Do pain problems in young school children persist into early adulthood? A 13-year follow-up

In a longitudinal study, 335 children ages 8, 11 and 14, first studied in 1989 were followed-up on two occasions in 1991 and 2002. The subjects filled in questionnaires on pain, the first two times in school, the last as a postal survey.

To determine if headache and back pain during the school years were transitory or if they grew into pain problems in adulthood; to determine predictors of pain.

In the 2002 study, 59% of the women and 39% of the men reported pain at 21, 24 and 27 years. A total of 68 (52 women, 16 men) or 20% of the subjects reported pain symptoms in all three studies. The cumulative incidence rate for the presence of pain in the cohort studied was 31% for 1989-2002 and 43% for 1991-2002. Four of the 10 individuals with pain also reported signs of stress. Three predictors were found: reported back pain in 8-14-year-olds (p < 0.0001); reported headaches once a week or more in the same age group (p < 0.0001); and a positive response in the ages 10-16 to the question: "Do you often feel nervous?" (OR=2.1, 95% CI 1.3-3.4). When adjusted for age, sex and all psychosocial risk determinants studied in multiple logistic regression, a positive answer to this question was a significant predictor of pain in young adulthood. A positive response by the 10-16-year-olds to "Do you find it difficult to describe your feelings?" was a predictor of pathological anxiety in early adulthood, but stress perceived in childhood/adolescence did not predict future pain or stress.

Since pain reports in childhood and early adolescence seem to be associated with the report of pain in early adulthood, more attention should be given to the way ill-health is managed in adolescence in this vulnerable group.