Pain and health in adolescents and young adults – pieces of a puzzle

Background: Musculoskeletal pain is a burden for the individual and for society, and it has a negative impact on overall health. The biological, psychological, and social factors that govern pain and health form a complex puzzle to put together. Musculoskeletal pain conditions may be alleviated by physical activity, but a too high level of physical activity may also increase the risk of pain. Youth athletes may be especially vulnerable to developing pain due to factors related to training load and physical maturity. Being physically active and maintaining a healthy diet is associated with better health, but if carried out to excess these health behaviours may become unhealthy. Our understanding of musculoskeletal pain and health in adolescents and young adults needs to be developed, both in individuals involved in sports and exercise and in the general population. Aim: The overall aim was to study musculoskeletal pain and its relationship to various health-related factors in adolescents and young adults enrolled in sport or general education programmes. Methods: Study I was a cross-sectional study on university students (aged 19–29) from an exercise science programme (n = 118) and a business programme (n = 89), assessing health status, physical activity, and orthorexia nervosa (an exaggerated fixation on healthy food). Study II was a cross-sectional study (n = 178), and Study III a 2-year longitudinal (n = 131) study on sport school students (aged 14 at baseline), assessing musculoskeletal pain, health status, physical maturity, and sports performance. Study IV was a 3-year longitudinal study on students from a general upper secondary school (n = 256, aged 16 at baseline), assessing chronic musculoskeletal pain, health status, physical activity, sleep, stress, anxiety, and depression. Results: In Study I, compared to business students, exercise science students reported more pain, but better general health. A high level of physical activity in combination with ortho