1
|
Dawu W, Kaiting L, Dawei C, Yuzhang T, Weiwei Y. Differences in risk factors for flare-ups in patients with lumbar radicular pain may depend on the definition of flare. Scand J Pain 2024; 24:sjpain-2024-0023. [PMID: 39158005 DOI: 10.1515/sjpain-2024-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/28/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES The objective was to determine whether specific physical activity (PA) or psychological stress factors are associated with different definitions of flare-ups (pain-defined flares [PDFs]: periods of increased pain lasting at least 2 h, when pain intensity is distinctly worse than it has been recently; and non-pain-defined flares [NPDFs]: obviously uncomfortable feelings, such as fatigue, loss of function, or emotional/psychosocial fluctuations, without major fluctuations in pain intensity based on 11-point scales) among people with lumbar radicular pain. METHODS This was a case-crossover study. Participants with acute or subacute lumbar radicular pain completed serial face-to-face or online assessments for 6 weeks at 3-day intervals to determine whether they experienced sciatica flare-ups (PDF/NPDF) after specific types of PA or psychological stresses. RESULTS A total of 152 participants were enroled. There were 597 PDF and 323 NPDF case periods and 800 control periods. The odds of PDFs were increased by prolonged walking and standing, and the odds of NPDFs were increased by prolonged sitting, mental distress, and depressed mood. According to the multivariable analyses, prolonged sitting (OR: 3.0, 95% CI: 1.7-5.5), prolonged walking (OR: 6.2, 95% CI: 3.9-9.9), and prolonged standing (OR: 5.6, 95% CI: 3.3-9.5) were significantly associated with the odds of PDFs, and prolonged sitting (OR: 3.4, 95% CI: 1.8-6.2), mental distress (OR: 6.7, 95% CI: 2.5-17.5), and depressed mood (OR: 5.8, 95% CI: 2.6-12.8) associated with the odds of NPDFs. CONCLUSIONS Prolonged sitting, walking, and standing triggered the occurrence of PDF. Prolonged sitting, mental distress, and depressed mood triggered the occurrence of NPDF.
Collapse
Affiliation(s)
- Wang Dawu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Li Kaiting
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Chen Dawei
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Tao Yuzhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yi Weiwei
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, 1 You-Yi Road, Chongqing 400016, P.R. China
| |
Collapse
|
2
|
Felício DC, Filho JE, de Oliveira TMD, Pereira DS, Rocha VTM, Barbosa JMM, Assis MG, Malaguti C, Pereira LSM. Risk factors for non-specific low back pain in older people: a systematic review with meta-analysis. Arch Orthop Trauma Surg 2022; 142:3633-3642. [PMID: 34021388 DOI: 10.1007/s00402-021-03959-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To conduct a systematic review about risk factors associated with non-specific low back pain (LBP) in older people. METHODS The study protocol was prospectively registered with Prospero (CRD42020191619). This systematic review with meta-analysis included cohort studies that investigated risk factors for LBP in older people. The following databases were searched up to 12 December 2020: MEDLINE (Ovid), Embase, CINAHL, SCOPUS and Web of Science. Two independent reviewers appraised methodological quality using the Critical Appraisal Checklist for Cohort Studies instrument. RESULTS We identified 3939 potentially relevant publications. After removing duplicates, screening title, and abstracts, we assessed 86 publications in full text. We included the remaining 11 publications for analysis. There is strong evidence that depressive symptoms are a risk of reporting future back pain onset (I2 = 52,7%, Odds ratio 1.4, CI 1.28-1.53). CONCLUSION Depressive symptoms are a risk factor for LBP in older people. Due to the limitations of the literature, the role of some risk factors remains unclear. An additional high-quality prospective cohort is needed to better elucidate these relationships.
Collapse
Affiliation(s)
- Diogo Carvalho Felício
- Programa Pós-Graduação Em Ciências da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. .,Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Programa Pós-Graduação Em Ciências da Reabilitação E Desempenho Físico-Funcional, Juiz de Fora, MG, Brazil.
| | - José E Filho
- Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Programa Pós-Graduação Em Ciências da Reabilitação E Desempenho Físico-Funcional, Juiz de Fora, MG, Brazil
| | - Túlio M D de Oliveira
- Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Programa Pós-Graduação Em Ciências da Reabilitação E Desempenho Físico-Funcional, Juiz de Fora, MG, Brazil
| | - Daniele S Pereira
- Programa Pós-Graduação Em Ciências da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vitor T M Rocha
- Programa Pós-Graduação Em Ciências da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Juliana M M Barbosa
- Programa Pós-Graduação Em Ciências da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Marcella Guimarães Assis
- Programa Pós-Graduação Em Ciências da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Carla Malaguti
- Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Programa Pós-Graduação Em Ciências da Reabilitação E Desempenho Físico-Funcional, Juiz de Fora, MG, Brazil
| | - Leani S M Pereira
- Programa Pós-Graduação Em Ciências da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| |
Collapse
|
3
|
Mu C, Jester DJ, Cawthon PM, Stone KL, Lee S. Subjective social status moderates back pain and mental health in older men. Aging Ment Health 2022; 26:810-817. [PMID: 33733930 PMCID: PMC8919683 DOI: 10.1080/13607863.2021.1899133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Back pain and poor mental health are interrelated issues in older men. Evidence suggests that socioeconomic status moderates this relationship, but less is known about the role of subjective social status (SSS). This study examined if the association between back pain and mental health is moderated by SSS. METHOD We used a sample of community-dwelling older men (≥65 years) from the Osteoporotic Fractures in Men Study (N = 5994). Participants self-reported their back pain severity and frequency over the past 12 months. SSS was assessed with the MacArthur Scale of SSS. Mental health was assessed with the SF-12 Mental Component Summary (MCS). RESULTS Severe back pain was associated with lower SF-12 MCS scores (p = .03). Back pain frequency was not associated with SF-12 MCS scores. SSS moderated the back pain and mental health relationship. Among men with higher national or community SSS, the association between back pain severity and SF-12 MCS scores was not significant. However, among men with lower national or community SSS, more severe back pain was associated with lower SF-12 MCS scores (p's < .001). Among those with lower national or community SSS, greater back pain frequency was also associated with lower SF-12 MCS scores (p's < .05). CONCLUSION Where one ranks oneself within their nation or community matters for the back pain and mental health relationship. Higher SSS may be a psychosocial resource that buffers the negative associations of severe and frequent back pain on mental health in older men.
Collapse
Affiliation(s)
- Christina Mu
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Dylan J. Jester
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Peggy M. Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA;,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, USA;,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| |
Collapse
|
4
|
Muthuri S, Cooper R, Kuh D, Hardy R. Do the associations of body mass index and waist circumference with back pain change as people age? 32 years of follow-up in a British birth cohort. BMJ Open 2020; 10:e039197. [PMID: 33310796 PMCID: PMC7735102 DOI: 10.1136/bmjopen-2020-039197] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To investigate whether cross-sectional and longitudinal associations of body mass index (BMI) and waist circumference (WC) with back pain change with age and extend into later life. DESIGN British birth cohort study. SETTING England, Scotland and Wales. PARTICIPANTS Up to 3426 men and women from the MRC National Survey of Health and Development. PRIMARY OUTCOME MEASURES Back pain (sciatica, lumbago or recurring/severe backache all or most of the time) was self-reported during nurse interviews at ages 36, 43, 53 and 60-64 years and in a postal questionnaire using a body manikin at age 68. RESULTS Findings from mixed-effects logistic regression models indicated that higher BMI was consistently associated with increased odds of back pain across adulthood. Sex-adjusted ORs of back pain per 1 SD increase in BMI were: 1.13 (95% CI: 1.01 to 1.26), 1.11 (95% CI: 1.00 to 1.23), 1.17 (95% CI: 1.05 to 1.30), 1.31 (95% CI: 1.15 to 1.48) and 1.08 (95% CI: 0.95 to 1.24) at ages 36, 43, 53, 60-64 and 68-69, respectively. Similar patterns of associations were observed for WC. These associations were maintained when potential confounders, including education, occupational class, height, cigarette smoking status, physical activity and symptoms of anxiety and depression were accounted for. BMI showed stronger associations than WC in models including both measures. CONCLUSIONS These findings demonstrate that higher BMI is a persistent risk factor for back pain across adulthood. This highlights the potential lifelong consequences on back pain of the rising prevalence of obesity within the population.
Collapse
Affiliation(s)
- Stella Muthuri
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK
| | | |
Collapse
|
5
|
Efficacy of an integrated, active rehabilitation protocol in patients ≥ 65 years of age with chronic mechanical low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 29:586-595. [PMID: 31845031 DOI: 10.1007/s00586-019-06248-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/03/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE This retrospective study aimed to determine the efficacy of an integrated active, rehabilitation protocol in patients ≥ 65 years of age with chronic mechanical low back pain and compare the results in similar patients in 50-64 years age group. METHODS Pre- and post-treatment mean numerical pain rating scale (NPRS) score, mean Oswestry disability index (ODI) score, treatment outcome category and minimal clinically important difference (MCID) thresholds achieved for NPRS and ODI scores post-treatment were compared among 697 patients in the 50-64 years and 495 patients in the ≥ 65 years age groups. RESULTS At a mean treatment duration of 57 days (range, 30-90 days), both mean NPRS score (p < 0.0001) and mean ODI score (p < 0.0001) were significantly higher in the ≥ 65 years age group when compared to the 50-64 years age group. However, post-treatment outcome categories (p = 0.17) and percentage of patients who achieved MCID thresholds for NPRS score (p = 0.13) and ODI score (p = 0.18) were not significantly different between the two groups. There was a significant correlation between post-treatment NPRS score and patient age and pre-treatment NPRS score and between post-treatment ODI score and incidence of osteoporosis and pre-treatment ODI score. CONCLUSION Although mean NPRS and ODI scores achieved were significantly better in patients of 50-64 years of age, our integrated active, rehabilitation protocol helped achieve significant improvement in NPRS score, MCID thresholds for NPRS and ODI scores and treatment outcomes in patients ≥ 65 years of age, similar to patients in the 50-64 years of age group, at the end of 3 months of treatment. These slides can be retrieved under Electronic Supplementary Material.
Collapse
|
6
|
de Souza IMB, Sakaguchi TF, Yuan SLK, Matsutani LA, do Espírito-Santo ADS, Pereira CADB, Marques AP. Prevalence of low back pain in the elderly population: a systematic review. Clinics (Sao Paulo) 2019; 74:e789. [PMID: 31664424 PMCID: PMC6807687 DOI: 10.6061/clinics/2019/e789] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/14/2019] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to estimate the prevalence of low-back pain (LBP) and to identify the level of functional disability in elderly individuals in different populations. From January 1985 to October 2018, a search was performed using the following databases: Embase, LILACS, SciELO, Scopus, Medline, and the Web of Science. The descriptors were low-back pain, back pain, lower-back pain, prevalence, and elderly in Portuguese and English. Two independent reviewers conducted a search for studies and evaluated their methodological quality. The search strategy returned 2186 titles, and 35 were included in this review. The studies evaluated 135,059 elderly individuals aged between 60 and 102 years, and the prevalence of LBP ranged from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This review indicated a high prevalence of LBP in elderly individuals and functional disability that affects factors important for independence. However, the studies used different methodologies, suggesting that more studies be conducted with scientific accuracy, methodological quality, and low risk of bias to contribute to the proposal of preventive actions for elderly populations.
Collapse
Affiliation(s)
- Ingred Merllin Batista de Souza
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Tina Fujii Sakaguchi
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Susan Lee King Yuan
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Luciana Akemi Matsutani
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | | | - Amélia Pasqual Marques
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| |
Collapse
|
7
|
Can We Trust the Literature on Risk Factors and Triggers for Low Back Pain? A Systematic Review of a Sample of Contemporary Literature. Pain Res Manag 2019; 2019:6959631. [PMID: 31214272 PMCID: PMC6535889 DOI: 10.1155/2019/6959631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/01/2019] [Accepted: 04/14/2019] [Indexed: 01/07/2023]
Abstract
Background Risk factors (RFs) for the "disease" of low back pain (LBP) are probably different from the triggers of new episodes of LBP. Investigating RFs for the onset of the "disease" and the triggers of LBP is problematic if researchers fail to discern the different types of pain-free status of participants at and before baseline. There is a difference between never having had LBP and having been pain-free for a certain period only. In this review, we assessed the dependability of contemporary literature on RFs and triggers of LBP, in relation to the "disease" and the episodes, respectively. Methods A literature search from 2010 until 2017 was performed. Information on the definitions of LBP, potential RFs/triggers, and study design was extracted. Studies were reclassified based on the type of LBP concerning the "disease," episode, or mixed/unclear/chronic. RFs and triggers were grouped into major domains, and positive associations listed, respectively, for the "disease" and episodes. Results In 42 of the included 47 articles, it was not clear if the authors investigated RFs for the "disease" of LBP or triggers of new episodes. Only one study properly reported RFs for the onset of the "disease" of LBP, and four studies were deemed suitable to investigate triggers for a new episode of LBP. No study reproduced the results of other included studies. Conclusion Trustworthy information regarding RFs and triggers of LBP is rare in the current literature. Future research needs to use precise definitions of LBP (onset of the "disease" vs. episodes) and nominate the timing of the associated factors in relation to the types of LBP as these are two critical factors when studying causes of LBP.
Collapse
|