title: Non-specific neck pain in schoolchildren: prognosis and risk factors for occurrence and persistence. A 4-year follow-up study.
abstract: This study investigated the natural course of neck pain (NP) in 9-12-year-olds during a 4-year follow-up. Risk factors for the occurrence and persistence of weekly NP were explored separately for boys and girls. At baseline, 1756 schoolchildren completed a questionnaire eliciting musculoskeletal pain symptoms, other physical, and psychological symptoms and frequency of physical activity, and were tested for joint hypermobility. Symptoms during the preceding three months were asked using a five-level frequency classification. Re-evaluation was performed after one and four years using identical questionnaires. During follow-up, 24% reported none, 71% fluctuating, and 5% persistent weekly NP. The frequency of NP at baseline was linearly related to weekly NP during follow-up in both genders (P<0.001). Furthermore, a significant increasing linear trend towards a more persistent course of NP was seen in children with weekly other musculoskeletal and/or other physical and psychological symptoms at baseline. Among originally neck pain-free pre-/early adolescents, weekly other musculoskeletal pain symptoms (only in girls) and other physical and psychological symptoms (in both genders) predicted the occurrence of weekly NP during follow-up. In conclusion, neck pain in schoolchildren tends to fluctuate, but there also seems to exist a subgroup (5%) with persistent NP already in pre-/early adolescents, or even earlier. Co-occurrence of frequent other musculoskeletal symptoms and/or markers of psychological stress with frequent NP are risk indicators for a more persistent course, at least within next few years. Since adult chronic NP problems might originate in childhood, further studies are needed, including preventive interventions.
authors.affiliation: Department of Physical and Rehabilitation Medicine, University Hospital of Turku, P.O.Box 52, 20520 Turku, Finland The Rheumatism Foundation Hospital, Pikijärventie 1, 18120 Heinola, Finland Epidemiology Group, Department of Public Health, University of Aberdeen, Aberdeen AB25 2ZD, UK Department of Physical and Rehabilitation Medicine, Jyväskylä Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Ståhl
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Ashraf
authors.initials: A
authors.lastname: El-Metwally
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
authors.forename: Jari
authors.initials: J
authors.lastname: Ylinen
authors.forename: Jouko J
authors.initials: JJ
authors.lastname: Salminen
authors.forename: Marja
authors.initials: M
authors.lastname: Mikkelsson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000375:Aging / Q000502:physiology*; D002574:Cervical Vertebrae / Q000473:pathology / Q000503:physiopathology; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D042241:Early Diagnosis; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000503:physiopathology; D019547:Neck Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000503:physiopathology; D010147:Pain Measurement; D011379:Prognosis; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors