Baseline musculoskeletal pain and impaired sleep related to school pressure influence the development of musculoskeletal pain in N=107 adolescents in a 5-year longitudinal study

Purpose This longitudinal study followed 10- to 13-year-old adolescents for 5 years to investigate the effects of juvenile musculoskeletal (MSK) pain and psychosocial risk factors on future pain. We further predicted that increased MSK pain at follow-up would be positively related to current school pressure at follow-up and negatively related to current sleep quality. Sleep quality was tested as a potential mediator of the link between school pressure and MSK pain at follow-up after controlling for baseline MSK pain. Methods The baseline sample comprised 189 adolescents, and 5-year follow-up resulted in 107 15- to 18-year-old adolescents who had completed mandatory education. Adolescents responded to an online questionnaire about psychosocial stressors, MSK pain, school achievement and leisure activities. A longitudinal hierarchic linear regression including all significant baseline predictors was run to assess their impact on MSK pain 5 years later. Mediation analysis was used to investigate sleep quality as a potential mediator of the relationship between school pressure and MSK pain at follow-up. Results Baseline MSK pain predicted MSK pain over a time lag of 5 years (ss = .26, p = .02). The relationship between follow-up school pressure and current MSK pain was mediated by sleep quality at follow-up (B = .17, SEB = .07, 95% CI .06-.34) when baseline MSK pain was controlled. Conclusions Juvenile MSK pain predicts MSK pain in adolescence. A psychosocial mediation model including school pressure and sleep impairments has the potential to explain MSK pain mechanisms in adolescents. Graphic abstract These slides can be retrieved under Electronic Supplementary Material. [GRAPHICS] .