Teens with back pain are more likely to smoke, drink alcohol and suffer anxiety and depression, a study has found.

Adolescents with frequent back pain are more likely to smoke, drink alcohol and report feelings of anxiety and depression, according to new research led by the University of Sydney and University of Newcastle (UON).

Published yesterday in the Journal of Public Health, the study of over 6000 Australian teens aged 14 to 16 found the proportion of those who reported smoking, drinking or missing school rose incrementally with increasing frequency of back pain.

There was a significant difference between the mental health indicators of those who reported no pain in comparison to those with frequent back pain, although trends were less clear.

Co-author Dr Chris Williams, a Hunter New England Health clinical research fellow who researches with the UON and HMRI’s Public Health Program, says the study adds to emerging evidence of close links between musculoskeletal pain and elevated risk factors for chronic disease.

“We tend to think about these as problems that occur only in adults, but during adolescence there is a steep rise in pain from bones, joints, muscles, and back pain particularly,” Dr Williams said.

“At this stage we’re not entirely sure of the cause of this pain or how to best treat it, but for this study our focus was on potential health problems for adolescents who experience frequent and ongoing pain.”

Two independent cross-sectional data sets were used, one being a representative sample across Australia and the other from Hunter New England where the cohort had a lower socio-economic proportion. Results were relatively uniform.

They showed that 14- to 15-year-olds who experienced pain more than once a week were two to three times more likely to have drunk alcohol or smoked in the past month than those who rarely or never had pain. Similarly, students who experienced pain more than once a week were around twice as likely to have missed school in the previous term.

“Our research is providing mounting evidence that pain needs to be considered as part of the broader health concerns and development of adolescents,” Dr Williams said.

Lead author Associate Professor Steve Kamper, from the University of Sydney, said that pain in this age group is commonly dismissed as trivial or fleeting, despite being the cause of substantial health care use and school absences,

“This study shows that adolescents with frequent pain are also at increased risk of other health problems, which is of concern as both pain and these risky behaviours have ongoing consequences that stretch well into adulthood.”

Dr Williams believes more integrated approaches are needed for preventing and managing health problems in the population.

“People with pain don’t typically get assessed for, or supported to deal with, other broader health issues such as smoking, alcohol use, or other chronic health problems,” he said.

“Because frequent pain is so common it might be an important barrier to tackling some of these issues, which are also linked to some nasty health problems like cardiovascular disease and cancer.

“We need to untangle why that is, and how we can prevent it.”

* HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.