Public health

MSK pain in teens linked to to substance use, poor mental health

Adolescents with frequent back pain are more likely to smoke, drink alcohol and have poor mental health, public health researchers say.

A study of over 6000 Australian teens found a dose response relationship between the proportion of adolescents who reported smoking, drinking or missing school and increasing frequency of back pain.

The study, published in the Journal of Public Health, also found that frequent back pain was also related to feelings of anxiety and depression.

Lead author Associate Professor Steve Kamper said the findings suggest that musculoskeletal pain needs to be included in broader discussions about adolescent health.

“During adolescence pain from bones, joints, muscles, and back pain in particular, rises steeply. Despite being the cause of substantial health care use and school absences, pain in this age group is commonly dismissed as trivial or fleeting,” said Associate Professor Kamper from the University of Sydney School of Public Health.

“This study shows that adolescents with frequent pain are also at increased risk of other health problems, which is of concern as both pain and these risky behaviours have ongoing consequences that stretch well into adulthood.”

The findings are based on cross-sectional data collected from over 6000 adolescents aged 14 to 16 years during 2014 and 2015.

“While we can’t say back pain is the cause of risky behaviour or mental health concerns, the study suggests adolescent back pain may play a role in characterising overall poor health, and risk of chronic disease into adulthood,” said Dr Kamper.

The study authors said if other health risks influence the prognosis of musculoskeletal conditions, then addressing health-related behaviours and mental health issues should form part of clinical management.

“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 behaviours and indicators of poor mental health is indicated in adolescents with frequent MSK pain,” they wrote.

They also noted that public health interventions commonly target substance use, and mental health in children and adolescents but they do not address pain.

“If it is the case that the same children that are at-risk of poor health outcomes due to substance use and/or mental health issues are also likely to experience pain more frequently, this may have implications for the design and content of public health interventions.”

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