Musculoskeletal pain in obese compared with healthy-weight children

OBJECTIVES: To investigate whether obesity is associated with musculoskeletal pain in children.

MATERIALS AND METHODS: Obese (n=107) and healthy-weight (n=132) 10- to 13-year-old children (132 males, 107 females) participated in an observational case-control study. Children self-reported pain location (excluding abdominal pain), pain intensity (current and prior week), and pain prevalence (overall and lower limb) using the Pediatric Pain Questionnaire. Body composition was assessed (dual-energy x-ray absorptiometry) and children wore an accelerometer for 8 days.

RESULTS: After adjustment for accelerometry (weekly average counts per hour) and socioeconomic status, obese children had more intense pain (worst pain, P=0.006), pain in more locations (P≤0.005), and a higher prevalence of lower limb pain (60% vs. 52% respectively, P=0.012) than healthy-weight children. Significant relationships were observed between body mass index and total pain locations (P≤0.004, unadjusted and adjusted) and worst pain intensity (P≤0.009, adjusted for socioeconomic status/accelerometry). There were no significant relationships between percent body fat and pain variables (unadjusted/adjusted analyses, P=0.262 to 1.0).

DISCUSSION: Obesity in children was associated with increased overall and lower limb musculoskeletal pain, for which body mass index was a stronger predictor than adiposity. Clinicians treating obese children should screen for pain and prescribe exercise programs that take their symptoms into account.