Association between preadolescent spinal pain and painful temporomandibular disorders and headache in young adulthood

Painful temporomandibular disorders (p-TMD) frequently co-occur with headache and other musculoskeletal pain conditions, yet longitudinal evidence from preadolescence remains limited. This study examined whether preadolescent spinal pain is associated with p-TMD and headache in young adulthood. Data were obtained from the Danish National Birth Cohort (DNBC). Participants aged 18 years or older, who completed a validated TMD Pain Screener and headache questionnaire were included. Spinal pain at age 11 years (neck, middle back, and low back) was assessed using a modified Young Spine Questionnaire and categorized into three intensity/frequency groups. Logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for sex, sleep quality, mental health, and maternal socio-occupational status. Inverse probability weighting was used to reduce selection bias. Among 11,982 eligible participants, spinal pain data were available for 9639. Compared with participants reporting no or mild intensity and/or low-frequency spinal pain, those reporting moderate-to-severe intensity and/or high-frequency spinal pain in preadolescence had significantly higher odds of p-TMD in young adulthood (neck: OR 1.85, 95% CI: 1.52-2.25; middle-back: OR 1.74, 95% CI: 1.37-2.21; low back: OR 2.16, 95% CI: 1.64-2.85). Similar associations were observed for headache (neck: OR 1.81, 95% CI: 1.49-2.20; middle-back: OR 1.55, 95% CI: 1.20-2.00; low back: OR 1.64, 95% CI: 1.24-2.16). Spinal pain in preadolescence was associated with significantly higher odds of p-TMD and headache in young adulthood. These findings suggest that preadolescent spinal pain may represent an early marker of vulnerability to p-TMD and headache in young adulthood. PERSPECTIVE: This longitudinal cohort study demonstrates that spinal pain in preadolescence was associated with significantly higher odds of p-TMD and headache in young adulthood. These findings highlight the potential relevance of early-life spinal pain when considering later pain conditions across important developmental stages.