Baseline musculoskeletal pain and impaired sleep related to school pressure influence the development of musculoskeletal pain in N = 107 adolescents in a 5-year longitudinal study

• Published in: European spine journal 2020-03, Vol.29 (3), p.540-548
• Main Authors: Rolli Salathé, C., Kälin, W., Zilse, S., Elfering, A.
• Format: Article
• Language: English
• Subjects: Adolescents; Longitudinal studies; Medicine; Medicine & Public Health; Neurosurgery; Original Article; Pain; Pressure; Risk factors; Sleep; Surgical Orthopedics; Teenagers
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-019-06211-x

Purpose This longitudinal study followed 10- to 13-year-old adolescents for 5 years to investigate the effects of juvenile musculoskeletal (MSK) pain and psychosocial risk factors on future pain. We further predicted that increased MSK pain at follow-up would be positively related to current school pressure at follow-up and negatively related to current sleep quality. Sleep quality was tested as a potential mediator of the link between school pressure and MSK pain at follow-up after controlling for baseline MSK pain. Methods The baseline sample comprised 189 adolescents, and 5-year follow-up resulted in 107 15- to 18-year-old adolescents who had completed mandatory education. Adolescents responded to an online questionnaire about psychosocial stressors, MSK pain, school achievement and leisure activities. A longitudinal hierarchic linear regression including all significant baseline predictors was run to assess their impact on MSK pain 5 years later. Mediation analysis was used to investigate sleep quality as a potential mediator of the relationship between school pressure and MSK pain at follow-up. Results Baseline MSK pain predicted MSK pain over a time lag of 5 years ( ß  = .26, p  = .02). The relationship between follow-up school pressure and current MSK pain was mediated by sleep quality at follow-up ( B  = .17, SE B  = .07, 95% CI .06–.34) when baseline MSK pain was controlled. Conclusions Juvenile MSK pain predicts MSK pain in adolescence. A psychosocial mediation model including school pressure and sleep impairments has the potential to explain MSK pain mechanisms in adolescents. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.