Persistence and change in nonspecific low back pain among adolescents: a 3-year prospective study

This is a 3-year prospective study of juvenile low back pain (LBP).

To investigate persistence and change in LBP.

Earlier episodes of LBP are a strong risk factor for LBP in adults, while the persistence of LBP through adolescence is not known.

The material comprised all pupils in eighth and ninth grades (N = 105, mean age 14.7 years), living within two geographic areas in Eastern Norway in January 1997. The analyses included 88 adolescents at baseline, and 85 at follow-up. The questionnaire, which identified LBP as pain or ache in the low back during the preceding year, was answered at baseline in the classroom and at follow-up by post.

LBP was reported by 58% at baseline and by 39% at follow-up, and LBP provoked by manual work by 40% at baseline and 26% at follow-up. Thirty-one percent reported LBP at both occasions. LBP more than 7 days was reported by 32% at baseline, by 26% at follow-up, and by 18% at both occasions. Twenty-two percent of those reporting LBP at baseline rejected ever LBP at follow-up. Baseline reports of LBP predicted corresponding reports of LBP at follow-up: Odds ratio was 4.7 (95% confidence interval 1.7-12.7) for LBP generally, 9.1 (3.0-27.2) for LBP more than 7 days, 9.2 (2.9-28.8) for LBP provoked by manual work, and 3.8 (1.3-11.3) for LBP provoked by sitting at school.

The findings indicate a persistent, but changeable, trend in LBP from midadolescence until late adolescence. The consistency and the high rates of reports of LBP provoked by manual work and sitting imply needs for more research on the persistence of LBP, and on relevant interventions during school age.