Physical risk factors for adolescent neck and mid back pain: a systematic review

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Abstract

Background

Besides low back pain (LBP), also neck pain (NP) and mid back pain (MBP) are common health issues in adolescence. Psychological factors are regarded as main risk factors for spinal pain in adolescence, but recent studies suggest that the importance of physical factors might be underestimated. The purpose of this study was to summarize the results of studies on physical risk factors for adolescent NP and MBP.

Methods

Cross-sectional and prospective English studies on NP and MBP in adolescents aged 10 to 18 were searched by a professional librarian in Medline (OvidSP), Premedline (PubMed), EMBASE, Cochrane, CINAHL, PEDro and PsycINFO up to October 2016. Studies that were restricted to self-report via questionnaires were excluded.

Results

Eight cross-sectional studies could be included in this review. Some aspects of sagittal alignment in sitting (increased lumbar lordosis) and standing (anteroposition of the head, sway-back posture) were associated with NP. Study comparability was impeded by inconsistent definitions of NP and MBP and a wide variety of outcome measures.

Conclusions

This systematic review indicates that prospective studies using a consistent definition of NP and MBP are needed. Such studies might further investigate sagittal alignment in sitting and standing as possible risk factors for NP and MBP in adolescence using a consistent terminology for the outcomes and longitudinal research designs.

Electronic supplementary material

The online version of this article (10.1186/s12998-018-0206-y) contains supplementary material, which is available to authorized users.

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Most cited references 34

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The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins.

Kirsten Ohm Kyvik, Charlotte Leboeuf-Yde, Lise Hestbaek … (2006)

Prospective study with 8-year follow-up. To describe the evolution of low back pain from adolescence into adulthood. High prevalence rates of low back pain among children and adolescents have been demonstrated in several studies, and it has been theorized that low back pain in childhood may have important consequences for future low back pain. It is important to understand the nature of such a link if effective preventive programs are to be established. Almost 10,000 Danish twins born between 1972 and 1982 were surveyed by means of postal questionnaires in 1994 and again in 2002. The questionnaires dealt with various aspects of general health, including the prevalence of low back pain, classified according to number of days affected (0, 1-7, 8-30, >30). Low back pain in adolescence was found to be a significant risk factor for low back pain in adulthood with odds ratios as high as four. We also demonstrated a dose-response association: the more days with low back pain at baseline, the higher the risk of future low back pain. Twenty-six percent of those with low back pain for more than 30 days during the baseline year also had more than 30 days with low back pain during the follow-up year. This was true for only 9% of the rest of the sample. Our study clearly demonstrates correlations between low back pain in childhood/adolescence and low back pain in adulthood. This should lead to a change in focus from the adult to the young population in relation to research, prevention, and treatment.

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Musculoskeletal pain in children and adolescents

Steve J. Kamper, Nicholas Henschke, Lise Hestbaek … (2016)

ABSTRACT Introduction Musculoskeletal (MSK) pain in children and adolescents is responsible for substantial personal impacts and societal costs, but it has not been intensively or systematically researched. This means our understanding of these conditions is limited, and healthcare professionals have little empirical evidence to underpin their clinical practice. In this article we summarise the state of the evidence concerning MSK pain in children and adolescents, and offer suggestions for future research. Results Rates of self-reported MSK pain in adolescents are similar to those in adult populations and they are typically higher in teenage girls than boys. Epidemiological research has identified conditions such as back and neck pain as major causes of disability in adolescents, and in up to a quarter of cases there are impacts on school or physical activities. A range of physical, psychological and social factors have been shown to be associated with MSK pain report, but the strength and direction of these relationships are unclear. There are few validated instruments available to quantify the nature and severity of MSK pain in children, but some show promise. Several national surveys have shown that adolescents with MSK pain commonly seek care and use medications for their condition. Some studies have revealed a link between MSK pain in adolescents and chronic pain in adults. Conclusion Musculoskeletal pain conditions are often recurrent in nature, occurring throughout the life-course. Attempts to understand these conditions at a time close to their initial onset may offer a better chance of developing effective prevention and treatment strategies.

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The influence of different sitting postures on head/neck posture and muscle activity.

Joao Caneiro, Peter O'Sullivan, Angus Burnett … (2010)

To date the influence that specific sitting posture has on the head/neck posture and cervico-thoracic muscle activity has been insufficiently investigated. Therefore the aim of this study was to investigate whether three different thoraco-lumbar sitting postures affect head/neck posture and cervico-thoracic muscle activity. Twenty (10 men, 10 women) asymptomatic subjects were placed in 3 standardized thoraco-lumbar sitting postures (lumbo-pelvic, thoracic upright and slump) to investigate their influence on cervico-thoracic muscle activity and head/neck posture. There were significant differences in lumbar and thoracic curvatures in the 3 different sitting postures (P<0.002). Slump sitting was associated with greater head/neck flexion, anterior translation of the head (P<0.001) and increased muscle activity of cervical erector spinae (CES) compared to thoracic and lumbo-pelvic sitting (P=0.001). Thoracic upright sitting showed increased muscle activity of thoracic erector spinae (TES) compared to slump and lumbo-pelvic postures (P=0.015). Upper trapezius (UT) demonstrated no significant difference in muscle activation in the 3 sitting postures (P<0.991). This study demonstrates that different sitting postures affect head/neck posture and cervico-thoracic muscle activity. It highlights the potential importance of thoraco-lumbar spine postural adjustment when training head/neck posture.

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Author and article information

Contributors

Brigitte Wirth: +41 44 386 57 03 , brigitte.wirth@balgrist.ch

Tobias Potthoff: topotthoff@gmx.de

Sandra Rosser: s.rosser@gmx.ch

Barry Kim Humphreys: kim.humphreys@balgrist.ch

Eling D. de Bruin: eling.debruin@hest.ethz.ch

Journal

Journal ID (nlm-ta): Chiropr Man Therap

Journal ID (iso-abbrev): Chiropr Man Therap

Title: Chiropractic & Manual Therapies

Publisher: BioMed Central (London )

ISSN (Electronic): 2045-709X

Publication date (Electronic): 24 September 2018

Publication date PMC-release: 24 September 2018

Publication date Collection: 2018

Volume: 26

Electronic Location Identifier: 36

Affiliations

[1 ]ISNI 0000 0004 0518 9682, GRID grid.412373.0, Integrative Spinal Research, Department of Chiropractic Medicine, , University Hospital Balgrist, ; Forchstr. 340, 8008 Zurich, Switzerland

[2 ]ISNI 0000 0001 2156 2780, GRID grid.5801.c, Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, , ETH Zurich, ; Zurich, Switzerland

[3 ]ISNI 0000 0004 1937 0626, GRID grid.4714.6, Department of Neurobiology, Care Sciences and Society, , Karolinska Institutet, ; Huddinge, Sweden

Article

Publisher ID: 206

DOI: 10.1186/s12998-018-0206-y

PMC ID: 6151922

PubMed ID: 30258567

SO-VID: d4f400c6-e282-4ab3-9023-d24e9edd9066

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.