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Musculoskeletal Pain in Obese Compared With Healthy-Weight Children

Tsiros, Margarita D. PhD*; Buckley, Jonathan D. PhD*; Howe, Peter R. C. PhD*; Walkley, Jeff PhD; Hills, Andrew P. PhD; Coates, Alison M. PhD*

The Clinical Journal of Pain: July 2014 - Volume 30 - Issue 7 - p 583–588
doi: 10.1097/AJP.0000000000000017
Original Articles

Objectives: To investigate whether obesity is associated with musculoskeletal pain in children.

Materials and Methods: Obese (n=107) and healthy-weight (n=132) 10- to 13-year-old children (132 males, 107 females) participated in an observational case-control study. Children self-reported pain location (excluding abdominal pain), pain intensity (current and prior week), and pain prevalence (overall and lower limb) using the Pediatric Pain Questionnaire. Body composition was assessed (dual-energy x-ray absorptiometry) and children wore an accelerometer for 8 days.

Results: After adjustment for accelerometry (weekly average counts per hour) and socioeconomic status, obese children had more intense pain (worst pain, P=0.006), pain in more locations (P≤0.005), and a higher prevalence of lower limb pain (60% vs. 52% respectively, P=0.012) than healthy-weight children. Significant relationships were observed between body mass index and total pain locations (P≤0.004, unadjusted and adjusted) and worst pain intensity (P≤0.009, adjusted for socioeconomic status/accelerometry). There were no significant relationships between percent body fat and pain variables (unadjusted/adjusted analyses, P=0.262 to 1.0).

Discussion: Obesity in children was associated with increased overall and lower limb musculoskeletal pain, for which body mass index was a stronger predictor than adiposity. Clinicians treating obese children should screen for pain and prescribe exercise programs that take their symptoms into account.

*Nutritional Physiology Research Centre, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA

School of Health Sciences, RMIT University, Melbourne, Vic

Mater Mothers’ Hospital, Mater Research and Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Nathan, QLD, Australia

Present address: Peter R. C. Howe, PhD, Clinical Nutrition Research Centre, University of Newcastle, Callaghan, NSW, 2308, Australia.

The authors declare no conflict of interest. This study was funded by a seeding grant from the Physiotherapy Research Foundation and internal funds (ATN Centre for Metabolic Fitness). M.D.T. was supported by an Australian Post Graduate Award and the Nutritional Physiology Research Centre, Adelaide, SA, Australia. Supported by the Australian Technology Network Centre for Metabolic Fitness and the Physiotherapy Research Foundation, Camberwell, Vic, Australia.

Reprints: Margarita D. Tsiros, PhD, Nutritional Physiology Research Centre, School of Health Sciences, University of South Australia, P.O. Box 2471, Adelaide, SA 5001, Australia (e-mail:

Received January 8, 2013

Accepted August 2, 2013

© 2014 by Lippincott Williams & Wilkins