Two in three pupils reported lower back pain and more than half reported neck pain. These are not adults carrying years of strain, but children aged just 11 to 18. In several cases, the pain returns more than once a week, limits daily activities and even leads to absences from school. The findings of a Cypriot scientific study raise the alarm over a problem that already appears in adolescence and cannot be dismissed as just another case of “growing pains”.
The study was published on 23 April 2026 in the international scientific journal BMC Pediatrics. Its title translates as “The association of extracurricular activities, including mobile device use time, with musculoskeletal low back and neck pain among schoolchildren in Cyprus”. The authors are Michalis Zenios, Dimitris Markou, Lida Zeniou and Dimitrios Anastasiou.
The researchers examined the responses of 245 pupils from six public and private schools, collected during the 2023-2024 school year. Of the 300 questionnaires handed out, 245 were returned and analysed. The study was cross-sectional. This means it records associations at a specific point in time and does not prove what causes the pain.
More than half report neck pain
The figures show the scale of the problem in this sample. Of the 245 participants, 162 (66%) reported lower back painand 142 (58%) reported neck pain.
For many, however, the pain is more than occasional. 89 pupils reported lower back pain more than once a week, while 70 reported neck pain just as often.
The consequences go beyond discomfort. Forty-four pupils said lower back pain limited their activities, and 30 reported similar limits because of neck pain. Nine pupils said they had missed lessons because of lower back pain, and six because of neck pain.
These figures should not be added together, as they may concern the same children. They do show, however, that musculoskeletal pain is not always harmless or insignificant, in school or outside it. The research team itself stresses that such symptoms can affect daily functioning and, in some cases, may persist into adulthood.
Inherited pain?
The likelihood of reporting lower back pain increased with age. According to the multivariate analysis, each additional year of age was associated with around 33% higher odds of reporting such pain. In simple comparisons, girls reported lower back pain more often. However, the difference between boys and girls was no longer statistically significant in the corresponding multivariate model.
The study also found a strong link between the two areas of the body. Pupils who reported neck pain had around 3.7 times higher odds of also reporting lower back pain than those without neck pain. A similar association emerged in the opposite direction.
In addition, a parental history of lower back or neck pain was associated with around 2.7 times higher odds of pupils reporting neck pain. These are associations. They do not prove that one type of pain causes the other, or that pain is inherited. The researchers consider both biological and family or behavioural factors as possible explanations. They stress that we should not look for a single cause that applies to all pupils.
Screens, stress and school pressure
Another notable finding challenges the easy explanation often given to parents. Although 94% of pupils said they used mobile devices for more than two hours a day, the researchers found no statistically significant association between screen time and lower back or neck pain. Neither posture while using devices nor hours of sport were significantly linked to the pain.
This does not prove that mobile phones have nothing to do with musculoskeletal health. With so many pupils using devices for long hours, there were few light users to make meaningful comparisons. The study also measured hours of exercise, not the type of exercise or the quality of training.
The scientists point out that other factors, such as stress and school pressure, which were not assessed in this study, also need to be explored. This is one of the open questions the study leaves: whether, beyond hours spent on devices, lifestyle and psychosocial pressures affect how teenagers experience pain.
Their warning that not every pain should automatically be blamed on poor posture carries particular weight. Sometimes the pain may be linked to a more serious condition. It then needs a proper medical history and clinical assessment, with further tests where necessary. This does not mean that the children in the study had such conditions.
Children’s persistent pain should not automatically be put down to poor posture. The authors acknowledge that the findings are based on questionnaires from a small sample, without medical examinations or diagnoses. They cannot automatically be applied to all pupils in Cyprus. The warning, however, concerns something very specific: when pain keeps coming back, limits children’s lives or keeps them away from school, it deserves attention, not easy explanations.
