Spinal pain prevalence in childhood and socioeconomic patterns: a comparative study in four European birth cohorts

The aim of this study was to examine the prevalence and socioeconomic patterns of spinal pain in children and adolescents across different European contexts. We used individual participant data from four population-based birth cohorts from Denmark, Portugal, Italy, and Finland. Data on anatomical location, frequency, intensity, and pain-related functional limitations of spinal pain in children aged 7-18 years were analysed. Maternal educational level at birth was used as an indicator of the child's socioeconomic background. Socioeconomic patterns in spinal pain were quantified by the slope and relative indices of inequality. The prevalence of spinal pain varied from 4.6% (previous 3 months) in Portuguese 7-year-old boys to 92.3% (previous 12 months) in Danish 18-year-old girls. Prevalence increased with age, and females reported more pain than males. Among children reporting spinal pain, approximately 59% experienced frequent pain, 59% intense pain, and 35% pain-related functional limitations, with notable differences across cohorts and age groups. We found no consistent socioeconomic gradient in the prevalence of spinal pain. However, among children reporting spinal pain, socioeconomic differences were more apparent in pain frequency, intensity, and daily-life functional limitations, although the direction and magnitude of these gradients varied across cohorts.

Spinal pain is common in children and adolescents, but no consistent socioeconomic pattern was observed in its occurrence. Spinal pain appears prevalent across all socioeconomic groups, with inequalities emerging more clearly in the frequency, severity, and functional impact of pain, although these patterns varied across settings.

• Paediatric spinal pain is common, but prevalence estimates vary widely across studies. • Evidence on socioeconomic inequalities in childhood spinal pain is mixed and inconsistent.

• Prevalence varies markedly across cohorts reflecting both methodological and contextual differences. • Inequalities in pain frequency, intensity, and daily-life impact are more apparent than those in spinal pain prevalence.