Is there a correlation between children with back pain and screen time and physical activity?  

It has become a well-known fact over time that back pain also appears in children from an early age. So far, the focus has been on several risk factors, including screen time and physical activity.

In recent years, screen time has increased among children and adolescents, both in leisure time and at school, where computers, tablets and mobile phones have become an integrated part of daily life. A natural consequence is less time for physical activity. However, the evidence for the effect of physical activity on back pain is unclear, so it is essential to focus on an increased understanding of the interaction between screen time, physical activity, and back pain in relation to future prevention of back pain in children.

This study is based on online questionnaires among more than 45,000 11-year-old children from the Danish National Birth Cohort collected 2010-20141,2. Among other things, they answered questions about their time spent using computers, tv and other screens, different aspects of physical activity and frequency and intensity of back pain (neck, upper and lower back).

The study showed an increased risk of moderate to high intensity of back pain as screen time increased. Children with more than six hours screen time daily, had a significantly higher risk of high intensity back pain compared to children with less than two hours of daily screen time. Inactive children had a higher risk of having back pain than moderately active children. Among boys with high screen time, physical activity seemed to be associated with less back pain. The strongest association was found between back pain and screen time; furthermore, the association between back pain and screen time was independent of physical activity, which indicates they should possibly be seen as two independent risk factors.

In addition, the same tendency was seen between severe back pain and physical activity as in other studies i.e., a shift from low to moderate activity seems to prevent severe back pain whereas high activity increases the risk. There was no difference between neck, upper or lower back pain.

The authors conclude that reduction of screen time and increased physical activity may contribute to prevention of back pain in children, in particular children who spend extensive time in front of a digital screen. Data used in this study is from 2010 – 2014 and the use of digital screens has exploded since then, which means that there is a different situation today. However, it is not possible to say anything about the causal relation; this should be explored in future studies. Yet the development of effective prevention of back pain is essential as it can potentially have great societal implications regarding overall health and quality of life in general. 

1. Olsen J MI. Better health for mother and child - the Danish National Birth Cohort (DNBC), its structure, history and aims. Norsk Epidemiologi 2014;24 (1-2):37-8.

2. Joergensen AC, Strandberg-Larsen K, Andersen PK, et al. Spinal pain in pre-adolescence and the relation with screen time and physical activity behavior. BMC musculoskeletal disorders 2021;22(1):393. doi: 10.1186/s12891-021-04263-z [published Online First: 2021/04/28]

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