Epidemiology of Adolescent Spinal Pain: A Systematic Overview of the Research Literature

Leah J. Jeffries, BPhysioHons; Steve F. Milanese, MAppSc; Karen A. Grimmer-Somers, PhD

Disclosures

Spine. 2007;32(23):2630-2637. 

In This Article

Abstract and Introduction

Study Design: Systematic literature review.
Objective: To explore the available research literature, and provide an up-to-date synthesis of the epidemiology of idiopathic adolescent spinal pain (IASP).
Summary of Background Data: IASP and its potential causes have been a concern to researchers for over 2 decades. Because it has been suggested that IASP is related to the incidence of adult spinal pain, it appears important to synthesize what is currently known about IASP.
Method: A systematic meta-synthesis approach was used to identify secondary review articles and primary epidemiological studies regarding any type of IASP (neck, upper back, or low back).
Results: A total of 56 primary epidemiological (cross-sectional or longitudinal) studies were identified. Spinal or back pain was the most commonly reported measure, with the lifetime prevalence figures ranging from 4.7% to 74.4%. The lifetime prevalence of low back pain had a similar range, 7% to 72%. The prevalence of pain in other areas of the spine (i.e., thoracic spine and neck) was variably reported, as were incidence rates for all areas of the adolescent spine. IASP is thus a significant problem, and the prevalence figures approach those of adults. There is some evidence that IASP is a risk factor for spinal pain in adulthood. However, there was considerable variation in how back pain was defined, the areas of the spine that were reported on, the manner in which data were collected and reported, thus preventing any significant comparisons of prevalence or incidence rates across studies.
Conclusion: Although there is wide discrepancy in the manner in which adolescent spinal pain is reported, it is evident that lifetime prevalence rates increase steadily with age and approximate adult levels by around the age of 18 years. There is an opportunity for further longitudinal research, with standardized methodology, to be undertaken that builds on the findings from this large group of studies.

Since the 1980s, idiopathic adolescent spinal pain (IASP) and its potential causes have been a concern to researchers. It has been suggested that IASP is related to the incidence of adult spinal pain, possibly by underpinning the establishment of psychosocial patterns, postures, experiences, attitudes, concepts, beliefs, and behaviors related to recurrent pain events.[1,2] Although the incidence of depression, anxiety, drug addiction, and eating disorders significantly increases during adolescence, and the risk of death is much higher in this period than in any other stage of life,[3] adolescence is generally considered a healthy time period from a musculoskeletal perspective.[1] Spinal pain, however, appears to be a normal life experience[4] for many young people.

Improving our understanding of IASP, including its impact and potential causes, requires an understanding of earlier research findings, in particular the methodologic processes underpinning standardization of data recording. This article explores the currently available research literature regarding the epidemiology of IASP, using a systematic meta-synthesis approach and provides a synthesis of what is currently known about IASP prevalence and incidence, with suggestions for standardization of research methodology to facilitate comparison and synthesis of the literature in the future.

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