBP in adolescents before their work-life begins should be a concern to health professionals, teachers and parents.

【 授权许可】

   
2014 Chiwaridzo and Naidoo; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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【 参考文献 】

• [1]Burton AK, Belague F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, Leclerc A, Muller G, Van der Beek AJ: Chapter 2 European guidelines for prevention in low back pain November 2004. Eur Spine J 2006, 15(Suppl 2):136-168.
• [2]Walker BF: The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord 2000, 13:205-217.
• [3]Louw QA, Morris LD, Grimmer-Somers K: The prevalence of low back pain in Africa: a systematic review. BMC Musculoskelet Disord 2007, 8:1-14. BioMed Central Full Text
• [4]Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R: A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012, 64:2028-2037.
• [5]Kjaer P, Wedderkopp N, Korsholm L, Leboeuf-yde C: Prevalence and tracking of back pain from childhood to adolescence. BMC Musculoskelet Disord 2011, 12:1-11.
• [6]Brattberg G: Do pain problems in young school-children persist into early adulthood? A 13-year follow up. Eur J Pain 2004, 8:187-199.
• [7]Watson K, Papageorgiou AC, Jones GT, Taylor S, Symmons DP, Silman AJ, Macfarlane GJ: Low back pain in school-children: occurrence and characteristics. Pain 2002, 97:87-92.
• [8]Jeffries LJ, Milanese SF, Grimmer-Somers KA: Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine 2007, 32:2630-2637.
• [9]Hill JJ, Keating JL: A systematic review of the incidence and prevalence of low back pain in children. Phys Ther Rev 2009, 14:272-285.
• [10]Bejia I, Abid N, Ben- Salem K, Letaief M, Younes M, Touzi M, Bergaoui N: Low back pain in a cohort of 622 Tunisian school-children and adolescents: an epidemiological study. Eur Spine J 2005, 14:331-336.
• [11]Kovacs FM, Mufraggi N, De Real MT G, Lopez J, Gestoso M: Risk factors for non-specific low back pain in school-children and their parents: a population based study. Pain 2003, 103:259-268.
• [12]Sjolie AN: Associations between activities and low back pain in adolescents. Scand J Med Sci Sports 2004, 14:352-359.
• [13]Jones MA, Stratton G, Reily T, Unnithan VB: A school-based survey of recurrent non-specific low back pain prevalence and consequences in children. Health Educ Res 2004, 19:284-289.
• [14]Chiang H, Jacobs K, Orsmond G: Gender-age environmental associates of middle school students’ low back pain. Work 2006, 26:197-206.
• [15]Shehab D, Al-Jarallah K, Al-Ghareeb F, Sanaseeri S, Al-Fadhli M, Habeeb S: Is low back pain prevalent among Kuwait children and adolescents? Med Princ Pract 2004, 13:142-146.
• [16]Ayanniyi O, Mbada CE, Muolokwu CA: Prevalence and profile of back pain in Nigerian adolescents. Med Princ Pract 2011, 20:368-373.
• [17]Jordaan R, Kruger M, Stewart AV, Becker PJ: The association between low back pain, gender, and age in adolescents. S Afr J Physiother 2005, 61:15-20.
• [18]Sjolie AN: Low back pain in adolescents is associated with poor hip mobility and high body mass index. Scand J Med Sci Sports 2004, 14:168-175.
• [19]Gierlach P: Physician perspectives on children’s musculoskeletal and vision disorders in Geneva, Switzerland. [http://www.iea.cc/ECEE/pdfs/PhysicianPerspctvsChldrnsMuscAndVisnDis_Gierlach.pdf webcite]
• [20]Masiero S, Carraro E, Celia A, Sarto D, Ermani M: Prevalence of non-specific low back pain in school-children aged between 13 and 15 years. Acta Paediatr 2008, 97:212-216.
• [21]Stanton TR, Latimer J, Maher CG, Hancock MJ: A modified Delphi approach to standardise low back pain recurrence terminology. Eur Spine J 2011, 14:744-752.
• [22]Burton AK, Clarke RD, McClune TD, Tiloston K: The natural history of low back pain in adolescents. Spine 1996, 21:2323-2328.
• [23]Hestbaek L, Leboeuf-yde C, Kyvik KO: Is co-morbidity in adolescence a predictor for adult low back pain? A prospective study of a young population. BMC Musculoskelet Disord 2006, 7:1-7. BioMed Central Full Text
• [24]Jones GT, Macfarlane GJ: Predicting persistent low back pain in school-children: a prospective cohort study. Arthritis Rheum 2009, 61:1359-1366.
• [25]Bandason T, Rusakaniko S: Prevalence and associated factors of smoking among secondary school students in Harare. Tob Induced Dis 2010, 8:1-9. BioMed Central Full Text
• [26]Prista A, Belague F, Nordin M, Skovron M: Low back pain in Mozambican adolescents. Eur Spine J 2004, 13:341-345.
• [27]Fannuchi GL, Stewart AV, Jordaan R, Becker P: Exercise reduces the intensity and prevalence of low back pain in 12–13 year old children: a randomised trial. Aust J Physiother 2009, 55:97-104.
• [28]Harreby M, Nygaard B, Jessen E, Larsen E, Storr-Paulsen A, Lindahl A, Fisker I, Laegaard E: Risk factors for low back pain in a cohort of 1389 Danish school-children: an epidemiological study. Eur Spine J 1999, 8:444-450.
• [29]Bejia I, Abid N, BenSalem K, Touzi M, Bergaoui N: Reproducibility of a low back pain questionnaire in Tunisian adolescents. Clin Rheumatol 2006, 25:715-720.
• [30]Watson KD, Papageorgiou AC, Jones GT, Taylor S, Symmons DP, Silman AJ, Macfarlane GJ: Low back pain in school-children: the role of mechanical and psychosocial factors. Arch Dis Child 2003, 88:12-17.
• [31]Haraldstad K, Sorum R, Eide H, Natvig G, Helseth S: Pain in children and adolescents: prevalence, impact on daily life and parents’ perception, a school survey. Scand J Caring Sci 2011, 25:27-36.
• [32]Yao W, Luo G, Ai F, Chen Q: Risk factors for non-specific low back pain in Chinese adolescents: a case–control study. Pain Med 2012, 13:1-7.
• [33]Sato T, Ito T, Hirano OM, Kikuchi R, Endo N, Tanabe N: Low back pain in childhood and adolescents: assessment of sports activities. Eur Spine J 2011, 20:94-99.
• [34]Milanese S, Grimmer-Somers K: What is adolescent low back pain? Current definitions used to define the adolescent with low back pain. J Pain Res 2010, 3:57-66.
• [35]Shehab DK, Al-Jarallah KF: Non-specific low back pain in Kuwait children and adolescents: associated factors. J Adolesc Health 2005, 36:32-35.
• [36]Hershkovich O, Friedlander A, Gordon B, Azri H, Derazne E, Tzur D, Shamis A, Afek A: Associations of body mass index and body height with low back pain in 829, 791 adolescents. Am J Epidemiol 2013, 178:1-7.
• [37]Haselgrove CI, Straker L, Smith A, Sullivan P, Perry M, Sloan N: Perceived school bag load, duration of carriage, and method of transport to school are associated with spinal pain in adolescents: an observational study. Aust J Physiother 2008, 54:193-200.
• [38]Grimmer K, Williams M: Gender-age environmental associates of adolescent low back pain. Appl Ergon 2000, 31:343-360.
• [39]Pellise F, Belague F, Rajmil L, Cedraschi C, Aguirre M, Fontecha C, Ferrer M: Prevalence of low back pain and its effect on health-related quality of life in adolescents. Arch Paediatr Adolesc Med 2009, 163:65-71.
• [40]Woolf A, Pfleger B: Burden of major musculoskeletal conditions. Bull World Health Organ 2003, 81:646-656.
• [41]Bockowski L, Sobaniec W, Kulak W, Sendrowski K, Roszkowska M: Low back pain in school-age children: risk factors, clinical features and diagnostic management. Adv Med Sci 2007, 52:221-223.
• [42]Limon S, Valinsky LJ, Ben-shalom Y: Children at risk: risk factors for low back pain in the school-environment. Spine 2004, 29:697-702.
• [43]Yun LJ, Sheng W, Hua HL, Shan Shan W, Lei Y, Shan Fa Y, Li Ping L, Jian Xian W, Di Yan H: Risk factors of low back pain among Chinese occupational population: a case–control study. Biomed Environ Sci 2012, 25:421-429.