Frequency of Cervical, Thoracic and Lumber Pain and Postural Changes in Madrassa Students

Cervical, Thoracic, Lumber Pain and Postural Changes in Students


  • Ramsha Masood Ibadat International University, Islamabad, Pakistan
  • Fatima Razi Fatima Clinic, Rawalpindi, Pakistan
  • Ibraheem Zafar Shifa Tameer-i-Millat University, Islamabad, Pakistan
  • Muhammad Saad Shafiq Ibadat International University, Islamabad, Pakistan
  • Naveed Ahmad Shifa Tameer-i-Millat University, Islamabad, Pakistan
  • Iqra Naz Ibadat International University, Islamabad
  • Memoona Aslam Ibadat International University, Islamabad



pain, postural changes, madrassa students, anterior longitudinal ligament (ALL), posterior longitudinal ligament (PLL), intervertebral disc (IV)


Musculoskeletal pain and abnormal postural change is very common among school going students. The prevalence is also high in madrassa students. Their number increase because of bad posture, prolong sitting and repetitive movement. Objective: The objective of the study was to find the frequency of pain in cervical, thoracic, and lumbar spine and postural abnormalities occurring in madrassa students. Methods: This is a descriptive cross sectional study which was conducted from 15th February 2016 to 28th June 2016 at different madrassa’s of Rawalpindi and Islamabad. This include: Madrassa Zia-ul-Quran, Shah Khalid Colony Rawalpindi, DarulSufah Faisal Colony Rawalpindi, Madrassa Hazrat Abdullah bin Abbas(R.A) Islamabad, Madrassa Hazrat Salman Pharsi(R.A) DhokMangtal, Rawalpindi, Madrassa Abdullah bin Umar (R.A) Jinnah Garden, Phase I, Islamabad, Madrassa KhadijahtulQubra, Khayaban-e-Sirsyed, Rawalpindi, JamyaAmna Zia ulBinat, Railway scheme 7, Rawalpindi. A sample of 205 male and female madrassa students (age 10-17year) was recruited through convenient sampling. The inclusion criteria was both gender, male & female, Age; 10-17, only madrassa students, exclusion criteria was, students above the age of 17 years, students under 10 year of age, children with poliomyelitis, active tuberculosis, neurological problems, congenital deformities Normal posture and pain was assessed by Adam’s bend test and Numeric pain rating scale (NRPS). Later the data was analyzed through SPSS 17. Result: A total sample size of 205 was selected in which 61% were male students and 39% were female students. The mean age of the madrassa students is 13.19±2.06 of which 12.98±2.00 male and 13.51±2.14.Out of 205(100%) madrassa students 74.6% madrassa students have pain, most of them have moderate intensity of pain 55.6% and 12.7% have severe intensity of pain and 25.4% madrassa students have no pain. 78.5% of the madrassa students were sitting with low level of desk and 21.5% with appropriate leveled height of the desk. Only 6.8% of madrassa students have activity restriction due to pain. Forward head posture is present in 37.1% of madrassa students and absent in 62.9% of the students out of 100%. 36.6% of madrassa students presents with rounded shoulders. Out of 100% of madrassa students 36.1% of madrassa students have increased thoracic kyphotic and lumber Lordotic curve.In 11.7% of the madrassa students Adams forward bending test for scoliosis came positive and negative in 88.3% of the madrassa students. Conclusion: It is concluded that the cervical and lumber pain is more prevalent in madrassa students and some of the students show increased kyphotic and lordotic curves which is correlated with long periods of sitting for recitation in forward flexion of head, neck, and back and poor posture maintenance.


Koh MJ, Park SY, Woo YS, Kang SH, Park SH, Chun HJ, et al., Assessing the Prevalence of Recurrent Neck and Shoulder Pain in Korean High School Male Students: A Cross-sectional Observational Study. KJP. 2012; 25(3):161-7.

Hush JM, Maher, CG, Refshauge KM., Risk factors for neck pain in office workers: a prospective study. BMC musculoskeletal disorders. 2006; 7(1):81.

Kanchanomai S, Janwantanakul P, Pensri P, Jiamjarasrangsi W, Risk factors for the onset and persistence of neck pain in undergraduate students: 1-year prospective cohort study. BMC public health. 2011; 11(1):566.

Ruivo RM, Pezarat CP, Carita AI, Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Brazilian journal of physical therapy. 2014; 18(4):363-71.

Bruno AG, Anderson DE, D'Agostino, J, Bouxsein ML, The effect of thoracic kyphosis and sagittal plane alignment on vertebral compressive loading. Journal of Bone and Mineral Research. 2012; 27(10):2144-51.

Eva B, Karen MC, Jeremy L. Intrarater and Interrater Reliability of the Flexicurve Index, Flexicurve Angle, and Manual Inclinometer for the Measurement of Thoracic Kyphosis. Rehabilitation research and practice. 2013.

Roux C, Fechtenbaum J, Kolta S, Said‐Nahal R, Briot K, Benhamou CL, Prospective assessment of thoracic kyphosis in postmenopausal women with osteoporosis. Journal of Bone and Mineral Research. 2010; 25(2):362-8.

Sedrez JA, Rosa MIZ, Noll M, Medeiros FS, Candotti CT. Risk factors associated with structural postural changes in the spinal column of children and adolescents. RevistaPaulista de Pediatria. 2015; 33(1):72-81.

Lewis JS, Valentine RE. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC musculoskeletal disorders. 2010; 11(1):39.

Mirbagheri SS, Rahmani-Rasa A, Farmani F, Amini P, Nikoo MR. Evaluating Kyphosis and Lordosis in Students by Using a Flexible Ruler and Their Relationship with Severity and Frequency of Thoracic and Lumbar Pain. Asian spine journal. 2015 Jun 1;9(3):416-22.

Shamsi M, Veisi K, Karimi L, Sarrafzadeh J, Najafi F. Normal Range of Thoracic Kyphosis in Male School Children. ISRN orthopedics. 2014 Apr 6;2014.

Harrison DE, Cailliet R, Harrison DD, Janik TJ. How do anterior/posterior translations of the thoracic cage affect the sagittal lumbar spine, pelvic tilt, and thoracic kyphosis?. European Spine Journal. 2002 Jun 1;11(3):287-93.

Sato T, Hirano T, Ito T, Morita O, Kikuchi R, Endo N, Tanabe N. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan. European Spine Journal. 2011 Feb 1;20(2):274-9.

Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J, Grivas TB, Knott P, Kotwicki T, Maruyama T, Minozzi S. 2011 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis. 2012 Jan 20;7(1):1.

Baroni MP, Sanchis GJ, De Assis SJ, Dos Santos RG, Pereira SA, Sousa KG, Lopes JM. Factors Associated With Scoliosis in Schoolchildren: a Cross-Sectional Population-Based Study. Journal of Epidemiology. 2015;25(3):212.

Trobisch P, Suess O, Schwab F. Idiopathic scoliosis. DtschArztebl Int. 2010 Dec 10;107(49):875-83.

Kaspiris A, Grivas TB, Weiss HR, Turnbull D. Surgical and conservative treatment of patients with congenital scoliosis: α search for long-term results. Scoliosis. 2011 Jun 4;6(1):1.

Tsiligiannis T, Grivas T. Pulmonary function in children with idiopathic scoliosis. Scoliosis. 2012 Mar 23;7(1):7.

Zhu Z, Zhao Q, Wang B, Yu Y, Qian B, Ding Y, Qiu Y. Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy. BMC musculoskeletal disorders. 2011 Sep 30;12(1):1.

Greendale GA, Nili NS, Huang MH, Seeger L, Karlamangla AS. The reliability and validity of three non-radiological measures of thoracic kyphosis and their relations to the standing radiological Cobb angle. Osteoporosis International. 2011 Jun 1;22(6):1897-905.

Katzman WB, Wanek L, Shepherd JA, Sellmeyer DE. Age-related hyperkyphosis: its causes, consequences, and management. journal of orthopaedic& sports physical therapy. 2010 Jun;40(6):352-60.

Kotwicki T, Chowanska J, Kinel E, Czaprowski D, Tomaszewski M, Janusz P. Optimal management of idiopathic scoliosis in adolescence. Adolesc Health Med Ther. 2013 Jul 23;4:59-73.

Izatt MT, Bateman GR, Adam CJ. Evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in scoliosis. Scoliosis. 2012 Jul 30;7(1):1

Zeng Y, Chen Z, Qi Q, Guo Z, Li W, Sun C, Liu N. The posterior surgical correction of congenital kyphosis and kyphoscoliosis: 23 cases with minimum 2 years follow-up. European Spine Journal. 2013 Feb 1;22(2):372-8.

Palmisani M, Dema E, Cervellati S. Surgical treatment of adult degenerative scoliosis. European Spine Journal. 2013 Nov 1;22(6):829-33.

Müller C, Fuchs K, Winter C, Rosenbaum D, Schmidt C, Bullmann V, Schulte TL. Prospective evaluation of physical activity in patients with idiopathic scoliosis or kyphosis receiving brace treatment. European Spine Journal. 2011 Jul 1;20(7):1127-36.

Wang JS. Effect of joint mobilization and stretching on respiratory function and spinal movement in very severe COPD with thoracic kyphosis. Journal of physical therapy science. 2015 Oct;27(10):3329.

Steilen D, Hauser R, Woldin B, Sawyer S. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability. The open orthopaedics journal. 2014;8:326.

Chin KJ, Karmakar MK, Peng P. Ultrasonography of the adult thoracic and lumbar spine for central neuraxial blockade. The Journal of the American Society of Anesthesiologists. 2011 Jun 1;114(6):1459-85.

Lewis JS, Valentine RE. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC musculoskeletal disorders. 2010 Mar 1;11(1):1.

.Marré B, Ballesteros V, Martínez C, Zamorano JJ, Ilabaca F, Munjin M, Yurac R, Urzúa A, Lecaros M, Fleiderman J. Thoracic spine fractures: injury profile and outcomes of a surgically treated cohort. European Spine Journal. 2011 Sep 1;20(9):1427-33

Sedrez JA, Da Rosa MI, Noll M, da Silva Medeiros F, Candotti CT. Risk factors associated with structural postural changes in the spinal column of children and adolescents. RevistaPaulista de Pediatria (English Edition). 2015 Mar 31;33(1):72-81.

Gu SY, Hwangbo G, Lee JH. Relationship between position sense and reposition errors according to the degree of upper crossed syndrome. Journal of physical therapy science. 2016 Jan;28(2):438.

Ghorbani L, Daneshjoo AH, Nazarian A, قربانیقهفرخی ل, دانشجو ع, نظریانعب. Assessment of the prevalence of kyphosis disorders in students. Journal of Research in Rehabilitation Sciences. 2010 Jun 2;4(2).

.Brianezi L, Cajazeiro DC, Maifrino LB. Prevalence of postural deviations in school of education and professional practice of physical education. J Morphol Sci. 2011;28(1):35-6.

Penha PJ, João SM, Casarotto RA, Amino CJ, Penteado DC. Postural assessment of girls between 7 and 10 years of age. Clinics. 2005 Feb;60(1):9-16.

Yamamoto S, Shigematsu H, Kadono F, Tanaka Y, Tatematsu M, Okuda A, Iwata E, Koizumi M, Tanaka Y. Adolescent Scoliosis Screening in Nara City Schools: A 23-Year Retrospective Cross-Sectional Study. Asian spine journal. 2015 Jun 1;9(3):407-15.

Brink Y, Louw Q, Grimmer K, Jordaan E. The spinal posture of computing adolescents in a real-life setting. BMC musculoskeletal disorders. 2014 Jun 20;15(1):1.

Adegoke BO, Odole AC, Adeyinka AA. Adolescent low back pain among secondary school students in Ibadan, Nigeria. African health sciences. 2015 Jun;15(2):429-37.

Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Brazilian journal of physical therapy. 2014 Aug;18(4):364-71.

Nejati P, Lotfian S, Moezy A, Moezy A, Nejati M. The relationship of forward head posture and rounded shoulders with neck pain in Iranian office workers. Medical journal of the Islamic Republic of Iran. 2014;28:26

Drake R. Gray's Anatomy for Students. 2nd ed. London, United Kingdom: Elsevier Health Sciences; 2009.

Snell R. clinical anatomy for medical students. 5th ed. Boston: Little brown and Co; 1995.

Marieb E. Human anatomy. 2nd ed. USA Canada: Benjamin/Cummings; 1997.



DOI: 10.54393/pbmj.v5i1.235
Published: 2022-01-31

How to Cite

Masood, R., Razi, F. ., Zafar, I. ., Shafiq, M. S. ., Ahmad, N. ., Naz, I., & Aslam, M. (2022). Frequency of Cervical, Thoracic and Lumber Pain and Postural Changes in Madrassa Students: Cervical, Thoracic, Lumber Pain and Postural Changes in Students. Pakistan BioMedical Journal, 5(1), 112–117.



Original Article


Most read articles by the same author(s)