Abstract
Many studies in UK and other countries over the past 15 years have shown a high one year prevalence of back pain in teenagers rising from around 12% at the age of 12 to adult levels in excess of 30% by the age of 19.
Around 8% of all adolescents are significantly affected by chronic or recurrent back or neck pain sufficient to compromise school attendance and/or sport. Girls report around 10% more disability than boys.
Adolescent back pain, especially when accompanied by MRI changes at the age of 15, is associated with continuing symptoms in adult life.
Associated risk factors are physical, environmental, psychosocial and genetic. Some of these can be rectified, others clearly cannot, but once identified, they can usually be managed satisfactorily to minimise disability.
Known physical factors include too little or occasionally too much exercise, also many schools do not have adequate lockers which necessitates carrying heavy loads of books, sports equipment, etc. often in inadequate bags. A maximum load of 15% of body weight is recommended.
Environmental factors include poorly designed lowest cost school furniture causing postural strain, which cannot be adjusted to take account of the half metre variation in height of 15 year olds. One size does not fit all. Much school furniture would be illegal in an office, School is the workplace of the child.
This paper reviews the recent literature which indicates that attention to these factors results in better school performance and less back pain but further research is required.
Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
