1. Home>
2. Specialties>
3. Pediatrics and Adolescent Medicine>
4. Summary and Comment

What a Pain! Back, Neck, and Shoulder Problems in Teens

A reminder that complaints of chronic pain by adolescents warrant screening for depression and stress.

Chronic abdominal pain is a common complaint in adolescence; chronic musculoskeletal pain is a less familiar symptom. Dutch investigators — concerned about an increase in the number of teenagers presenting with low back and neck/shoulder pain — used a self-administered, school-based questionnaire to assess whether computer use, physical activity, stress, and depression were associated with musculoskeletal pain (present for 4 or more days in the month preceding the survey) in 3485 adolescents (age range, 12–16).

The prevalence of neck/shoulder pain was significantly higher among girls than boys (14.2% vs. 8.7%), as was the prevalence of low back pain (9.5% vs. 5.6%). Arm pain (overall prevalence about 4%) did not differ by sex. Computer use and physical activity were not correlated with any of the pain complaints. After controlling for sex, the odds of experiencing pain in any of the three regions were two to three times higher among those who scored 16 or higher on the Center for Epidemiologic Studies Depression Scale (CES-D), a well-validated instrument for measuring depressive symptoms in adolescents. Respondents who reported feeling stress "regularly/often" were 1.5 to 2 times more likely to report neck/shoulder and low back pain than were those who indicated they experienced stress "never/only once."

Comment: This study serves as a gentle reminder that complaints of chronic pain, regardless of location, should prompt screening for depression and stress among adolescents. Asking adolescents with such complaints about their mood and about life at home, at school, or with friends may yield valuable clues to the etiology of the pain.

— Alain Joffe, MD, MPH, FAAP

Published in Journal Watch Pediatrics and Adolescent Medicine May 5, 2006

Citation(s):

Diepenmaat AC et al. Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents. Pediatrics 2006 Feb; 117:412-6.

• Original article (Subscription may be required)
• Medline abstract (Free)