Back pain linked to mental health problems and risky behaviors in teenagers

During adolescence, the prevalence of musculoskeletal pain (pain arising from the bones, joints or muscles) in general, and back pain in particular rises steeply. Although often dismissed as trivial and fleeting, adolescent back pain is responsible for substantial health care use, school absence, and interference with day-to-day activities in some children.

The aim of this study was to determine whether adolescents who experience back pain more often were also more likely to report other health risk indicators, such as alcohol use, smoking, school absenteeism, and depression or anxiety.

Researchers used data collected from approximately 6500 teenagers. The proportion of participants reporting smoking, drinking, and missing school rose incrementally with increasing frequency of pain. For example, 14-15 year olds that experienced pain more than once a week were 2-3 times more likely to have drunk alcohol or smoked in the past month than those who rarely or never had pain. Similarly, students that experienced pain more than once a week were around twice as likely to have missed school in the previous term. The trend with anxiety and depression was less clear, although there was a marked difference between the children who reported no pain, and those who reported frequent pain.

Back pain and unhealthy behaviors not only occur together, but also track into adulthood. This means that they are responsible for current issues, and also have implications for future health. Adolescent back pain may play a role in characterizing poor overall health, and risk of chronic disease throughout life. The researchers involved with the study believe this is of concern because the developing brain may be susceptible to negative influences of toxic substances, and use in early adolescence may increase the risk of substance abuse and mental health problems in later life.

"Findings like this provide an argument that we should be including pain in the broader conversation about adolescent health," said the paper's lead author, Steven Kamper. "Unfortunately our understanding of the causes and impacts pain in this age group is quite limited, the area is badly in need of more research."