Early age at menarche is associated with post-menarche back pain: An analysis of the Raine Study

Introduction Back pain (BP) experienced by females during adolescent years appears to predispose them to an increased likelihood of its presence in adulthood. Understanding this phenomenon by identifying risk factors of those at risk potentially fosters preventative strategies and effective treatments. Objectives To investigate for associations between post-menarche BP and low back pain (LBP) and age at menarche (AAM) in Australian adolescents using the Western Australian pregnancy cohort (The Raine Study). Methods This study used data from a longitudinal cohort study. BP data were collected retrospectively using a questionnaire. Menarche data was split into three established age classifications early (<12-years), normal (>= 12 to >14-years) and late (>= 14-years). Logistic regression models examined the effect of AAM on BP. Results 666 female participants provided valid menarche data with 183 (27.5%) early AAM, 429 (64.4%) normal AAM and 54 (8.1%) with late AAM. The mean AAM was 12.59 years. BP was disclosed by 27.5% in the 14-year follow-up and 31.5% in the 17-year follow-up. Participants who had early AAM had 79% higher odds of experiencing BP compared to participants who had normal AAM, after adjusting for confounders at the 14-year follow-up (adjOR 1.79, 95% CI 1.18-2.64). Conclusion There is evidence of an association, in this cohort, of early AAM with post-menarche BP. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures. Significance Age at menarche is related to a range of health issues. This study sought to investigate if it was a risk factor for spinal pain. We used an existing Australian data base to explore this possibility and found an association with early age onset and post-menarche back pain. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures.