ADOLESCENT SPINAL PAIN AND PHYSICAL ACTIVITY

Spinal pain is experienced by more than three-quarters of people at some point in their life and can lead to disability, considerable distress, and time off work and sport. There is good evidence that spinal pain tends to be first felt in adolescence by at least half the population, and several studies have shown that spinal pain during adolescence is one of the strongest risk factors for adult spinal pain. Knowledge of the causes of adolescent spinal pain is therefore important to health and sports professionals as it may help to ensure that advice is effective not only in preventing or decreasing adolescent spinal pain, but also in reducing the chance of problems later in life.

BY DR MARK PERRY MCSP, PHD INTRODUCTION

Much research has been done into adolescent spinal pain. This research can be divided into three main areas. The first area concerns psychological or social factors. Most studies appear to agree that there is an association between adolescent spinal pain and factors such as depression, psychosomatic symptoms and social deprivation. The second area concerns physical factors. These studies have tended to be rather conflicting, although it does appear that obesity, extremes of spinal posture, and reductions in flexibility, motor coordination and aerobic fitness are weakly associated with a higher risk of adolescent spinal pain. The third area of study concerns activity. This will be the focus of this article, as it is an area that has the potential to directly inform preventive or rehabilitative advice. It seems intuitive that the activities that are performed (or not performed) day after day and week after week will relate to the health of the spine, and the scientific literature seems to bear this out to a certain extent. However, the anecdotal belief that low activity is bad and high activity is good is not necessarily true.

COMPUTER USE

One sedentary activity that has been studied extensively is computer use. Seeing an adolescent slumped over a laptop leads naturally to the assumption that the spine will suffer, and two recent studies from Finland appear to support this (1,2). In the study by Hakala and colleagues, adolescents using computers for more than 5 hours a day were twice as likely as non-users to have back pain (1). Those using the computer for more than 8 hours a day were two and a half times as likely as non-users to have neck pain. The authors concluded that the growing use of information technology might explain the growth in adolescent spinal pain over the past 15 years. Auvinen and colleagues observed a similar relationship in boys, though not in girls (2), possibly reflecting

12 sportEX medicine 2009;41(Jul):12-19