Determinants of adolescent health care use for low back pain.
BACKGROUND
Recent studies have indicated that low back pain (LBP) is common already in adolescence, but only few studies have evaluated the factors that determine LBP-related health care use at this age.


METHODS
The study population included 1987 adolescents aged 18 from the Oulu Back Study, a subcohort of the 1986 Northern Finland Birth Cohort. We used logistic regression to evaluate whether enabling resources, need factors, personal health habits or psychological problems are associated with seeking health care for LBP, among adolescents reporting LBP during the last year.


RESULTS
Of the 1987 respondents, 50% of the females and 42% of the males reported having had LBP during the previous year. Of the 921 respondents with LBP, 89 (16%) females, and 59 (16%) males had consulted a health care professional. In both genders, pain intensity was strongly associated with seeking care [visual analogue scale (VAS) 8-10 vs. VAS 0-3; males: OR 16.6, 95% CI 3.8-72.5, females: OR 18.8 95% CI 6.3-56.1]. In addition, LBP-related daily activity limitations (impairment index 4-6 vs. 0 OR 15.7 95% CI 1.7-142.5) were associated with care seeking among males. Student status was also associated with care seeking among males (OR 2.34 95% CI 1.02-5.36).


CONCLUSIONS
Approximately one out of six adolescents with LBP seeks medical care. Intensity of pain and daily activity limitations appear to be the main determinants of seeking care for LBP in adolescence.
Department of Physical and Rehabilitation Medicine, Institute of Clinical Medicine, University of Oulu, Finland.
A H
AH
Tiira
M V
MV
Paananen
S P
SP
Taimela
P J
PJ
Zitting
M-R
MR
Järvelin
J I
JI
Karppinen
D000203:Activities of Daily Living; D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires