Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Oct 24, 2024
Date Accepted: May 19, 2025
Prevalence of chronic back pain and associated factors in children and adolescents: Analysis from the 2001–2019 HBSC cross-sectional study
ABSTRACT
Background:
Low back pain (LBP), which is considered a leading cause of adult disability worldwide, is seldom studied in children and adolescents despite it being associated with multiple detrimental health outcomes in this age group.
Objective:
This study aimed to determine the prevalence, time trends and associated factors of LBP among children and adolescents.
Methods:
Data were extracted from the cross-sectional Health Behavior in School-Aged Children (HBSC) study from 2001–2019. The final sample size for this study consisted of 1,011,368 children and adolescents (51.01% girls). Generalized linear mixed models were developed to explore the probability of having daily LBP in the population of the HBSC by age group, sex, socioeconomic status, excess weight status, and year of data collection. Additionally, we analyzed country-level changes in LBP incidence over time.
Results:
The time trend indicated a general increase in the prevalence of daily LBP in children and adolescents over time. Indeed, Northern and Eastern Europe, as well as parts of North America, presented a relatively higher prevalence of daily LBP (range 7–9%). Older age (OR = 1.50; 95% CI 1.46–1.55; p<0.001), female sex (OR = 1.45; 95% CI 1.42–1.48; p<0.001), excess weight (OR = 1.14; 95% CI 1.11–1.17; p<0.001), lower socioeconomic status (OR 0.83; 95% CI 0.81–0.85; P<0.001), and later years of data collection (OR = 1.04; 95% CI 1.04–1.05; p<0.001) were associated with a greater likelihood of daily LBP.
Conclusions:
This study revealed a sustained upward trend in the prevalence of LBP in children and adolescents over the years (2001-2019), especially in North America and Northern and Eastern Europe. In addition, older age, female sex, and excess weight were associated with a greater probability of experiencing daily LBP. Moreover, a lower socioeconomic status was associated with an increased risk of LBP, potentially indicating differences in lifestyle, access to healthcare, or other protective factors. Clinical Trial: Not applicable.
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