Low back pain in 71 percent of youths in Egypt – associated with low vitamin D – April 2017

Mechanical factors and vitamin D deficiency in schoolchildren with low back pain: biochemical and cross-sectional survey analysis.

J Pain Res. 2017 Apr 11;10:855-865. doi: 10.2147/JPR.S124859. eCollection 2017.
Alghadir AH 1, Gabr SA 1,2, Al-Eisa ES 1.

• 1 Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
• 2 Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

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OBJECTIVE:
This study was designed to evaluate the role of vitamin D, muscle fatigue biomarkers, and mechanical factors in the progression of low back pain (LBP) in schoolchildren.

BACKGROUND:
Children and adolescents frequently suffer from LBP with no clear clinical causes, and >71% of schoolchildren aged 12-17 years will show at least one episode of LBP.

MATERIALS AND METHODS:
A total of 250 schoolchildren aged 12-16 years were randomly enrolled in this study. For all schoolchildren height, weight, percentage of daily sun exposure and and areas of skin exposed to sun, method of carrying the bag, and bag weight and type were recorded over a typical school week. Pain scores, physical activity (PA), LBP, serum vitamin 25(OH)D level, serum bone-specific alkaline phosphatase, creatine kinase (CK), and lactate dehydrogenase (LDH) activities and calcium (Ca) concentrations were estimated using prevalidated Pain Rating Scale, modified Oswestry Low Back Pain Disability Questionnaire, short-form PA questionnaire, and colorimetric and immunoassay techniques.

RESULTS:
During the period of October 2013-May 2014, LBP was estimated in 52.2% of the schoolchildren. It was classified into moderate (34%) and severe (18%). Girls showed a higher LBP (36%) compared with boys (24%). In schoolchildren with moderate and severe LBP significantly higher (P=0.01) body mass index, waist, hip, and waist-to-hip ratio measurements were observed compared with normal schoolchildren.
LBP significantly correlated with

• less sun exposure, lower PA,
• sedentary activity (TV/computer use), [which reduces vitamin d]
• overloaded school bags.