Assessing the association between low back pain, quality of life, and life events as reported by schoolchildren in a population-based study

Low back pain (LBP) is prevalent in teenagers but not necessarily detrimental to their quality of life (QoL). This population-based study evaluated a global QoL score and the association between LBP and life events and/or health problems affecting QoL. Schoolchildren were investigated in Fribourg-Switzerland and Barcelona-Spain. In addition to the KIDSCREEN, a health-related QoL questionnaire, two Numerical Rating Scales were used to assess QoL in general, and the influence of LBP on QoL. Open questions explored life events and health problems affecting QoL; responses were submitted to content analysis. Adolescents were stratified: Pain-free, Other pain (OP), isolated LBP (IsoLBP), LBP + other pains (LBP + OP), and LBP + whole-body pain (LBP + WBP). Between-group comparisons were performed using Chi-squared tests and ANOVA. Linear regression analysis was performed to assess between-group differences in the impact of LBP on QoL. Schoolchildren (1,470) (mean age= 15.05 years, 52.6%=boys) completed the questionnaire. LBP lasting >1 day in the last month was reported by 39.8% (N= 560): of them, 242 (43.2%) reported IsoLBP, 268 (47.9%) LBP + OP, and 50 (9.1%) LBP + WBP. QoL was lower in LBP + WBP (mean=6.44 vs. LBP + OP=7.8; IsoLBP=7.6, OP=7.96, Pain-free=8.1; p<0.001). There were 18.5% who reported health problems and 15.3% life events with a perceived impact on QoL. Prevalence was higher in LBP + WBP with >30% of this group identifying life events and/or health problems vs. 10-12% in PFree or IsoLBP groups (p< 0.001). IsoLBP affected QoL marginally (mean=2.4±2.2) compared to LBP + WBP (mean=4.9±2.4) (p<0.001). LBP affected QoL marginally. These results stress the distinction between disease and common life experience. They also indicate the potential value of global QoL assessments in clinical settings.