Prediction of cervical and low-back pain based on routine school health examinations. A nine- to twelve-year follow-up study.

The school health records of 302 persons from the village of Röros, Norway, were scrutinized concerning the notes made by the author when performing a routine school health examination of all the subjects, then aged 16, in the years 1970-73. The notes concerning assessment of posture, findings on muscle palpation, subjective complaints and decisions of therapeutic measures were recorded and classified. A follow-up study was made in 1982 by sending the subjects a questionnaire asking information on subjective complaints, health care consumption and incapacity due to cervical and low-back pain during the follow-up period of 9-12 years. Information was obtained from 98% of the material. The initial findings at the school health examination were considered as risk factors, and the reported morbidity during follow-up period as outcome measures. Morbidity from cervical and low-back pain in the groups with and without each risk factor was then compared. The results show that muscular tension in adolescence, especially in the neck and shoulders, is a significant risk factor for later excess morbidity from cervical pain. No consistent risk factor for lumbar pain was found. Cervical pain occurred more frequently in the females than in the males, while there was no difference between the sexes in the occurrence of lumbar pain. Lumbar pain tends to be somewhat more incapacitating than cervical pain.