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Low Back Pain a Common Problem in Chinese Children

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More and more children around the world are reporting low back pain. In this study, public health officials from China report on this problem among their children. It turns out that one-fourth of all boys (ages 10 to 18) and one-third of all girls (the same ages) have low back pain.

How does this high prevalence of low back pain in Chinese schoolchildren compare to children in other countries? Studies show a 22 per cent prevalence rate in British children, 30 per cent in American children, and 50 per cent in Danish children. Japanese children had a much lower point prevalence of 10 per cent but a 29 per cent lifetime prevalence.

Prevalence refers to the number of people who report low back pain at one specific point (day) in time or over a short period of time (e.g., three weeks or three months). The prevalance rate in Chinese children was determined using a questionnaire filled out by 2100 school children.

The children were all from one large city (population of more than 10 million). Information collected from the children included age, sex (male versus female), height, weight, and report of low back pain at least once in the last three months.

Other questions about pain included pain intensity, frequency (how often the child experienced pain), duration (how long the pain lasted), description (e.g., sharp, dull), and the impact of pain on daily life. The presence of leg pain, pain with sports activity, and pain after sitting or getting up were also recorded.

After analyzing the data, they found that girls are affected twice as often as boys. Low back pain is more common as children get older. And children with low back pain are likely to have the same painful symptoms in their adult years. In fact, in this study, between ages 10 and 17 the number of children reporting low back pain doubled from 20 to 43 per cent.

You might think that sitting for long periods of time in school, in front of a television, or while using a computer would increase the prevalence of low back pain. But, in fact, there were just as many students with low back pain who were engaged in sports activities (probably due to injury but this was not reported). With so many children around the world affected by low back pain, the question comes up: Why?

This study did not analyze the why but the authors suggested a few possibilities. Heavier backpacks, longer study time, and greater numbers of children affected by anxiety and/or depression might be contributing factors.

With over one billion people in China and 17 per cent being school-aged children, the high prevalence of low back pain could become a costly problem. The authors of this study suggest additional research is needed to identify possible cause and effect. This information could aid efforts to reduce the number of school-aged children affected by low back pain.

Reference: Weiguang Yao, MD, et al. A Cross-Sectional Survey of Nonspecific Low Back Pain Among 2081 Schoolchildren in China. In Spine. October 15, 2011. Vol. 36. No. 22. Pp. 1885-1890.

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