ORIGINAL ARTICLE Psychosocial and lifestyle correlates of musculoskeletal pain patterns in adolescence: A 2-year follow-up study L. Jussila 1,2 , M. Paananen 1,2 , S. Näyhä 1,3,4 , S. Taimela 5 , T. Tammelin 6 , J. Auvinen 3 , J. Karppinen 1,2 1 Finnish Institute of Occupational Health, Health and Work Ability, and Disability Prevention Centre, Oulu, Finland 2 Institute of Clinical Medicine, Department of Physical and Rehabilitation Medicine, University of Oulu and University Hospital of Oulu, Finland 3 Institute of Health Sciences, University of Oulu, Finland 4 Center for Environmental and Respiratory Health Research, University of Oulu, Finland 5 Hjelt Institute, Department of Public Health, University of Helsinki, Finland 6 LIKES – Research Center for Sport and Health Sciences, Jyväskylä, Finland Correspondence Markus Paananen E-mail: markus.paananen@oulu.fi Funding sources This work was supported by grants from the Academy of Finland (Dr. Karppinen; #129504, SALVE). There are no conflicts of interest to report. Conflicts of interest None declared. Accepted for publication 4 June 2013 doi:10.1002/j.1532-2149.2013.00353.x Abstract Background: The prevalence of musculoskeletal (MS) pain has been increasing among adolescents in the last decades. This may be related to either adverse changes in lifestyle and/or the psychosocial environment. Our study analysed the psychosocial and lifestyle correlates of musculoskeletal pain progression in adolescence. Methods: The study was based on the 1986 Northern Finland Birth Cohort and included 1773 adolescents at the ages of 16 to 18. Latent class analysis was applied to find the homogeneous profiles of MS pains in four body areas (neck, shoulder, low back and limb). We analysed the associations between time spent in sedentary activities and sleeping, physical activity level, body mass index, alcohol consumption, smoking, and emotional and behavioural factors at 16 years, and belonging to pain clusters at 16 and 18 years. Results: We found an association between a higher probability of MS pains between 16 and 18 years and increasing emotional and behavioural problems in both genders. Among boys, a high likelihood of MS pains during follow-up was also associated with a long time spent sitting and insufficient sleeping time. Among girls, alcohol consumption associated with high pain probability. MS pains already co-occur to a large extent in their early course. Conclusions: The strong overlap of emotional and behavioural problems and MS pains in adolescence requires awareness in both research and clinical work. 1. Introduction Adolescence is a period of intense psychosocial and physical maturation. Autonomous behaviour em- erges, and the lifestyles of adolescents may be predic- tive of those in later life (Aarnio et al., 2002; Telama et al., 2005; Eccleston et al., 2008). The ongoing changes in society and in adolescents’ biopsychosocial environment and health behaviour affect their every- day life. Trends of increasing overweight and obesity (Wang and Lobstein, 2006), sleep disturbances (Palermo et al., 2011), sedentary activities (Nelson et al., 2006) and emotional problems (Collishaw et al., 2010), and a decrease in the overall level of physical activity (Hills et al., 2011) have been observed among adolescents. A variety of physical symptoms have also shown an increasing trend (Hakala et al., 2002). Musculoskeletal (MS) pains are prevalent (Hoftun et al., 2011) and often co-occur in multiple sites in adolescence © 2013 European Pain Federation - EFIC ® Eur J Pain 18 (2014) 139–146 139