Association of Musculoskeletal Pain With Foot Type, Plantar Pressure, Physical Activity, Psychosocial Factors, and Daily Living Habits Among Adolescents

Background: In recent years, musculoskeletal pain (MSP) has gained widespread attention globally and has become a significant public health issue affecting people of all ages, especially those affected by adolescence. Many musculoskeletal problems have a biomechanical origin, often linked to foot type and plantar pressure. Objectives: The aim of this study is to provide new insights into the multifactorial nature of MSP by exploring its associations with foot type, plantar pressure, physical activity, psychosocial factors, and daily living habits in adolescents. Design: A cross-sectional observational study was conducted among adolescents recruited from community and schools in Guangzhou, China Methods: Chi-square tests and logistic regression analysis were employed to investigate the associations between the prevalence of musculoskeletal pain and various factors, including foot type, plantar pressure, physical activity levels, psychosocial factors, study pressure and daily living habits like sleep duration, sleep quality, and screen time. Given the high prevalence and clinical relevance, we further analyzed factors associated with neck, back, and foot pain. Results: This study included 216 adolescents (15.83 ± 1.05 years). The analysis revealed that physical activity, sleep duration, and study pressure significantly associated with the incidence of neck pain. Emotional symptoms at the threshold or abnormal and poor sleep quality both associated with low back pain. Foot type and plantar pressure did not show statistical significance in association with overall musculoskeletal pain. However, when specific pain sites were examined, foot pain was significantly associated with maximum plantar pressure ⩾ 1000 N/dm 2 , average plantar pressure ⩾ 180 N, and flatfoot or high-arched foot. Conclusions: Our study found that while foot type and plantar pressure were not associated with overall musculoskeletal pain, they were significantly associated with foot pain specifically. Low physical activity, insufficient sleep, and high study pressure were linked to neck pain, while poor sleep quality and emotional symptoms were associated with low back pain. These findings highlight the multifactorial nature of musculoskeletal pain and the need for comprehensive assessments in primary care. Clinical trial number: This study was registered at Chinese Clinical Trials Registry ( http://www.chictr.org.cn/ ) on August 12, 2024. Clinical trial number: ChiCTR2400088109.