European Journal of Pediatrics

, Volume 178, Issue 12, pp 1903–1911 | Cite as

Early-life programming of pain sensation? Spinal pain in pre-adolescents with pain experience in early life

  • Anne Cathrine JoergensenEmail author
  • Raquel Lucas
  • Lise Hestbaek
  • Per Kragh Andersen
  • Anne-Marie Nybo Andersen
Original Article


Neurobiological mechanisms can be involved in early programming of pain sensitization. We aimed to investigate the association between early-life pain experience and pre-adolescence spinal pain. We conducted a study of 29,861 pre-adolescents (age 11–14) from the Danish National Birth Cohort. As indicators of early-life pain, we used infantile colic and recurrent otitis media, reported by mothers when their children were 6 and 18 months. Self-reported spinal pain (neck, middle back, and/or low back pain) was obtained in the 11-year follow-up, classified according to severity. Associations between early-life pain and spinal pain in pre-adolescents were estimated using multinomial logistic regression models. To account for sample selection, inverse probability weighting was applied. Children experiencing pain in early life were more likely to report severe spinal pain in pre-adolescence. The association appeared stronger with exposure to two pain exposures (relative risk ratio, 1.31; 95% CI, 1.02–1.68) rather than one (relative risk ratio, 1.14; 95% CI, 1.05–1.24). We observed similar results when using headache and abdominal pain as outcome measures, underpinning a potential neurobiological or psychosocial link in programming of pain sensitization.

Conclusion: Experience of early-life pain is seemingly associated with spinal pain in pre-adolescence. The study highlights that early-life painful experiences can influence programming of future pain responses.

What is Known:

Spinal pain in pre-adolescents is common, causes marked discomfort and impairment in everyday life, and may be an important predictor of spinal pain later in life.

Neurobiological mechanisms have been suggested as involved in early programming of pain sensitization.

What is New:

Pain exposure in early postnatal life in terms of infantile colic and recurrent otitis media is associated with spinal pain in pre-adolescence; thus, experience of such painful conditions in the early postnatal period may seemingly influence programming of future pain sensation.


Back pain, Spinal pain, Pain sensitivity, Pre-adolescence, Epidemiology 



The Danish National Birth Cohort


The 11-year follow-up in the Danish National Birth Cohort


Inverse probability weighting


International Standard Classification of Education


Relative risk ratio

Spinal pain

Neck pain, middle back pain, and/or low back pain


The Young Spine Questionnaire

95% CI

95% confidence interval



The Danish National Birth Cohort was established with a significant grant from the Danish National Research Foundation. Additional support was obtained from the Danish Regional Committees, the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Health Foundation, and other minor grants. The DNBC biobank has been supported by the Novo Nordisk Foundation and the Lundbeck Foundation. Follow-up of mothers and children have been supported by the Danish Medical Research Council (SSVF 0646, 271-08-0839/06-066023, O602-01042B, 0602-02738B), the Lundbeck Foundation (195/04, R100-A9193), the Innovation Fund Denmark 0603-00294B (09-067124), the Nordea Foundation (02-2013-2014), Aarhus Ideas (AU R9-A959-13-S804), University of Copenhagen Strategic Grant (IFSV 2012), and the Danish Council for Independent Research (DFF-4183-00594 and DFF-4183-00152).

Authors’ Contributions

Joergensen, MSc, conceptualized and designed the study, contributed to methods development, carried out data management and analyses and interpretation of results, and drafted the manuscript.

Prof. Nybo Andersen conceptualized and designed the study, contributed to methods development and to the interpretation of results and critical revision of the manuscript.

Dr. Hestbaek contributed to the conceptualization and design of the study, to methods development, to interpretation of results and to critical revision of the manuscript.

Dr. Lucas contributed to the conceptualization and design of the study, to methods development, to the interpretation of results and to critical revision of the manuscript.

Prof. Kragh Andersen supervised in statistical methods and analyses and contributed to the interpretation of results and critical revision of the manuscript.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of this article.

Funding information

The study was supported by the Danish Council for Independent Research (DFF-7016-00344).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Approval of the study was obtained from the Danish Data Protection Agency through the joint notification of the Faculty of Health and Medical Sciences at the University of Copenhagen and the DNBC Steering Committee.

Supplementary material

431_2019_3475_MOESM1_ESM.pdf (312 kb)
ESM 1 (PDF 312 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Section of Epidemiology, Department of Public Health, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagen KDenmark
  2. 2.Medical School and Institute of Public Health (EPIUnit)University of PortoPortoPortugal
  3. 3.Department of Sport Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
  4. 4.Section of Biostatistics, Department of Public Health, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark

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