High prevalence of daily and multi-site pain--a cross-sectional population-based study among 3000 Danish adolescents

Abstract

Background: Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12-19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index, HRQoL and sports participation).

Methods: A population-based cross-sectional study was conducted among 4,007 adolescents aged 12-19 years in Denmark. Adolescents answered an online questionnaire during physical education lessons. The questionnaire contained a mannequin divided into 12 regions on which the respondents indicated their current pain sites and pain frequency (rarely, monthly, weekly, more than once per week, almost daily pain), characteristics, sports participation and HRQoL measured by the EuroQoL 5D. Multivariate regression was used to calculate the odds ratio for the association between almost daily pain, multi-site pain and respondent characteristics.

Results: The response rate was 73.7%. A total of 2,953 adolescents (62% females) answered the questionnaire. 33.3% reported multi-site pain (pain in > 1 region) while 19.8% reported almost daily pain. 61% reported current pain in at least one region with knee and back pain being the most common sites. Female sex (OR: 1.35-1.44) and a high level of sports participation (OR: 1.51-2.09) were associated with increased odds of having almost daily pain and multi-site pain. Better EQ-5D score was associated with decreased odds of having almost daily pain or multi-site pain (OR: 0.92-0.94).

Conclusion: In this population-based cohort of school-attending Danish adolescents, nearly two out of three reported current pain and, on average, one out of three reported pain in more than one body region. Female sex, and high level of sports participation were associated with increased odds of having almost daily pain and multi-site pain. The study highlights an important health issue that calls for investigations to improve our understanding of adolescent pain and our capacity to prevent and treat this condition.

Figure 1

Prevalence rates of region-specific pain for females (n = 1828).

Figure 2

Prevalence rates of region-specific pain for males (n = 1125).

Figure 3

Box and whisker plot for EQ-5D index score. The EQ-5D index score is divided into adolescents with no pain, one region of pain, multi-site pain, and daily pain. The boxes are bordered at the 25th and 75th percentile (the interquartile range (IQR)) and the diamonds represent the median EQ-5D index scores. The whiskers display the boundary of 1.5 times the interquartile range above and below the median. Outliers beyond the whiskers are shown as individual circles.