Back pain in teens linked to substance use and poor mental health

The study of more than 6000 Australian teens, published today in the Journal of Public Health, found the proportion of adolescents who reported smoking, drinking or missing school rose incrementally with increasing frequency of back pain.

While mental health trends were less clear, there was a significant difference between the mental health indicators of those who reported no pain in comparison to those with frequent back pain.

Lead author Associate Professor Steve Kamper said the findings suggest pain needs to be included in broader discussions about adolescent health.

“During adolescence pain from bones, joints,muscles, and back pain in particular, rises steeply. Despite being the cause of substantial health care use and school absences, pain in this age group is commonly dismissed as trivial or fleeting,” said Associate Professor Kamper from the University of Sydney School of Public Health.

“This study shows that adolescents with frequent pain are also at increased risk of other health problems, which is of concern as both pain and these risky behaviours have ongoing consequences that stretch well into adulthood.”

The study is based on cross-sectional data collected from over 6000 Australian teenagers aged 14 to 16 years, sourced from two large independent studies conducted during 2014 and 2015.

While the point-in-time nature of the data does not allow researchers to explore cause and effect, the reporting of frequent pain appears to be a sign of other potentially less visible health issues.

For example, 14 and 15-year-olds who experienced pain more than once a week were two to three times more likely to have drunk alcohol or smoked in the past month than those who rarely or never had pain.

Similarly, students who experienced pain more than once a week were around twice as likely to have missed school in the previous term.

“While we can’t say back pain is the cause of risky behaviour or mental health concerns, the study suggests adolescent back pain may play a role in characterising overall poor health, and risk of chronic disease into adulthood,” said Dr Kamper.

Dr Kamper said pain in adolescence is not well understood and further research is urgently needed to inform better clinical treatment and management for this age group.