Objective: This study aimed to investigate prevalence, characteristics, perceived predisposing factors and mode of treatment sought for back pain among school-aged adolescents in Nigeria. Subjects and Methods: A self-administered questionnaire employed in this cross-sectional study was distributed to 4,400 students [mean age 15.0 ± 1.7 years (range 10–19)] from 44 randomly selected schools. Results: Of the 4,400 questionnaires, 3,185 were completed (1,455 boys and 1,730 girls), thereby yielding a response rate of 72.4%. The lifetime and point prevalence of back pain were 59 and 17%, respectively. Low back pain was the most prevalent type, reported by 25%. The prevalence of back pain was 59.7% among boys and 57.5% among girls. Back pain was significantly associated with age, religion and involvement in commercial activity (p < 0.05). Among those with back pain, most cases were mild (56%), but chronic in 21%, and 27% used self-medication. Prolonged sitting posture (17%) was the most implicated predisposing factor to back pain. Conclusion: Back pain is common among Nigerian adolescent students, but it is mostly mild. The prevalence of back pain increased with advancing age in both genders. More research is needed to find necessary risk factors and interventions including appropriate back education to reduce back pain.

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