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Ferran Pellisé, MD, PhD; Federico Balagué, MD; Luis Rajmil, MD, PhD; Christine Cedraschi, PhD; Mario Aguirre, MD, PhD; Cesar G. Fontecha, MD, PhD; Maribel Pasarín, MD, MPH; Montse Ferrer, MD, PhD

Arch Pediatr Adolesc Med. 2009;163(1):65-71.

Objectives  To assess the prevalence of low back pain (LBP) in adolescents and the clinical features of LBP in 2 European countries and to evaluate the effect of LBP on health-related quality of life (HRQOL) using standardized validated generic and disease-specific instruments.

Design  Cross-sectional study.

Setting  Secondary schools of Barcelona, Spain, and Fribourg, Switzerland.

Participants  Representative sample of adolescents from the 2 cities.

Intervention  Selected adolescents completed a questionnaire including a generic HRQOL (KIDSCREEN-52) and 2 LBP-specific instruments.

Main Outcome Measures  Results of KIDSCREEN-52, the Roland-Morris Disability Questionnaire, and the Hanover Functional Ability Questionnaire.

Results  A total of 1470 adolescents (52.6% male) with a mean (SD) age of 15.05 (1.17) years completed the questionnaires (response rate, 85.1%). Low back pain was reported by 587 adolescents (39.8%): isolated LBP in 250 (42.6%), LBP plus other pain in 271(46.2%), LBP plus whole-body pain in 50 (8.5%, and unclassifiable LBP in 16 (2.7%). Five hundred adolescents (34.7%) reported no pain, and 369 (25.6%) reported other pain without LBP. In those with isolated LBP, the percentage of adolescent boys was higher (54.6%; P < .001) and the LBP was mildest. In those with LBP plus whole-body pain, the percentage of adolescent girls was higher (62%; P < .001) and LBP was most severe. All KIDSCREEN scores in the group with LBP plus whole-body pain were significantly lower than in the other groups (effect size, 0.52-1.24). No differences were found between the groups who reported isolated pain, no pain, or other pain with no LBP. On the LBP-specific instruments, adolescents who reported LBP plus other pain had significantly poorer scores (P < .001) compared with those with isolated LBP but better scores (P < .001) than those with LBP plus whole-body pain.

Conclusions  Low back pain in adolescents is a prevalent symptom with overall low associated disability and little effect on health-related quality of life. A subset of adolescents in whom LBP is associated with whole-body pain report significant impairment and deserve more attention.

Author Affiliations: Spine Unit, Hospital Universitari de Traumatologia I Rehabilitació Vall d’Hebron (Dr Pellisé), Paediatric Orthopaedic Unit, Hospital Universitari Materno-Infantil Vall d’Hebron (Drs Aguirre and Fontecha), Catalan Agency for Health Technology Assessment (Dr Rajmil), Barcelona Public Health Agency (Dr Pasarín), and Health Services Research Unit, Institut Municipal Investigació Médica (Dr Ferrer), El Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (Dr Rajmil, Pasarin and Ferrer), Barcelona, Spain; Department of Rheumatology, Physical Medicine and Rehabilitation, Hôpital Cantonal, Fribourg (Dr Balagué), and Divisions of General Medical Rehabilitation, and Clinical Pharmacology and Toxicology, Hôpitaux Universitaires Genève (Dr Cedraschi), Geneva, Switzerland.

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