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Eur J Pediatr. 2018 Dec;177(12):1803-1810. doi: 10.1007/s00431-018-3235-6. Epub 2018 Sep 19.

Does lower extremity pain precede spinal pain? A longitudinal study.

Author information

1
Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. sfuglkjaer@health.sdu.dk.
2
Department of Orthopaedics and Traumatoloy, University Hospital Basel, Spitalstr 21, CH-4031, Basel, Switzerland.
3
Institute for Medical Biometry and Statistics, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany.
4
Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
5
Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230, Odense M, Denmark.
6
Institute of Regional Health Services Research, University of Southern Denmark, Winsloewparken 193, 5000, Odense C, Denmark.
7
Sports Medicine Clinic, Orthopaedic Department, Hospital Lillebaelt, Østre Hougvej 55, 5500, Middelfart, Denmark.
8
Health Sciences Research Centre, University College Lillebaelt, Vestre Engvej 51C, 7100, Vejle, Denmark.

Abstract

The main objective was to investigate whether children aged 9-15 years at baseline were more likely to experience an incident event of spinal pain after experiencing lower extremity pain. Children's musculoskeletal pain was monitored by weekly mobile phone text message responses from parents, indicating whether the child had spinal pain, lower extremity pain, or upper extremity pain the preceding week. Data were analyzed using mixed effect logistic regression models and cox regression models. The association between an incident event of spinal pain and LE pain the preceding weeks increased with increasing observation period and was statistically significant for 12 and 20 weeks (OR = 1.34 (95% CI 1.05 to 1.70) and OR = 1.39 (95% CI 1.11 to 1.75), respectively). We found that the likelihood increased in children with more frequent or longer duration of lower extremity pain. The reversed relationship was investigated as well, and we also found a positive association between spinal pain and a subsequent incidence event of lower extremity pain, but less pronounced.Conclusion: Children were more likely to experience an incident event of spinal pain after experiencing lower extremity pain. The likelihood increased in children with more frequent or longer duration of lower extremity pain. What is Known: • Both spinal pain and lower extremity pain often start early in life and is common already in adolescence. What is New: • Children were more likely to experience an incident event of spinal pain after experiencing LE pain. • The likelihood increased in children with more frequent or longer duration of LE pain.

KEYWORDS:

Childhood; Epidemiology; Kinetic chain; Low back pain; Predictor; Risk factor

PMID:
30232592
DOI:
10.1007/s00431-018-3235-6

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