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Factors Affecting Low Back Pain in Adolescents

Korovessis, Panagiotis MD, PhD; Repantis, Thomas MD; Baikousis, Andreas MD

Journal of Spinal Disorders & Techniques: December 2010 - Volume 23 - Issue 8 - p 513–520
doi: 10.1097/BSD.0b013e3181bf99c6
Original Articles

Study Design Prospective multifactorial study on low back pain (LBP) in adolescents.

Background Data Most studies on LBP have focused on adults although many investigations have shown that the roots of LBP lie in adolescence. Several mechanical, physical, and behavioral factors have been associated with nonspecific LBP in adolescents.

Objective To investigate the effect of all previously reported parameters together with psychological and psychosocial factors using advanced statistics, on LBP in adolescents aged 15 to 19 years.

Material and Methods Six hundred and eighty-eight students aged 16±1 years from 5 randomly selected high schools participated in this study and completed a questionnaire containing questions on daily activity, backpack carrying, psychological and psychosocial behavior. Anthropometric data as well as biplane spinal curvatures together with questionnaire results were included in the analysis using advanced statistics.

Results LBP reported 41% of the participants. Generally, statistically significant correlations were found between LBP (0.002), physical activity (P<0.001), physician consultation (P=0.024), and depression (P<0.001). Sex-related differences were shown regarding LBP intensity (P=0.005) and frequency (P=0.013), stress (P<0.03), depression (P=0.005), and nervous mood (P=0.036) in favor of male students. Male adolescents had continuous energy (P=0.0258) and were calm (P=0.029) in contrast with female counterparts.

Discussion LBP was sex-related and was less common in adolescents with frequent activity. Adolescent girls with stress, depressive mood, and low energy have more LBP than boys, which makes physician consultation for LBP more common in female adolescents.

Conclusions Systematic physical activity and control of psychological profile should decrease LBP frequency and intensity.

Orthopaedic Department, General Hospital “Agios Andreas,” Patras, Greece

We have not received funding for research from any of the following organizations: National Institutes of Health, Wellcome Trust, Howard Hughes Medical Institute, or others.

Reprints: Panagiotis Korovessis, MD, PhD, Chief Orthopaedic Department, General Hospital “Agios Andreas,” 1 Tsertidou str. 26224, Patras, Greece (e-mail:

Received July 10, 2009

Accepted August 31, 2009

© 2010 Lippincott Williams & Wilkins, Inc.