1. Alessandro Andreucci, Paul Campbell, Kate Dunn
Risk factors for the onset of musculoskeletal pain in children and adolescents. A systematic review.
Alessandro Andreucci, Paul Campbell, Kate Dunn
Research Institute for Primary Care & Health Sciences, Keele University, Keele Staffordshire, ST5 5BG, UK
Background
Musculoskeletal (MSK) pain is the leading cause of years lived with disability globally.
MSK pain is experienced during the life-course and may begin in childhood.
However, clear information on the risk factors for the onset of MSK pain in young people is lacking.
Aim
Summarise evidence of risk factors for the onset of MSK pain in children and adolescents.
Quality of the studies
27 studies of high quality (more than 10 quality criteria met)
16 studies of medium quality (between 6 and 10 quality criteria met)
Evidence of association for the onset of MSK pain
Strong evidence of association between:
Low quality sleep and neck pain
Day-time tiredness and neck pain
High levels of psychopathologies and neck/limb pain
Parental pain presence and back pain
Moderate evidence of association between:
Early puberty and back pain
Headache and neck pain
Results
The electronic search yielded 35,167 references. Eligible studies after title, abstract and full-text screening: 43 (total population = 38,067 subjects).
Methods
Five databases (MEDLINE, PsycINFO, AMED, EMBASE, HMIC) were systematically searched from inception to 20 November 2014 to identify studies reporting incident MSK pain in child and adolescent populations.
Inclusion criteria
Prospective studies conducted in the general population, school or primary care settings, on individuals aged between 6 and 19 years.
Exclusion criteria
Studies with a sample size ≤30
Pain not self-reported by the children.
No restrictions on language or publication date were applied.
Analysis
A best evidence synthesis was applied to the extracted data that considered both study quality and consistency of findings (Table 1 and 2).
Conclusions
This systematic review is the first comprehensive review of risk factors for MSK pain in children and adolescents.
It highlights a number of potential risk factors for the onset of MSK pain, with evidence for the different specific body sites reported.
These findings generate the possibility to design and test interventions on the targets identified to reduce the onset of MSK pain.
Samples description
24 from the school setting
18 from the general population setting
1 from the hospital setting
None from primary care settings
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