Musculoskeletal Problems in Overweight and Obese Children

Marjolein Krul; Johannes C. van der Wouden; François G. Schellevis; Lisette W. A. van Suijlekom-Smit; Bart W. Koes

doi:10.1370/afm.1005

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Table 1.

Self-Reported Musculoskeletal Problems in Normal-Weight and Overweight and Obese Children

Area of Complaint	Normal-Weight Children % (n)^a	Overweight and Obese Children % (n)^b	OR (95%CI)
Note: Positive response to survey question: In the last 2 weeks did you experience any xxx problems? Reference group (OR = 1.0) for each row is normal-weight children.
NA=not available.
^a Group total = 2,140; age-group 2–11 y, n = 1,374; age-group 12–17 y, n = 766.
^b Group total = 319; age-group 2–11 y, n = 234; age-group 12–17 y, n = 85.
^c P<.05.
All musculoskeletal
All ages	17.7 (379)	21.9 (70)	1.31 (0.98–1.74)
2–11 y	6.6 (90)	11.5 (27)	1.86 (1.18–2.93)^c
12–17 y	37.7 (289)	50.6 (43)	1.69 (1.08–2.65)^c
Neck and back
All ages	9.6 (206)	10.7 (33)	1.12 (0.76–1.66)
2–11 y	2.0 (28)	5.1 (12)	2.60 (1.30–5.19)^c
12–17 y	23.2 (178)	25.9 (22)	1.15 (0.69–1.93)
Upper extremity
All ages	1.2 (26)	1.3 (4)	1.03 (0.36–2.98)
2–11 y	0.4 (5)	0.0 (0)	NA
12–17 y	2.7 (21)	4.7 (4)	1.75 (0.59–5.23)
Lower extremity
All ages	6.9 (147)	10.7 (33)	1.62 (1.09–2.41)^c
2–11 y	4.1 (57)	6.8 ( 16)	1.70 (0.96–3.01)
12–17 y	12.4 ( 90)	20.0 (17)	1.77 (0.99–3.14)
Hip and knee
All ages	3.5 (75)	4.1 (13)	1.17 (0.64–2.13)
2–11 y	1.8 (25)	1.7 (4)	0.94 (0.32–2.72)
12–17 y	6.5 (50)	10.5 (9)	1.70 (0.80–3.58)
Ankle and foot
All ages	3.4 (72)	6.3 (20)	1.92 (1.15–3.20)^c
2–11 y	2.4 (32)	5.1 (12)	2.27 (1.15–4.47)^c
12–17 y	5.5 (40)	10.0 (8)	1.89 (0.85–4.17)

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Table 2.

Musculoskeletal Problems Reported to Family Physicians in Normal-Weight and Overweight and Obese Children

Area of Complaint	Normal-Weight Children^a% (n)	Overweight and Obese Children^b% (n)	OR (95%CI)
Note: Illness episodes during prior 12 months recorded in family physician’s electronic medical record. Reference group (OR 1.0) for each row is normal-weight children.
^a Group total = 2,140; age-group 2–11 y, n = 1,374; age-group 12–17 y, n = 766.
^b Group total = 319; age-group 2–11 y, n = 234; age-group 12–17 y, n = 85.
^c P<.05.
All musculoskeletal
All ages	14.1 (301)	16.0 (51)	1.16 (0.84–1.61)
2–11 y	9.5 (130)	10.3 (24)	1.09 (0.69–1.73)
12–17 y	22.3 (171)	31.8 (27)	1.62 (1.00–2.64)
Neck and back
All ages	2.1 (45)	3.1 (10)	1.51 (0.75–3.02)
2–11 y	1.1 (15)	1.3 (3)	1.18 (0.34–4.10)
12–17 y	3.9 (30)	8.2 (7)	2.20 (0.94–5.18)
Upper extremity
All ages	1.8 (38)	2.2 (7)	1.24 (0.55–2.80)
2–11 y	1.3 (18)	1.3 (3)	0.98 (0.29–3.35)
12–17 y	2.6 (20)	4.7 (4)	1.84 (0.62–5.52)
Lower extremity
All ages	6.1 (130)	7.8 (25)	1.32 (0.84–2.10)
2–11 y	3.9 (53)	4.3 (10)	1.11 (0.56–2.22)
12–17 y	10.1 (77)	17.6 (15)	1.92 (1.05–3.51)^c

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Supplemental Appendix

Supplemental Appendix. International Classification of Primary Care Codes Used to Identify Musculoskeletal Problems.

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The Article in Brief

Musculoskeletal Problems in Overweight and Obese Children

Marjolein Krul , and colleagues

Background Childhood obesity is spreading at alarming rates in children. This study compares the frequency of musculoskeletal problems in overweight and obese children with the frequency of problems in children with normal weight.

What This Study Found Overweight and obese children experience musculoskeletal problems more often than normal-weight children. In a study of 2,459 children aged 2 to 17 years seen in Dutch family practices, researchers found that overweight and obese children aged 2 to 11 years were 1.86 times more likely to report musculoskeletal problems in daily life than were their normal-weight peers. Overweight and obese children aged 12 to 17 years were 1.69 times more likely to do so. Additionally, overweight and obese children across both age-groups more frequently sought medical help for ankle and foot problems. Children older than 12 years of age more frequently sought help for problems with their lower extremities than did normal-weight children.

Implications

Overweight and obesity in children creates a vicious cycle in which being overweight, having musculoskeletal problems, and a low fitness level reinforce each other.
It is important for clinicians to be aware of the higher occurrence of musculoskeletal problems in overweight and obese children, to provide adequate management of their problems, and proactively give healthy lifestyle advice.