Risk factors for persistence of multiple musculoskeletal pains in adolescence: a 2-year follow-up study

Musculoskeletal pain in multiple sites is common already in adolescence, and may lead to subsequent musculoskeletal complaints in adulthood. We examined predictive factors for the persistence of multiple musculoskeletal pains in adolescence over a 2-year time span. A postal questionnaire was administered to a subsample of the Northern Finland Birth Cohort 1986 (n=1773) when subjects were aged 16 and 18. The adjusted odds ratios (OR) and 95% confidence intervals (CI) for the possible risk factors of new-onset of multiple pains at 18 years and 2-year persistence of multiple pains were obtained using multinomial logistic regression. Multiple musculoskeletal pains were common; 43% of boys and 63% of girls at 16, and 61% of boys and 81% of girls at 18 reported pain in more than one site during the last 6 months. Moreover, multiple pains had a high persistence rate, as 75% of boys and 88% of girls with multiple pains at 16 reported multiple pains also at 18. In the multivariate analysis, emotional and behavioral problems (internalizing problems, OR 2.3; externalizing problems, OR 2.2), and high sitting time (OR 1.6) among boys, and internalizing problems (OR 3.7), high physical activity level (OR 1.6), short sleeping time (OR 1.7), and smoking (OR 1.9) among girls were predictive factors for the persistence of multiple pains. No statistically significant associations between the baseline variables and new-onset multiple pains were found. Multiple musculoskeletal pains appear to have a high tendency to persist in adolescence; both psychosocial factors and lifestyle factors contribute to this vulnerability.