Association between untreated low back pain and injury proneness and confounding role of behavioral-health difficulties among younger adolescents: a population-based study

Purpose Low back pain (LPB) is mostly left untreated (LBP untreated ) and may increase the injury risk due to associated behavioral-health difficulties (BHDs) among adolescents. This study assessed the association between LBP untreated (vs. treated LBP (LBP treated )) and injuries and the mediating role of BHDs among younger adolescents (10–16 years). Methods This population-based study compared 328 adolescents with LBP untreated (mean age = 13.7 ± 1.3) with 291 with LBP treated (mean age = 13.3 ± 1.2) from north-eastern France. They completed a questionnaire collecting, at school-year end, socioeconomic features, LBP treated /LBP untreated , BHDs (alcohol/tobacco use, excessive screen-time, poor social support, poor physical health, depressive symptoms, and pain limiting activities), and injuries during the current school-year. Data were analyzed using multinomial logistic regression models and Kaplan–Meier estimates. Results The proportion of subjects without alcohol/tobacco use or depressive symptoms decreased with time more quickly since age 10 among the adolescents with LBP untreated than among those with LBP treated . Hence, most LBP early started and the subjects with LBP untreated had a higher risk of single injury (sex-age-class-level-socioeconomic-features-adjusted relative risk ratio RR = 1.63, p