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A longitudinal study.To estimate the prevalence and incidence of neck and shoulder pain in young adults and to identify the associated and predictive factors of neck and shoulder pain based on 7-year follow-up.Several work-related, psychosocial, and sociodemographic factors have been verified as being related to neck and shoulder pain in adult populations, but far fewer longitudinal studies concerning the topic have been carried out in young populations.A random sample of 826 high school students was investigated when they were 15 to 18 years old and again at 22 to 25 years of age. Altogether, 394 (48%) patients participated in both surveys. The outcome variable was weekly neck and shoulder pain during the past 6 months in adulthood, and the explanatory variables included some sociodemographic factors, leisure time activities, self-assessed physical condition, psychosomatic stress symptoms, and symptoms of fatigue and sleep difficulties.In 7 years, the prevalence of weekly neck and shoulder pain increased from 17% to 28%. Among those who were asymptomatic at baseline, 6-month incidence of occasional or weekly neck and shoulder pain was 59% 7 years later. In an adjusted model, psychosomatic symptoms remained an associated factor for prevalent neck and shoulder pain 7 years later for both females and males. In females, neck and shoulder pain in adolescence was associated with prevalent neck and shoulder pain in adulthood, and sports loading dynamically in the upper extremities was an associated factor for a low prevalence of neck and shoulder pain 7 years later. In separate analyses of incident neck and shoulder pain, psychosomatic stress symptoms predicted neck and shoulder pain in adulthood.In young adults, the incidence of neck and shoulder pain is high, and the associated factors ofneck and shoulder pain are already multifactorial in a young population.