Back Pain Frequency, Mental Health, and Substance Use in Adolescents

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The percentage of participants reporting smoking, drinking, and missing school was found to increase with the frequency of back pain.
The percentage of participants reporting smoking, drinking, and missing school was found to increase with the frequency of back pain.

Adolescents who experience more frequent back pain may be more likely to smoke and drink alcohol and report feelings of anxiety and depression, according to a study published in the Journal of Public Health.

To evaluate the relationship between back pain and health risks in adolescents (mean age, 14 to 15), researchers used cross-sectional data from the Healthy Schools Healthy Futures study (n=2075) and the Australian Child Wellbeing Project (n=3608). Adolescents were grouped according to self-reported back pain frequency.

Back pain was reported to be experienced rarely/never by 51.9 % and 66.7% of participants from the Australian Child Wellbeing Project and the Healthy Schools Healthy Futures studies, respectively, and was reported as occurring daily by 6.5% and 7.7% of participants, respectively.

The percentage of participants reporting smoking, drinking, and missing school was found to increase with the frequency of back pain in both cohorts, as indicated by test-for-trend analyses. Of participants in the Healthy Schools Healthy Futures study with daily back pain, 90% and 89.4% had symptoms of depression and anxiety, respectively, and 20.8% and 21.3% reported smoking and drinking, respectively. Percentages were reduced in this cohort in participants with rare/never back pain: smoking (9.3%; P <.01), drinking (12.6%; P =.01), depression (78.1%; P <.01), and anxiety (86.5%; P <.01).

Study limitations include the inability to generalize findings to a global population as both samples were from a single country.

 “[T]is study suggests that consideration of behavioral health risks and mental health should be incorporated into research aimed at understanding the pathology of [musculoskeletal pain] in adolescents,” concluded the study authors.

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Reference

Kamper SJ, et al. Back pain, mental health and substance use are associated in adolescents. [published online September 10, 2018] Journal of Public Health. doi:10.1093/pubmed/fdy129

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