Prevalence of low back pain and its effect on health-related quality of life in adolescents.
OBJECTIVE
To assess the prevalence of low back pain (LBP) in adolescents and the clinical features of LBP in 2 European countries and to evaluate the effect of LBP on health-related quality of life (HRQOL) using standardized validated generic and disease-specific instruments.


METHODS
Cross-sectional study.


METHODS
Secondary schools of Barcelona, Spain, and Fribourg, Switzerland.


METHODS
Representative sample of adolescents from the 2 cities. Intervention Selected adolescents completed a questionnaire including a generic HRQOL (KIDSCREEN-52) and 2 LBP-specific instruments.


METHODS
Results of KIDSCREEN-52, the Roland-Morris Disability Questionnaire, and the Hanover Functional Ability Questionnaire.


RESULTS
A total of 1470 adolescents (52.6% male) with a mean (SD) age of 15.05 (1.17) years completed the questionnaires (response rate, 85.1%). Low back pain was reported by 587 adolescents (39.8%): isolated LBP in 250 (42.6%), LBP plus other pain in 271(46.2%), LBP plus whole-body pain in 50 (8.5%, and unclassifiable LBP in 16 (2.7%). Five hundred adolescents (34.7%) reported no pain, and 369 (25.6%) reported other pain without LBP. In those with isolated LBP, the percentage of adolescent boys was higher (54.6%; P < .001) and the LBP was mildest. In those with LBP plus whole-body pain, the percentage of adolescent girls was higher (62%; P < .001) and LBP was most severe. All KIDSCREEN scores in the group with LBP plus whole-body pain were significantly lower than in the other groups (effect size, 0.52-1.24). No differences were found between the groups who reported isolated pain, no pain, or other pain with no LBP. On the LBP-specific instruments, adolescents who reported LBP plus other pain had significantly poorer scores (P < .001) compared with those with isolated LBP but better scores (P < .001) than those with LBP plus whole-body pain.


CONCLUSIONS
Low back pain in adolescents is a prevalent symptom with overall low associated disability and little effect on health-related quality of life. A subset of adolescents in whom LBP is associated with whole-body pain report significant impairment and deserve more attention.
Pellisé
Ferran
F
Spine Unit, Hospital Universitari de Traumatologia I Rehabilitació Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. 24361fpu@comb.es
Balagué
Federico
F
Rajmil
Luis
L
Cedraschi
Christine
C
Aguirre
Mario
M
Fontecha
Cesar G
CG
Pasarín
Maribel
M
Ferrer
Montse
M
D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D010147:Pain Measurement; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D014505:Urban Population