Back pain in teens tied to smoking, drinking alcohol, anxiety, depression

Adolescents with more frequent back pain were also more likely to report anxiety and depression, and more likely to smoke and drink alcohol, according to findings recently published in the Journal of Public Health.

“There is mounting evidence that adolescent back pain is prevalent, associated with a large disability burden in its own right, and responsible for substantial health care utilization, medication usage, school absence and interference with physical and day-to-day activities,” Steven Kamper, PhD, of the Centre for Pain, Health and Lifestyle in New South Wales, Australia and colleagues wrote. “Previous studies have reported associations between [musculoskeletal] pain, substance use and poor mental health, but the relationships between them are unclear.”

Researchers used data from two cohorts. A total of 6,388 adolescents living in Australia, aged 14 to 16 years (48.8% female) were surveyed on back pain, mental health status (anxiety, depression, and missed school) and substance abuse use (smoking and alcohol use).

Kamper and colleagues found that 6.5% of the first cohort said they had daily back pain. Test-for-trend analysis showed increasing frequency of back pain was also related to increased frequency of depression, anxiety, missing school, smoking and drinking (P < .01, all). In the second cohort, 7.7% said they had daily back pain. Using the same analytical method, increasing frequency of back pain was also linked to increasing rates of smoking, depression and anxiety (P < .01 for all) and drinking (P =.01). Data on missed school were not available.

“These findings may have implications for clinical practice. They point to the fact that adolescents with frequent pain are at increased risk of other health problems. In the event that these other health risks influence the prognosis of painful conditions, then addressing health-related behaviors and mental health issues should form part of clinical management,” Kamper and colleagues wrote.

“Even if not causally related to the course of musculoskeletal pain, there is an argument that comprehensive health care of the individual should include management of these factors. In either case, screening for health-related risk behaviors and indicators of poor mental health is indicated in adolescents with frequent musculoskeletal pain,” they added.

By Janel Miller

31 October 2018

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