title: Adolescent neck and shoulder pain--the association with depression, physical activity, screen-based activities, and use of health care services.
abstract: OBJECTIVE
  Neck and shoulder pain is frequent in adolescents, and multiple factors seem to affect the risk of such symptoms. We aimed to investigate the prevalence of neck and shoulder pain in Norwegian adolescence and to examine whether behavioral and emotional factors were associated with the risk of neck and shoulder pain. Finally we aimed to investigate whether neck and shoulder pain was related to the use of health services.
  
  
  METHODS
  Data from the population-based study ung@hordaland were used. Participants were asked how often during the last 6 months they had experienced neck and shoulder pain. The association between frequent neck and shoulder pain and physical activity, symptoms of depression, and screen-based activities was evaluated using logistic regression analyses stratified by gender. The relative risk of visiting health services when reporting neck and shoulder pain was calculated using multiple logistic regression analyses.
  
  
  RESULTS
  Frequent neck and shoulder pain was reported by 20.0% (1,797 of the total 8,990) and more often by girls than boys (p < .001). A high score of depressive symptoms was the strongest risk factor for neck and shoulder pain in both boys and girls (odds ratio = 6.14 [95% confidence interval 4.48-8.42] and odds ratio = 3.10 [95% confidence interval 2.63-3.67], respectively). Frequent screen-based activities slightly increased the risk while physical activity was protective. Individuals reporting neck and shoulder pain more often visited their general practitioner (47.1% vs. 31.8%) and school health services (24.6% vs. 13.5%).
  
  
  CONCLUSIONS
  Frequent neck and shoulder pain was reported in 20% of Norwegian adolescents. Symptoms of depression and screen-based activities increased the risk of neck and shoulder pain while physical activity was protective. Individuals reporting neck and shoulder pain visited health services more frequently than others.
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway. Electronic address: makalani.myrtveit@med.uib.no.
authors.forename: Solbjørg Makalani
authors.initials: SM
authors.lastname: Myrtveit
authors.affiliation: Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway; Uni Health, Uni Research, Bergen, Norway; Department of Psychiatry, Helse Fonna HF, Haugesund, Norway.
authors.forename: Børge
authors.initials: B
authors.lastname: Sivertsen
authors.affiliation: Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway; Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Jens Christoffer
authors.initials: JC
authors.lastname: Skogen
authors.affiliation: The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Frostholm
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, Bergen, Norway.
authors.forename: Kjell Morten
authors.initials: KM
authors.lastname: Stormark
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, Bergen, Norway.
authors.forename: Mari
authors.initials: M
authors.lastname: Hysing
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D040421:Cell Phone / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D009043:Motor Activity; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D020069:Shoulder Pain / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D013690:Television / Q000706:statistics & numerical data; D018910:Video Games / Q000706:statistics & numerical data
keywords: Adolescent health; Depression; Health services; Neck and shoulder pain; Physical activity; Risk factors; Screen-based activities