What is adolescent low back pain? Current definitions used to define the adolescent with low back pain

Figures & data

Table 1 Potential causes for ALBP

Primary spinal disorders Mechanical Disc lesions or herniations Spondylolysis and spondylolisthesis Scheuermanns disease Overuse injuries Traumatic injuries Congenital disorders – scoliosis, spinal fusion, spinalstenosis Inflammatory/Infectious Diskitis Disc calcifications Inflammatory rheumatic disorders Infections of the bone/soft tissue Arachnoiditis Neoplasms Benign tumors – osteoid osteoma, osteochondroma, lipoma, giant cell tumor, Malignant tumors – Ewings sarcoma, osteogenic sarcoma, neuroblastoma, cord tumors Radiation Therapy sequalae Systemic or nonspinal diseases Hematolgic disorders – sickle cell, leukemia, Hodgkin’s, and non-Hodgkin’s lymphoma Aortic dissection Intra-abdominal diseases Fibrositis Marfans disease Psychological Nonspecific causes

Notes: Adapted from Balague and Nordin,¹⁷ and King.¹⁸

Figure 1 Number of studies on adolescent low back pain prevalence published by decade.

Figure 2 Relationship between average period prevalence rates for general adolescent low back pain.

Table 2 Characteristics of the studies presenting ALBP prevalence data used in this review

		Studies		Subjects
		n	%	n	%
Origin of study sample	European	34	77	267,976	96.3
	Middle East	2	4.6	5,400	1.9
	Australasia	3	6.8	2,124	0.8
	Americas	3	6.8	1,879	0.7
	Africa	2	4.6	826	0.3
Data collection methodology	School	40	91	60,083	21.6
	National Survey	4	9	218,122	78.4
Period recall (% add up to greater than 100 as some studies use multiple recall periods)	PP	14	31.8	21,737	7.8
	1M	15	34.1	15,503	5.6
	3M	3	6.8	4,871	1.8
	6M	6	13.6	206,988	74.4
	1Y	12	27.3	36,935	13.3
	LT	20	45.5	38,247	13.7

Abbreviations: ALBP, adolescent low back pain; PP, point prevalence; 1W, 1-week; 1M, 1-month; 3M, 3-month; 6M, 6-month; 1Y, 1-year; LT, lifetime.

Table 3 Characteristics of the studies presenting ALBP prevalence data used in this review

Study	Definition	ALBP grouping
Grimmer and Williams,^Citation32 Cakmak et al,^Citation27 Legg et al,^Citation8 Mogensen et al,^Citation44 Wedderkop et al,^Citation60 Balague et al,^Citation25,Citation4,Citation21 Prista et al,^Citation49 Harreby et al,^Citation33 Shehab et al^Citation51	Any pain in the low back.	General
Watson et al,^Citation58 Murphy et al,^Citation45,Citation46 Jones et al^Citation35,Citation38	Low back pain lasting for one day or longer.	General
Auvinen et al^Citation23	Any pain or aching in the low back area.	General
Olsen et al^Citation47	Pain or other trouble with the lower part of the back.	General
Sjolie^Citation53	Pain, ache, or discomfort in the lower back, not related to trauma or menstrual pain.	General
Ebrall,^Citation19 Skoffer and Foldspang^Citation54	Any pain or discomfort in the low back.	General
Mierau et al^Citation43	Pain, soreness, or hurt over the low back.	General
Kristensen et al^Citation40	Any ache, pain, or discomfort in the lower back.	General
Jones et al^Citation37	Any low back pain or pain occurring regularly.	General, Chronic/recurrent
Vikat et al^Citation57	Pain in the low back at least weekly.	Chronic/recurrent
El-Metwally et al,^Citation29 Mikkelson et al^Citation61	Any pain or ache in the low back – paper reported on monthly or weekly recurrence only.	Chronic/recurrent
Feldman et al^Citation30,Citation31	Low back pain with a frequency of at least once per week.	Chronic/recurrent
Hakala et al^Citation34	Back pain at least weekly over the past half a year.	Chronic/recurrent
Diepenmaat et al^Citation28	Pain lasting a day or longer with >4 days per month.	Chronic/recurrent
Taimela et al,^Citation2 Kujala et al^Citation41	Low back pain that interfered with school, work, or leisure activities.	Severe/disabling
Masiero et al^Citation42	Any nonoccasional pain that in some way limited the student in daily activities.	Severe/disabling
Burton et al^Citation26	Quite bad pain, other than occasional twinges.	Severe/disabling
Prendeville and Dockrell^Citation48	An episode of low back pain and/or discomfort that interrupted normal daily activities and/or required treatment. Low back pain due to any structural abnormalities or menstrual pain is excluded.	Severe/disabling

Table 4 Period prevalence rates for each category of ALBP

Study		Prevalence (%)
		PP-1W	1M	3M	6M	1Y	LT
General low back pain	Auvinen et al^Citation23				39
	Balague et al^Citation4	13					40
	Balague et al^Citation21	9.4					32.5
	Balague et al^Citation24						20
	Balague et al^Citation25						51
	Bejia et al^Citation36	13					28.4
	Cakmak et al^Citation27						32
	Ebrall^Citation19	16.7					57
	Grimmer and Williams^Citation32	25.4
	Harreby et al^Citation33	13.9	30.6			50.8	58.9
	Jones et al^Citation35		18.6
	Jones et al^Citation37	15.5					40.2
	Jones et al^Citation38		25.4
	Kjaer et al^Citation39		22
	Kovacs et al^Citation50	25					61
	Kristensen et al^Citation40						63
	Legg et al^Citation8						48
	Mierau et al^Citation43				33
	Mogensen et al^Citation44		40
	Mohseni-Bandpei et al^Citation62	15	14		15.6	17.4
	Murphy et al^Citation45	20	36
	Murphy et al^Citation46		22				55
	Olsen et al^Citation47					22	30.4
	Prista et al^Citation49						58
	Shehab et al^Citation51	35					57.8
	Sjolie^Citation52,Citation53					57
	Skoffer and Foldspang^Citation54			51.3		60.3	64.8
	Staes et al^Citation55		38
	Troussier et al^Citation56	23
	Van Gent et al^Citation63		46.5
Recurrent	Watson et al^Citation58,Citation59		23.9
	Wedderkopp et al^Citation60		14.8
	Diepenmaat et al^Citation28		7.5
	El-Metwally et al^Citation29			22.4
	Feldman et al^Citation30,Citation31				24.9
	Balague et al^Citation25						48
	Jones et al^Citation37					13.1
	Prista et al^Citation49		12			13.5	28
	Shehab et al^Citation51						36
	Staes et al^Citation55		3
	Sjolie^Citation53					32
	Vikat et al^Citation57				27
	Hakala et al^Citation34				11.7
Disabling	Kristensen et al^Citation40					22
	Skoffer and Foldspang^Citation54			24.2
	Kujala et al^Citation41					10.7
	Masiero et al^Citation42					20.5
	Prendeville and Dockrell^Citation48	17				28	41.5
	Taimela et al^Citation2					14.2
	Kjaer et al^Citation39		8
	Balague et al^Citation25		24.3
	Burton et al^Citation26	7					30

Abbreviations: ALBP, adolescent low back pain; PP, point prevalence; 1W, 1-week; 1M, 1-month; 3M, 3-month; 6M, 6-month; 1Y, 1-year; LT, lifetime

Table 5 Summary of period prevalence rates for each category of adolescent low back pain

		Prevalence rates (%)
		General	Severe/disabling	Recurrent/chronic
0–1 week	Average (50th %ile)	16.1	12	N/A
	Range (%min–%max)	9.4–35	7–17	N/A
	No of Studies	12	2	N/A
1-month	Average (50th %ile)	24.65	16.15	7.5
	Range (%min–%max)	14–46.5	8–24.3	3–12
	No of Studies	12	2	3
3-month	Average (50th %ile)	51.3	24.2	22.4
	Range (%min–%max)	51.3	24.2	22.4
	No of Studies	1	1	1
6-month	Average (50th %ile)	33	N/A	24.9
	Range (%min–%max)	15.6–39	N/A	11.7–27
	No of Studies	3	N/A	3
12-month	Average (50th %ile)	50.8	20.5	13.5
	Range (%min–%max)	17.4–60.3	10.7–28	13.1–32
	No of Studies	5	5	3
Lifetime	Average (50th %ile)	51	35.75	36
	Range (%min–%max)	20–64.8	30–41.5	28–48
	No of Studies	17	2	3

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