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Eur J Pediatr. 2019 Oct 17. doi: 10.1007/s00431-019-03475-9. [Epub ahead of print]

Early-life programming of pain sensation? Spinal pain in pre-adolescents with pain experience in early life.

Author information

1
Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Oster Farimagsgade 5, bd. 24, Box 2099, DK-1014, Copenhagen K, Denmark. acjo@sund.ku.dk.
2
Medical School and Institute of Public Health (EPIUnit), University of Porto, Porto, Portugal.
3
Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
4
Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
5
Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Oster Farimagsgade 5, bd. 24, Box 2099, DK-1014, Copenhagen K, Denmark.

Abstract

Neurobiological mechanisms can be involved in early programming of pain sensitization. We aimed to investigate the association between early-life pain experience and pre-adolescence spinal pain. We conducted a study of 29,861 pre-adolescents (age 11-14) from the Danish National Birth Cohort. As indicators of early-life pain, we used infantile colic and recurrent otitis media, reported by mothers when their children were 6 and 18 months. Self-reported spinal pain (neck, middle back, and/or low back pain) was obtained in the 11-year follow-up, classified according to severity. Associations between early-life pain and spinal pain in pre-adolescents were estimated using multinomial logistic regression models. To account for sample selection, inverse probability weighting was applied. Children experiencing pain in early life were more likely to report severe spinal pain in pre-adolescence. The association appeared stronger with exposure to two pain exposures (relative risk ratio, 1.31; 95% CI, 1.02-1.68) rather than one (relative risk ratio, 1.14; 95% CI, 1.05-1.24). We observed similar results when using headache and abdominal pain as outcome measures, underpinning a potential neurobiological or psychosocial link in programming of pain sensitization.Conclusion: Experience of early-life pain is seemingly associated with spinal pain in pre-adolescence. The study highlights that early-life painful experiences can influence programming future pain responses. What is Known: • Spinal pain in pre-adolescents is common, causes marked discomfort and impairment in everyday life, and may be an important predictor of spinal pain later in life. • Neurobiological mechanisms have been suggested as involved in early programming of pain sensitization. What is New: • Pain exposure in early postnatal life in terms of infantile colic and recurrent otitis media is associated with spinal pain in pre-adolescence; thus, experience of such painful conditions in the early postnatal period may seemingly influence programming of future pain sensation.

KEYWORDS:

Back pain,; Epidemiology; Pain sensitivity,; Pre-adolescence,; Spinal pain,

PMID:
31624948
DOI:
10.1007/s00431-019-03475-9

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