Faculty of medecine in Tunis, University Tunis El Manar, Tunis, Tunisia.
Rheumatology department, Mongi Slim Hospital, La MARSA, Tunisia.
Pediatr Rheumatol Online J. 2024 Sep 9;22(1):84. doi: 10.1186/s12969-024-01007-w.
The prevalence of back and neck pain is common in children and adolescents, and in some series the numbers are alarming. Various risk factors have been identified, although some are controversial.
To determine the prevalence of neck and back pain in children and adolescents and to investigate the potential association with various risk factors identified in the literature.
We established a questionnaire targeting parents of children and adolescents aged between 6 and 18 years old in Tunisia. The recruitment of participants was done online using the Google Forms application. The questionnaire was divided into 2 parts: Part one collected the sociodemographics characteristics of the participants : age, gender, body mass index (BMI), exposure to passive smoking, the practice of a physical activity, puberty status and age at puberty if applicable, type and weight of the schoolbag, mean daily time spent on electronic devices, type of school the child attends (private/public), mode of transport from home to school, parental history of neck and/or back pain (mid or low back pain (LBP)), posture of the sitting position of the child, and finally whether the child reports neck/ back pain. The second part was aimed at parents whose child reported neck and/or back pain. We asked about the weekly frequency of neck/back pain, school absenteeism due to neck/back pain, whether it prevented the child from practicing physical activity and, finally, whether the child had ever seen a doctor/chiropractor/physiotherapist for their neck/back pain.
Eighty-eight children (45 females, 43 males) were enrolled. Mean age was 11.9 ± 3.8 years [6-18]. Mean BMI was 18.8 ± 4.2 [15.8-35.5]. Thirty-four (38.6%) were pubescent. Twenty-five (28.4%) children were exposed to passive smoking. Parental history of spine pain was found in 58% of cases. A poor sitting position was noted in n = 49 (55.7%). Mean daily screen time was 88.3 ± 75.56 min [0-360]. Prevalence of spine pain was 44% (n = 39) distributed as follows: neck pain (n = 21, 23.8%), mid back pain (n = 15, 17%), LBP (n = 26, 29.5%), neck, mid back and low back pain (n = 4, 4.5%) Professional help seeking for spine pain in children was reported by 15 participants (25.3%). Among them, 20.3% visited a physician and 5% consulted a chiropractor or physiotherapist. A significant correlation was found between spine pain and age (p = 0.006) and BMI (p = 0.006). A significant association was found between LBP and exposure to passive smoking, puberty status, type of school bag and poor posture. A positive parental history of spine pain was significantly associated with the presence of spine pain in their children with p = 0.053 (neck pain), p = 0.013 (back pain) and p < 0.00 (LBP) respectively. A significant association was found between the presence of spine pain and school absenteeism, participation in sports, consultation with a doctor or physiotherapist/chiropractor (p < 0.0001 respectively).
The prevalence of spinal pain was frequent in our series. A positive parental history of spinal pain, a bad posture while sitting, passive smoking, use of backpack, higher age and higher BMI were potential associated factors.
背部和颈部疼痛在儿童和青少年中很常见，在一些系列研究中，发病率令人担忧。已经确定了各种风险因素，尽管有些存在争议。
确定儿童和青少年颈部和背部疼痛的患病率，并调查与文献中确定的各种潜在风险因素的关联。
我们为突尼斯的儿童和青少年的父母制定了一份问卷。通过 Google Forms 应用程序在线招募参与者。问卷分为两部分：第一部分收集参与者的社会人口统计学特征：年龄、性别、体重指数（BMI）、被动吸烟暴露、体育活动的实践情况、青春期状态和青春期年龄（如有）、书包类型和重量、每天花费在电子设备上的平均时间、孩子就读的学校类型（私立/公立）、从家到学校的交通方式、父母有颈部和/或背部疼痛史（中或下背部疼痛（LBP））、孩子坐姿的姿势，以及孩子是否报告颈部/背部疼痛。第二部分针对报告颈部和/或背部疼痛的父母。我们询问了颈部/背部疼痛的每周频率、因颈部/背部疼痛而缺课、疼痛是否妨碍孩子进行体育活动，以及孩子是否因颈部/背部疼痛看过医生/脊椎按摩师/物理治疗师。
共纳入 88 名儿童（45 名女性，43 名男性）。平均年龄为 11.9±3.8 岁[6-18 岁]。平均 BMI 为 18.8±4.2[15.8-35.5]。34 名（38.6%）儿童青春期。25 名（28.4%）儿童暴露于被动吸烟。58%的病例有脊柱疼痛家族史。有 49 名（55.7%）儿童坐姿不良。平均每天屏幕时间为 88.3±75.56 分钟[0-360]。脊柱疼痛的患病率为 44%（n=39）分布如下：颈部疼痛（n=21，23.8%）、中背部疼痛（n=15，17%）、LBP（n=26，29.5%）、颈部、中背部和下背部疼痛（n=4，4.5%）有 15 名参与者（25.3%）因脊柱疼痛寻求专业帮助。其中，20.3%的人去看了医生，5%的人咨询了脊椎按摩师或物理治疗师。脊柱疼痛与年龄（p=0.006）和 BMI（p=0.006）呈显著相关。LBP 与被动吸烟、青春期状态、书包类型和不良姿势显著相关。父母有脊柱疼痛史与孩子存在脊柱疼痛显著相关，p=0.053（颈部疼痛）、p=0.013（背部疼痛）和 p<0.00（LBP）。脊柱疼痛的存在与缺课、参加运动、咨询医生或物理治疗师/脊椎按摩师之间存在显著关联（分别为 p<0.0001）。
在我们的研究中，脊柱疼痛的患病率很高。父母有脊柱疼痛史、坐姿不良、被动吸烟、使用背包、年龄较大和 BMI 较高是潜在的相关因素。
