• Masamitsu Kamada, Takafumi Abe, Jun Kitayuguchi, Fumiaki Imamura, I-Min Lee, Masaru Kadowaki, Susumu S Sawada, Motohiko Miyachi, Yuzuru Matsui, and Yuji Uchio.
• Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Shinjuku-ku, Tokyo, Japan Physical Education and Medicine Research Center UNNAN, Unnan, Shimane, Japan Department of Orthopaedics, Shimane University School of Medicine, Izumo, Shimane, Japan MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Unnan City Hospital, Unnan, Shimane, Japan.
• Pain. 2016 Jun 1; 157 (6): 1339-1345.

AbstractPhysical activity has multiple health benefits but may also increase the risk of developing musculoskeletal pain (MSP). However, the relationship between physical activity and MSP has not been well characterized. This study examined the dose-response relationship between sports activity and MSP among adolescents. Two school-based serial surveys were conducted 1 year apart in adolescents aged 12 to 18 years in Unnan, Japan. Self-administered questionnaires were completed by 2403 students. Associations between time spent in organized sports activity and MSP were analyzed cross-sectionally (n = 2403) and longitudinally (n = 374, students free of pain and in seventh or 10th grade at baseline) with repeated-measures Poisson regression and restricted cubic splines, with adjustment for potential confounders. The prevalence of overall pain, defined as having pain recently at least several times a week in at least one part of the body, was 27.4%. In the cross-sectional analysis, sports activity was significantly associated with pain prevalence. Each additional 1 h/wk of sports activity was associated with a 3% higher probability of having pain (prevalence ratio = 1.03, 95% confidence interval = 1.02-1.04). Similar trends were found across causes (traumatic and nontraumatic pain) and anatomic locations (upper limbs, lower back, and lower limbs). In longitudinal analysis, the risk ratio for developing pain at 1-year follow-up per 1 h/wk increase in baseline sports activity was 1.03 (95% confidence interval = 1.02-1.05). Spline models indicated a linear association (P < 0.001) but not a nonlinear association (P ≥ 0.45). The more the adolescents played sports, the more likely they were to have and develop pain.

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