Stress and sleep-deprivation causing back pain for teens, not schoolbags, study suggests

Back pain in teenagers is not a legacy of schoolbags which are too heavy but of a combination of factors including stress and lack of sleep, new research suggests.

A team of researchers at the University of Limerick found that new approaches to tackling back pain are not being tested among teenagers.

Almost half (48 per cent) of adolescents who experience lower back pain go on to experience it in later life and more than a quarter (28 per cent) say it is significantly disabling for them.

The study, carried out by researchers at University of Limerick along with colleagues in the UK and Australia, was a scoping exercise which looked at 1,952 records of back pain among teenagers globally.

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The research, published in the European Journal of Pain, reveals that there is a lack of treatments addressing the specific needs of teenagers with persistent non-specific back pain.

It shows that treatments for adolescents with persistent back pain have primarily relied upon an outdated, biomechanical explanation of persisting pain.

Back pain is the biggest cause of disability in the world, and it starts for many people when they are teenagers. Many can suffer considerably with back pain, missing out on school, sports, and social engagement.

There was a time when it was assumed that back pain in teenagers was caused mostly by physical factors such as posture and heavy schoolbags. However, it is now accepted that back pain is influenced by factors such as sleep, physical activity, mood, and stress, the researchers say.

According to co-author Prof Kieran O’Sullivan recent studies that show lower back pain is often the result of a combination of physical and mental issues are not being taken into account when it comes to teenagers.

“For example, if a teenager has back pain, poor sleep, and low mood – each of which might be connected – they may be seeing multiple healthcare professionals, each of whom is trained to treat only one or two of these symptoms, often only for a short period of time, and who are likely unable to communicate with each other easily using electronic health records,” he said.

“To help teenagers with back pain recover better, we need to trial these new treatments, and to structure healthcare in a way where physical and mental health are considered together.”

Most teenagers who experience lower back pain are giving exercises to deal with it, but they have limited results, the researchers argue.

Most treatments being offered to teenagers with back pain tend to ignore the ‘big picture’ issues such as sleep, mood, stress, and relationships.

“Traditional approaches such as exercise can play a useful role in helping teenagers with back pain,” explained PhD researcher Sara D Hauber.

“However, exercise alone is rarely enough, and we have good evidence that other factors can have a major impact on a person’s pain.”

The new research builds on previous studies carried out at UL by Professor O’Sullivan that have challenged previously accepted thinking on the treatment of back pain.

One recent study showed that people who received personalised treatment, which specifically matched their health needs, did better than those who received similar recommended care in a non-personalised manner, while another demonstrated that that common understanding of ‘proper’ sitting posture was outdated and may in fact hinder the treatment of back pain.

The study, entitled Describing the nonsurgical, nonpharmacological interventions offered to adolescents with persistent back pain in randomised trials: A scoping review, by Sara D Hauber, Kieran O’Sullivan and others, has been published by the journal European Journal of Pain.