Association between untreated low back pain and injury proneness and confounding role of behavioral-health difficulties among younger adolescents: a population-based study.
cross_sectional · Level IV
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- Record sourced from PubMed, PMID 37103577.
- Also identified by DOI 10.1007/s00586-023-07679-4.
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Abstract
Low back pain (LPB) is mostly left untreated (LBP<sub>untreated</sub>) and may increase the injury risk due to associated behavioral-health difficulties (BHDs) among adolescents. This study assessed the association between LBP<sub>untreated</sub> (vs. treated LBP (LBP<sub>treated</sub>)) and injuries and the mediating role of BHDs among younger adolescents (10-16 years). This population-based study compared 328 adolescents with LBP<sub>untreated</sub> (mean age = 13.7 ± 1.3) with 291 with LBP<sub>treated</sub> (mean age = 13.3 ± 1.2) from north-eastern France. They completed a questionnaire collecting, at school-year end, socioeconomic features, LBP<sub>treated</sub>/LBP<sub>untreated</sub>, BHDs (alcohol/tobacco use, excessive screen-time, poor social support, poor physical health, depressive symptoms, and pain limiting activities), and injuries during the current school-year. Data were analyzed using multinomial logistic regression models and Kaplan-Meier estimates. The proportion of subjects without alcohol/tobacco use or depressive symptoms decreased with time more quickly since age 10 among the adolescents with LBP<sub>untreated</sub> than among those with LBP<sub>treated</sub>. Hence, most LBP early started and the subjects with LBP<sub>untreated</sub> had a higher risk of single injury (sex-age-class-level-socioeconomic-features-adjusted relative risk ratio RR = 1.63, p < 0.05, vs. LBP<sub>treated</sub>) and a much higher risk of ≥ 2 injuries (RR = 2.60, p < 0.001). BHDs played a strong mediating role in the association between LBP<sub>untreated</sub> and ≥ 2 injuries (contribution = 48%) but a modest mediating role in that between LBP<sub>untreated</sub> and single injury (contribution = 10%) (pseudo R<sup>2</sup> = 7.6%). LBP<sub>untreated</sub> is common and associated with injuries partly due to BHDs (which may alter physical/mental capabilities, risk perception/awareness, and vigilance) among younger adolescents. Our results may inform healthcare providers that they can detect/treat LBP and BHDs to prevent their aggravation and injuries.
Medical subject headings
- Low Back Pain