Is Puberty a Risk Factor For Back Pain?
Written by Editor   
Wednesday, September 14, 2016 12:00 AM

Back pain is a common condition that starts early in life and seems to increase markedly during puberty. According to two recent systematic literature reviews, the lifetime prevalence increases between the ages of 7 and 12 (on average from 1% to 17%) to reach the adult level around the age of 20. In relation to low back pain, it appears that puberty is the time for a rapid increase.

The time of puberty is the transition period from childhood to adulthood and over only a few years, both body and soul will undergo many changes. The most apparent morphological differences are increased height and a change in body composition. It has been proposed that these may impact back pain. The growth spurt, defined as an average gain of 10 cm per year, could be considered a particularly vulnerable period due to sudden mechanical loading changes on the spine. Girls start puberty earlier than boys, which may explain why they report back pain earlier than boys.

A systematic review was performed in order to investigate the link between puberty and back pain, using some Bradford Hill criteria for causality.  Researchers sought to obtain answers to the following questions: 1) Is there an association between puberty and back pain? If so, how strong is this association? And do the results remain unchanged also when controlling for age and sex? 2) Are the results of the studies consistent? 3) Is there a dose-response, showing a link between the increasing stages of puberty and the subsequent prevalence of back pain? 4) Is there a temporal link between puberty and back pain?

All our criteria for causality were fulfilled or somewhat fulfilled indicating the possibility of a causal link between puberty and back pain. 

Systematic searches were made on back pain for subjects <19 years, written in French or English. Four articles reporting five studies were included, two of which were longitudinal. 1) Some studies show a weak and others a strong positive association between puberty and back pain, which remains after controlling for age and sex; 2) Results were consistent across the studies; 3) There was a linear increase of back pain according to the stage of puberty 4) Temporality has not been sufficiently studied.