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 five 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 five-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 five 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 five 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, CI-95 = .06 to .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