Risk factors for traumatic and non-traumatic lower limb pain among preadolescents: a population-based study of Finnish schoolchildren
Open accessAbstract
Background: The child's lower limb is the most commonly reported musculoskeletal location with pain and also the most commonly injured site in sports. Some potential risk factors have been studied, but the results are inconsistent. We hypothesized that distinction of traumatic from non-traumatic pain would provide a clearer picture of these factors. The aim of this study is to assess factors associated with lower extremity pain and its impact on preadolescents in a population-based cohort. Methods: A structured pain questionnaire was completed by 1756 schoolchildren of third and fifth grades to assess musculoskeletal pain, psychosomatic symptoms, subjective disabilities, school absence and frequency of exercise. In addition, hypermobility and physical fitness were measured. Results: The knee was the most common site of pain followed by the ankle-foot and thigh. Of the children who reported pain in their lower extremity, approximately 70% reported at least one disability and 19 % reported school absence attributed to their pain during the previous three-month period. Children with traumatic pain had a higher subjective disability index than those with non-traumatic pain (P = 0.02). Age less than 11 years, headache, abdominal pain, depressive feelings, day tiredness, and vigorous exercise were more common in children with lower limb pain than those free of it. In the stratified analysis, younger age was related to both traumatic and non-traumatic pain groups. Vigorous exercise was positively associated with traumatic pain, while subjects with non-traumatic pain had more frequent psychosomatic symptoms. Conclusion: Risk factors and consequences of traumatic and non-traumatic lower limb pain are not similar. Traumatic lower limb pain is associated with practicing vigorous exercise and high level of physical fitness, while non-traumatic pain is more correlated with psychosomatic symptoms. These differences might be one of the reasons for the discrepancy of previous research conclusions. The two conditions need to be treated as different disorders in future studies.
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The association between GJH and acute onset intermittent MSK pain has been found in several population studies of adolescents and one study in symptomatic children.
“The association between GJH and acute onset intermittent MSK pain has been found in several population studies of adolescents [19, 20], and one study in symptomatic children [21].”
From Pediatric joint hypermobility: a diagnostic framework and narrative review (2023) · cites this paper as [21]
The Results section (page unavailable) reports no association between hypermobility and either traumatic or non-traumatic lower-limb pain in this population-based study of preadolescents. The Discussion likewise says pain occurrence did not differ between children with and without hypermobility. The paper does not report an association with acute-onset intermittent pain in adolescents. (LLM, conf=0.86)
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- Authors
- El-Metwally, A., Salminen, J. J., Auvinen, A., Kautiainen, H., & Mikkelsson, M.
- Affiliations
- Turku University Hospital (FI)
- Tampere University (FI)
- Reumasäätiön sairaala (FI)
- Venue
- BMC Musculoskeletal Disorders
- Published
- 2006-01-18
- Volume
- 7
- Issue
- 1
- Pages
- 3-3
- ISSN
- 1471-2474 (ISSN-L)
- PMC
- PMC1382225
- OpenAlex
- W1855568856
- Cited by
- 44
- References
- 40
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 2
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Musculoskeletal Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Tampere University Institutional Repository (Tampere University) (publishedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Signe ja Ane Gyllenbergin Säätiö
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- lower limb pain, trauma pain, preadolescents, elementary school students, risk factors, knee pain, thigh pain, psychosomatic symptoms, physical fitness, high-intensity exercise, school absenteeism, joint hypermobility, depressive mood, headache
- MeSH terms
- Age Factors, Child, Exercise Test, Female, Finland, Humans, Joint Instability, Male, Pain, Pain Measurement, Physical Fitness, Psychophysiologic Disorders, Surveys and Questionnaires, Risk Factors, Sex Factors, Cohort Studies, Exercise, Lower Extremity
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