Raine Study Participants


The Musculoskeletal Special Interest Group is able to investigate areas of human musculoskeletal health and disorders. The group has a range of measures on our participants relating to neuromuscular development, hypermobility assessment, motor control, posture, strength, pain (back, knee, hip, arm, leg and shoulder), pain sensitivity (cold and pressure), and musculoskeletal disorders (e.g. arthritis) across different ages and generations within the Raine Study.

The Raine Study musculoskeletal data is being used to track the development, mechanisms and consequences of musculoskeletal pain and pain sensitivity, and identify determinants and facilitators of musculoskeletal health.


SIG Leaders:

Dr Robert Waller, Curtin University

Key findings over the last 30 years have included:

Using information collected from the Raine Study participants, researchers found:

  • Low back pain emerges in adolescence and for many that sets a pain trajectory into young adulthood.
  • Low back pain has a complex, multidimensional nature (is influenced by multiple different factors) and has a substantial impact for some adolescents.
  • Spinal pain and mental ill-health combined are related to increased absence from work among young adults.
  • Challenging widely held beliefs about the role of posture in adolescent neck pain, neck postures in 17-year-olds were not associated with neck pain.
  • Novel aspects of pain sensitivity were found, with increased pain sensitivity in young women being associated with a low cortisol response to psychological stress and also with moderate or severe menstrual pain.

“Thanks to the Raine Study we have discovered important information about the development and consequences of musculoskeletal pain in adolescence and early adulthood, as well as a better understanding of pain sensitivity” – Professor Anne Smith, Curtin University


Patterns of low back pain were found, which provide unique information on low back pain and its impact during the transitions from adolescence to early adulthood.

Coenen P, Smith A, Paananen M, O’Sullivan P, Beales D, Straker L. Trajectories of low back pain from adolescence to young adulthood. Arthritis Care & Research. 2017;69(3):403-412. doi: 10.1002/acr.22949.


Low back pain is influenced by multiple factors, has substantial impact for some individuals at age 17, including missing school and reduced activity participation.  

O’Sullivan PB, Beales DJ, Smith AJ, Straker LM. Low back pain in 17 year olds has substantial impact and represents an important public health disorder: a cross-sectional study. BMC Public Health. 2012;12(1):100. doi: 10.1186/1471-2458-12-100.


Smith A, Beales D, O’Sullivan P, Bear N, Straker L. Low back pain with impact at 17 years of age is predicted by early adolescent risk factors from multiple domains: analysis of the Western Australian Pregnancy Cohort (Raine) Study. The Journal of Orthopaedic and Sports Physical Therapy. 2017;47(10):752-762. doi: 10.2519/jospt.2017.7464.


O’Sullivan P, Smith A, Beales D, Straker L. Understanding adolescent low back pain from a multidimensional perspective: implications for management. The Journal of Orthopaedic and Sports Physical Therapy. 2017;47(10):741-751. doi: 10.2519/jospt.2017.7376.


Comorbidity (i.e. two or more health conditions occurring at once) of spinal pain and mental ill-health is associated with increased absence from work at 22 years of age, but not reduced productivity while at work.  

Beales D, Kyaw-Myint S, Smith A, O’Sullivan P, Pransky G, Linton S, et al. Work productivity loss in young workers is substantial and is associated with spinal pain and mental ill-health conditions. Journal of Occupational and Environmental Medicine. 2017;59(3):237-45. doi: 10.1097/JOM.0000000000000990.


Cervical (neck) spine posture at age 17 is not associated with neck pain or headaches.  

Richards KV, Beales DJ, Smith AJ, O’Sullivan PB, Straker LM. Neck Posture clusters and their association with biopsychosocial factors and neck pain in australian adolescents. Physical Therapy. 2016;96(10):1576-87. doi: 10.2522/ptj.20150660.


Increased pain sensitivity at age 22 is associated with a higher pain experience. For those reporting a higher pain experience at 22 years, poor family functioning in early life was associated with increased pain sensitivity.

Waller R, Smith A, O’Sullivan P, Slater H, Sterling M, Straker L. Associations between musculoskeletal pain experience and pressure and cold pain sensitivity: a community-based cross-sectional study of young adults in the Raine Study. The Clinical Journal of Pain. 2019;35(1):56-64. doi: 10.1097/AJP.0000000000000650.


A low cortisol response to psychological stress is associated with musculoskeletal pain and with increased pain sensitivity in young women.

Paananen M, O’Sullivan P, Straker L, Beales D, Coenen P, Karppinen J, Pennell C, Smith A. A low cortisol response to stress is associated with musculoskeletal pain combined with increased pain sensitivity in young adults: a longitudinal cohort study. Arthritis Research & Therapy. 2015; 17:355. doi: 10.1186/s13075-015-0875-z.


The experience of mental health problems in adolescence is associated with increased risk of back and neck pain.

Rees C, Smith A, O’Sullivan P, Kendall G, Straker L. Back and neck pain are related to mental health problems in adolescence. BMC Public Health. 2011;11:382. doi: 10.1186/1471-2458-11-382.

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