Can Childhood Factors Predict Your Adult Back Pain?
Back pain is a commonly reported health problem worldwide. Pain is indeed a disability for many people, and it causes major activity limitations and work absences. Living with pain can also create a socioeconomic burden on the patient as well as the healthcare system, where pain accounts for a significant portion of the global healthcare spend.
The prevalence of severe and disabling back pain often increases as a person ages. For many people worldwide, back pain is intermittent but recurring, and a past history of back pain can predict future pain episodes. By examining the course of back pain across a person’s life, it is possible to identify groups of people who are more prone to pain.
In 2018, a group of British researchers took a novel approach to looking at pain profiles in adults. This research team wanted to look at the influence of childhood risk factors on the pain profiles of these adults. The study is interesting because most pain studies of adults are done on specific groups of people, such as certain individuals in workplace settings; even clinical studies tend to only follow people for up to five years, often with very few collection points along the way. Quite often, studies tend to look at back pain at a single moment in adulthood.
As such, many of the pain profiles published to date do not completely reflect what the long-term course of back pain is really like in the general adult population. In this longitudinal study, researchers used data from over 3,000 patients and looked at back pain in people age 31 to 68. The research team not only looked at childhood risk factors and family history of pain, but also gender, body size, health status, lifestyle health choices and socioeconomic position in society.
A novel patient group
The study population is very interesting. Data were taken from the Medical Research Council National Survey of Health and Development; all adults in the study were born during one week in March 1946 in England, Wales and Scotland; the group is a good representative example of the entire British population born during that time period. Researchers have been following the group from birth. Data has been collected at least every two years in childhood, and every five to ten years in adulthood. The study has a high participation rate; people have remained in the study across their lifetimes.
Study participants were first asked about back pain at age 31, and again at ages 36, 43, 53, and 60 to 64 years; adults were specifically asked whether they had experienced recurring or severe backache, sciatica and lumbago. At the last data collection at age 68, participants were asked about pain they had experienced in the previous month. Those that did experience pain were asked to identify the pain location and severity.
Previous longitudinal studies had centered on four profiles of back pain in adults: recovering, fluctuating, persistent, or recurring. This new British study was quite different. When relating back pain to childhood, the researchers identified four new pain profiles: no/occasional pain, early adulthood only pain, mid-adulthood onset of pain and persistent pain. Interestingly, the largest group (nearly 60%) had no or occasional pain. About 16 percent had early adulthood pain and another 16 percent had mid-adulthood pain onset. Only about 10 percent had persistent pain.
Interesting study results
The study produced some very interesting results:
- Adults who had early-adulthood only pain or persistent pain were more likely to have this pain if they had taller-than-average height at age 7.
- More men than women reported no or occasional back pain
- People with abdominal pain, male and female, were more likely to have persistent back pain and mid-adulthood pain onset
- People who had the poorest childhood healthcare or who had mothers that had poor maternal care were more likely to have mid-adulthood pain onset
The research team concluded that when one looks across an adult’s entire lifetime, the back pain profiles are different. The etiology of pain is complex across life. It is influenced by physical factors as well as social and psychological factors as well. The British study highlights the importance of early childhood health care and interventions for pain prevention and management, and it adds to the body of knowledge regarding long-term profiles of back pain.
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