The association of chronic neck pain, low back pain, and migraine with absenteeism due to health problems in Spanish workers

Correlation between psychosocial stresses, stress coping ability, pain intensity and degree of disability in patients with non-specific neck pain

This study was conducted to find out which factor among stress inducing factors and stress coping factors that can affect patients with non-specific neck pain has more correlation with the intensity of neck pain and the degree of disability. This study is a cross-sectional correlational study. 100 patients diagnosed with non-specific neck pain participated in this study. The characteristics of the participants in this study are as follows. There were 56 men and 44 women, with an average age of 34.11 years, height of 169.91, and weight of 66.97 kg. The participant`s pain intensity was 5.18 and disability index was 21.44. In order to evaluate the pain intensity and disability level of patients with non-specific neck pain, Numeric Pain Rating SCALE (NPRS), and Neck Disability Index (NDI) were investigated, respectively. Depression, Anxiety, Stress Scale-21 (DASS-21), and Tampa Scale of Kinesiophobia (TSK) were used to evaluate stress inducing factors. Brief Resolution Scale (BRS), Latack Coping Scale (LCS), and Pain Self-Efficacy Questionnaire (PSEQ) were used to evaluate stress coping factors. Spearman correlation coefficients were used to determine the correlation between NPRS, NDI, and DASS-21, TSK, BRS, LCS, and PSEQ in patients with non-specific neck pain. As a results of this study, the NPRS was correlated with NDI and TSK. The NPRS and NDI were found to have a moderate correlation, but they were correlated with TSK, but showed a weak correlation. The NDI was found to be correlated with TSK, DASS, BRS, and PSEQ. In addition, NDI showed a weak correlation with TSK, BRS, and PSEQ, but the DASS showed a moderate correlation, showing the strongest correlation among the factors. These outcomes suggest that psychosocial factors, particularly stress-related factors such as depression, anxiety, and fear of movement, exert a more pronounced influence on pain intensity and disability in individuals with non-specific neck pain.

Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

BACKGROUND

Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050.

METHODS

Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2·5th and 97·5th percentiles of 100 draws of the posterior distribution.

FINDINGS

Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32·5% (23·9-42·3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing.

INTERPRETATION

Although age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain.

FUNDING

Bill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.

Prevention of Work Absence Due to Back Pain: A Network Meta-Analysis

This paper reviewed the most effective strategies for preventing work absence due to back pain (BP) and BP episodes (the number of people reporting back pain). We searched randomized controlled trials (RCTs) of prevention strategies for BP from previous meta-analyses, PubMed, CENTRAL, and Embase and conducted a network meta-analysis. Thirteen RCTs (2033 participants) were included. Low- to high-quality evidence showed that exercise combined with ergonomics, education, back belts, and education combined with ergonomics did not prevent sickness absenteeism or BP episodes. There was moderate-quality evidence that exercise, especially resistance exercise, was the best prevention strategy to reduce the number of people reporting absenteeism due to BP (risk ratio [RR] = 0.10; 95% CI: 0.01 to 0.69). Moderate-quality evidence suggested that resistance and stretching exercises combined with education was the best prevention strategy to reduce pain (RR = 0.80; 95% CI: 0.67 to 0.96) and the number of absenteeism days for BP (standardized mean difference [SMD] = -0.39; 95% CI: -0.77 to -0.02). In conclusion, exercise, especially resistance and stretching exercises, and exercise combined with education were ranked as the best interventions to prevent sickness absenteeism and BP episodes.

Certainty of the Global Burden of Disease 2019 Modelled Prevalence Estimates for Musculoskeletal Conditions: A Meta-Epidemiological Study

Objectives: To describe and assess the risk of bias of the primary input studies that underpinned the Global Burden of Disease Study (GBD) 2019 modelled prevalence estimates of low back pain (LBP), neck pain (NP), and knee osteoarthritis (OA), from Australia, Brazil, Canada, Spain, and Switzerland. To evaluate the certainty of the GBD modelled prevalence evidence. Methods: Primary studies were identified using the GBD Data Input Sources Tool and their risk of bias was assessed using a validated tool. We rated the certainty of modelled prevalence estimates based on the GRADE Guidelines 30-the GRADE approach for modelled evidence. Results: Seventy-two primary studies (LBP: 67, NP: 2, knee OA: 3) underpinned the GBD estimates. Most studies had limited representativeness of their study populations, used suboptimal case definitions and applied assessment instruments with unknown psychometric properties. The certainty of modelled prevalence estimates was low, mainly due to risk of bias and indirectness. Conclusion: Beyond the risk of bias of primary input studies for LBP, NP, and knee OA in GBD 2019, the certainty of country-specific modelled prevalence estimates still have room for improvement.

Correlation between chronic conditions and job absenteeism among healthcare administration employees at King Abdullah Medical City in Makkah, Saudi Arabia

BACKGROUND

Globally, chronic conditions are becoming more prevalent, both in general and within the workforce. Moreover, the appropriate workplace recognition and interventions are lacking for employees with chronic conditions, which may affect productivity and quality of work as a result of increased rates of absenteeism among such employees.

OBJECTIVE

The main objective was to examine the correlation between healthcare administrators' chronic conditions and job absenteeism at King Abdullah Medical City (KAMC) in Makkah, Saudi Arabia.

METHODS

A cross-sectional study was conducted at KAMC in Makkah, Saudi Arabia. Data obtained from the responses of 225 administrative employees with a chronic condition working at KAMC. Data were analyzed using SPSS Statistics version 20.

RESULTS

The results of this study indicated that a significantly relationship exists between chronic heartburn, as well as other chronic conditions, such as irritable bowel syndrome, severe anemia, chronic fatigue, and high blood pressure or hypertension with employees' job absenteeism.

CONCLUSION

According to the obtained results, employees' chronic conditions have a significant impact on absenteeism. Therefore, we recommend that employers intervene to determine how employees' chronic conditions affect their health and prevent them from attending work. Providing workplace health and wellness programs within an organization can improve employee health, thereby reducing the rate of absenteeism and increase the rate of productivity in the working environment.

Prediction of Patient Satisfaction after Treatment of Chronic Neck Pain with Mulligan's Mobilization

Chronic neck pain is among the most common types of musculoskeletal pain. Manual therapy has been shown to have positive effects on this type of pain, but there are not yet many predictive models for determining how best to apply manual therapy to the different subtypes of neck pain. The aim of this study is to develop a predictive learning approach to determine which basal outcome could give a prognostic value (Global Rating of Change, GRoC scale) for Mulligan's mobilization technique and to identify the most important predictive factors for recovery in chronic neck pain subjects in four key areas: the number of treatments, time of treatment, reduction of pain, and range of motion (ROM) increase. A prospective cohort dataset of 80 participants with chronic neck pain diagnosed by their family doctor was analyzed. Logistic regression and machine learning modeling techniques (Generalized Boosted Models, Support Vector Machine, Kernel, Classsification and Decision Trees, Random Forest and Neural Networks) were each used to form a prognostic model for each of the nine outcomes obtained before and after intervention: disability-neck disability index (NDI), patient satisfaction (GRoC), quality of life (12-Item Short Form Survey, SF-12), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI II), pain catastrophizing scale (ECD), kinesiophobia-Tampa scale of kinesiophobia (TSK-11), Pain Intensity Visual Analogue Scale (VAS), and cervical ROM. Pain descriptions from the subjects and pain body diagrams guided the physical examination. The most important predictive factors for recovery in chronic neck pain patients indicated that the more anxiety and the lower the ROM of lateroflexion, the higher the probability of success with the Mulligan concept treatment.

Kinesiotape effectiveness in mechanical low back pain: A randomized clinical trial

BACKGROUND: Low back pain (LBP) is the most common musculoskeletal disorder work-related health problem in Europe, affecting millions of workers. It is estimated that 60–80% of the population will suffer at least one episode of mechanical LBP during their life. OBJECTIVE: To evaluate the kinesiotape (KT) effectiveness in mechanical LBP. METHODS: This was a double blinded, randomized-controlled clinical trial. Twenty-eight nursing and cleaning auxiliaries from Salamanca received a manual therapy program and a bandage of KT or false kinesiotape (FKT). They received two sessions a week for three weeks and a follow-up one month after the last session. Pain, range of motion and function were measured at baseline, at the end of each session and a month after the last session. RESULTS: Work-related musculoskeletal disorders and LBP are responsible for a high prevalence of sick-leave and absenteeism. Manual therapy and KT has demonstrated to reduce pain and to increase range of motion and function being effective in this population. There are statistically significant results in both groups in all measurements for all variables. KT seems to be superior, however, both have a positive effect on LBP. Although benefits decrease, long-term treatments focusing on pain alleviation and functional recovery is needed to maintain the benefits achieved. CONCLUSION: KT was an effective complement for this treatment. Although both show improvements, KT is recommended. Future studies are needed to demonstrate KT properties, to establish a treatment protocol to prevent chronic LBP and to avoid sick leave and absenteeism.

Association between back and neck pain and workplace absenteeism in the USA: the role played by walking, standing, and sitting difficulties

PURPOSE

There is a paucity of literature identifying factors that influence the back and neck pain (BNP)-workplace absenteeism relationship. Therefore, this study aimed to investigate the association between BNP and workplace absenteeism and potential mediating variables in a large sample of the US population.

METHODS

Nationally representative data collected in 2019 from the RAND American Life Panel (ALP) were used for this retrospective study. Workplace absenteeism was defined as the number of days of absence in the past 12 months for health-related reasons (count variable), while BNP corresponded to the presence of back pain due to spinal stenosis, back pain due to other causes, or neck pain (dichotomous variable). Control variables included sex, age, ethnicity, marital status, education, occupation, annual family income, health insurance, obesity, and diabetes. There were eight influential variables (depression, anxiety, sleep disorder, alcohol dependence, opioid dependence, walking difficulty, standing difficulty, and sitting difficulty). The association between BNP and workplace absenteeism was analyzed using a negative binomial regression model.

RESULTS

There were 1,471 adults aged 22-83 years included in this study (52.9% of men; mean [standard deviation] age 44.5 [13.0] years). After adjusting for control variables, BNP was positively and significantly associated with workplace absenteeism (incidence rate ratio = 1.40, 95% confidence interval: 1.07-1.83). Walking, standing, and sitting difficulties individually explained between 24 and 43% of this association.

CONCLUSIONS

Workplace interventions focusing on the management of BNP and overcoming difficulties in walking, standing, and sitting, potentially utilizing exercise, therapy, and ergonomic interventions, may prevent absenteeism.

Psychometric Evaluation of the Chinese Version of Occupational LowBack Pain Prevention Behaviors Questionnaire Among Clinical Nurses: A Validation Study

Objective

This study aimed to translate and validate of the Chinese version of the Occupational Low Back Pain Prevention Behaviors Questionnaire among clinical nurses.

Methods

A total of 1,186 clinical nurses were recruited from three provinces in northeast China. The reliability of the translated questionnaire was measured by internal consistency, split-half reliability, and test-retest reliability. The validity of the translated questionnaire was evaluated by content validity index, exploratory factor analysis and confirmatory factor analysis.

Results

The Cronbach's α value of the questionnaire was 0.891, and the coefficient values for the six domains ranged between 0.804 and 0.917. The split-half reliability and test-retest reliability were 0.663 and 0.734, respectively. Furthermore, the content validity index of the questionnaire was 0.938. The 6-factor structure, supported by the eigenvalues, total variance explained, and scree plot accounted for 63.038% of the total variance. In the confirmatory factor analysis, as the results of model fitting, χ²/df = 3.753, RMSEA = 0.048, GFI = 0.929, AGFI = 0.913, TLI = 0.934, IFI = 0.943, CFI = 0.943, PGFI = 0.759, PNFI = 0.807.

Conclusion

The Chinese version of the Occupational Low Back Pain Prevention Behaviors Questionnaire had suitable reliability and validity among clinical nurses. Under the high prevalence of occupational low back pain, the questionnaire can provide a reference for developing educational intervention plans among clinical nurses.

Association between type 2 diabetes and chronic low back pain in general practices in Germany

INTRODUCTION

There are conflicting results on the association between type 2 diabetes and chronic low back pain (CLBP). Therefore, the goal was to investigate the relationship between type 2 diabetes and CLBP in individuals followed in general practices in Germany.

RESEARCH DESIGN AND METHODS

Adults diagnosed for the first time with type 2 diabetes in 809 general practices in Germany between 2005 and 2018 (index date) were included. Adults without type 2 diabetes were matched (1:1) to those with type 2 diabetes by sex, age, index year, and the annual number of medical consultations (index date: a randomly selected visit date). The association between type 2 diabetes and the 10-year incidence of CLBP was analyzed in conditional Cox regression models adjusted for a wide range of comorbidities, including hypertension, lipid metabolism disorders, and obesity.

RESULTS

There were 139 002 individuals included in this study (women: 58.0%; mean (SD) age 62.5 (13.4) years). There was a positive association between type 2 diabetes and the incidence of CLBP in the overall sample (HR=1.23, 95% CI: 1.13 to 1.35). Sex-stratified analyses showed a higher risk of CLBP in women (HR=1.68, 95% CI: 1.43 to 1.90) and a lower risk in men with than in their counterparts without type 2 diabetes (HR=0.83, 95% CI: 0.71 to 0.97).

CONCLUSIONS

Newly diagnosed type 2 diabetes was associated with an increased risk of CLBP. There were important sex differences in the type 2 diabetes-CLBP relationship, and more research is warranted to investigate the underlying factors explaining these differences.

Productivity in older versus younger workers: A systematic literature review

BACKGROUND

Worldwide ageing and thus, workforce ageing, is a concern for both developed and developing nations.

OBJECTIVE

The aim of the current research was to determine, through a systematic literature review, the effects of age in three dimensions that are often used to define or assess productivity at work.

METHODS

PICO framework was used to generate search strategies, inclusion criteria and terms. Scopus and PubMed databases were used. Peer-reviewed journal papers written in English and published (or in press) between January 2014 and December 2018 were included.

RESULTS

After filtering through inclusion criteria, 74 papers were included in the review. Considering productivity, 41%of the findings showed no differences between younger and older workers, 31%report better productivity of younger workers and 28%reported that older workers had better productivity than younger workers. Performance was better in older workers (58%), presenteeism generally showed no significant differences between age groups (61%). Absenteeism was the only outcome where younger workers outperformed older workers (43%).

CONCLUSION

Overall, there was no difference in productivity between older and younger workers. Older workers performed better than younger workers, but had more absenteeism, while presenteeism showed no differences. As ageing has come to workplaces, holistic approaches addressing total health are suggested to overcome the worldwide workforce ageing phenomenon.

Acupuncture reduced the medical expenditure in migraine patients: Real-world data of a 10-year national cohort study

OBJECTIVES

According to the data of Organisation for Economic Cooperation and Development, almost all the countries got increased medical expenditures in these years. Among the diseases, migraine is a condition that affects predominantly young and middle-aged people. It results in great economic losses. So we perform this research to investigate the acupuncture effect of reducing medical expenditure and medical resources use.

PERSPECTIVE

Acupuncture is a non-pharmacologic treatment and it became popular in recent years. In Taiwan, about 13% migraine patients visited acupuncture doctor. We hypothesized that the acupuncture had the additional effect than the medical treatment.

SETTING

We analysed the economic cost and medical visits in the real word.

METHODS

We used national cohort data from Taiwan, retrospectively gathered between 2000 and 2010. We selected newly diagnosed migraine patients who were diagnosed by registered neurologists formally licensed by the Taiwan Neurological Society. We divided these patients into two groups: with and without acupuncture treatment. The main outcome was medical expenditures and visits within 1 year after acupuncture.

RESULTS

In migraine patients who received acupuncture treatment, medical expenditures on emergency care and hospitalization were significantly lower than the group without acupuncture treatment.

CONCLUSION

According to our real-world data, acupuncture can reduce the medical expenditure in migraine patients within 1 year after diagnosis. For the health policy maker, it is cost effective to encourage combining acupuncture and western medicine to treat migraine patients. For the doctors in routine clinical practice, who may consider to consult acupuncture doctors to deal with the migraine patients together.

Indirect Economic Impact of Chronic Pain on Education Workers: A Company Perspective

OBJECTIVE

The aim of this study was to estimate indirect cost (IC) related to chronic pain (CP) from an employer's perspective.

METHODS

A cost-of-illness study was performed on active workers and retirees due to CP, between October 2017 and March 2018, in one of the Brazilian public universities. IC was measured as a sum of absenteeism, presenteeism, and disability pensions. The analysis of factors associated with IC was based on Tweedie model.

RESULTS

CP had an average IC of R$9258.20 [95% confidence interval (95% CI) = 6907.37 to 11,950.17], which generates an impact of 6.42 million (95% CI = 4.37 to 10.99) per year, corresponding to 3.42% (95% CI = 2.33 to 5.85) of the payroll. The position (Measure of 2.00, 95% CI = 1.19 to 3.38) and pain intensity (Measure of 1.15; 95% CI = 1.02 to 1.30) presented independent association.

CONCLUSION

CP generates the high levels of IC for the education's employer. There is an urgent need to implement prevention programs aimed at improving CP control in the workplace.

Health related quality of life improvement in chronic non-specific neck pain: secondary analysis from a single blinded, randomized clinical trial

BACKGROUND

Chronic non-specific neck pain is related to limited cervical mobility, impaired function, neck muscles myofascial pain syndrome, and stress at work. The aforementioned factors are strongly related and may lead to a negative impact on health-related quality of life. There are some effective conservative Physical therapy interventions for treating chronic non-specific neck pain. Currently, Deep Dry Needling is emerging as an alternative for improving symptoms and consequently, the quality of life in patients with chronic non-specific neck pain. The purpose of the study was to examine the effectiveness of Deep Dry Needling of myofascial trigger points on health-related quality of life improvement, as a secondary analysis, in people with chronic non-specific neck pain.

METHODS

A randomized parallel-group blinded controlled clinical trial was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2011 to September 2014. One hundred thirty subjects with chronic non-specific neck pain and active myofascial trigger points in neck muscles were randomly allocated into two groups. Subjects in the intervention group (n = 65) were treated with Deep Dry Needling in active myofascial trigger points plus stretching in neck muscles; Control group (n = 65) received only stretching. Both interventions lasted 2 weeks, 2 sessions per week. Health-related quality of life was measured with Short Form-36 (SF-36), in 5 assessments: at baseline, after intervention period; and at 1, 3 and 6 months after intervention.

RESULTS

For both groups, SF-36 mean values increased in all dimensions in every assessment. Significant differences (p < 0.05) were found in favor of the intervention group for all dimensions at the last assessment. For some dimensions (physical function, physical role, social function and vitality), the evidence was more consistent from the beginning.

CONCLUSIONS

Deep Dry Needling plus stretching is more effective than stretching alone for Health-related quality of life improvement, especially for physical function, physical role, social function and vitality dimensions, in people with non-specific neck pain.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN22726482 . Registered 9 October 2011.

Budget impact analysis of demineralized bone matrix in combination with autograft in lumbar spinal fusion procedures for the treatment of lumbar degenerative disc disease in Spain

OBJECTIVE

To estimate the budget impact (BI) of introducing local autograft (LA) combined with demineralized bone matrix (LA + DBM) in lumbar spinal fusion (LSF) procedures to treat lumbar degenerative disc disease (LDDD) in Spain.

METHODS

A decision tree model was developed to evaluate the 4-year BI associated with introducing LA + DBM putty to replace currently available grafting methods, including iliac crest bone graft (ICBG), LA alone, and LA combined with beta-tricalcium phosphate (LA + ceramics), with 30%, 40%, and 30% market shares, respectively. The analysis was conducted for a hypothetical cohort of 100 patients with LDDD receiving LSF, assuming LA + DBM would replace 100% of the standard of care mix. The fusion rates extracted from the literature were validated by an expert panel. Costs (€2017) were obtained from different Spanish sources. Budget impact and incremental cost per successful fusion were calculated from the perspective of the Spanish National Health System (NHS).

RESULTS

Over 4 years, replacing currently available options with LA + DBM for 100 patients resulted in an additional cost of €12,330 (€123/patient), and an additional 14 successful fusions, implying a cost of €881 per additional successful fusion. When costs of productivity loss were included, the introduction of LA + DBM resulted in cost savings of €70,294 (€703/patient).

LIMITATIONS

The lack of high-quality, homogeneous, head-to-head research studying the efficacy of grafting procedures available to patients undergoing LSF, in addition to a lack of long-term follow-up in existing studies. Therefore, the number of fusions occurring within the model's time horizon may be underestimated.

CONCLUSIONS

Acquisition costs of DBM were partially offset by costs of failed fusions, adverse events and reoperation when switching 100 hypothetical LDDD patients undergoing LSF procedures from standard of care grafting methods to LA + DBM from the perspective of the Spanish NHS. DBM cost was entirely offset when costs of lost productivity were considered.

The prevalence and associated factors of symptomatic cervical Spondylosis in Chinese adults: a community-based cross-sectional study

BACKGROUND

Cervical spondylosis adversely affects life quality for its heavy disease burden. The report on the community-based prevalence and associated factors of cervical spondylosis is rare, especially in Chinese population. Whether prevention is needed and how to prevent it is not clear. This study aims to explore its prevalence and related lifestyle factors and provide evidence on prevention of cervical spondylosis.

METHODS

A community-based multistage cross-sectional survey of six communities from the Chinese population was conducted. A face-to-face interview was conducted to obtain individual information, and prevalence was calculated. Single-factor analysis and multivariable logistic regressions were used to explore the associated factors in total and subgroup populations.

RESULTS

A total of 3859 adults were analyzed. The prevalence of cervical spondylosis was 13.76%, although it differed significantly among the urban, suburban, and rural populations (13.07%, 15.97%, and 12.25%, respectively). Moreover, it was higher in females than in males (16.51% vs 10.49%). The prevalence among different age groups had an inverted U shape. The highest prevalence was in the age group from 45 to 60 years old. The associated factors differed by subgroups. There were positive associations between engaging in mental work, high housework intensity, and sleep duration of less than 7 h/day with cervical spondylosis. Going to work on foot was a negative factor of cervical spondylosis in the total population. For people aged less than 30 years, keeping the same work posture for 1-2.9 h/day was a special related factor. Exposure to vibration was an associated factor for females aged 45-60 years. Menopause was a special related factor for women.

CONCLUSIONS

Prevalence of cervical spondylosis was high in Chinese population. People younger than 60 years were the focus of prevention for cervical spondylosis. Moreover, the characters between male and female and among different age groups were different and required targeted interventions.

Patients' perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom

Background

Migraine is a distinct neurological disease that imposes a significant burden on patients, society, and the healthcare system. This study aimed to characterize the incremental burden of migraine in individuals who suffer from ≥4 monthly headache days (MHDs) by examining health-related quality of life (HRQoL), impairments to work productivity and daily activities, and healthcare resource utilization (HRU) in the EU5 (France, Germany, Italy, Spain, United Kingdom).

Methods

This retrospective cross-sectional study used data from the 2016 National Health and Wellness Survey (NHWS; N = 80,600). Short-Form 36-Item Health Survey, version 2 (SF-36v2) physical and mental component summary scores (PCS and MCS), Short-form-6D (SF-6D), and EuroQoL (EQ-5D), impairments to work productivity and daily activities (Work Productivity and Activity Impairment Questionnaire (WPAI), and HRU were compared between migraine respondents suffering from ≥4 MHDs (n = 218) and non-migraine controls (n = 218) by propensity score matching using sociodemographic characteristics. Chi-square, T-tests, and Mann-Whitney tests were performed to determine significant differences between the groups after propensity score matching.

Results

HRQoL was lower in migraine individuals suffering from ≥4 MHDs compared with non-migraine controls, with reduced SF-36v2 PCS (46.00 vs 50.51) and MCS (37.69 vs 44.82), SF-6D health state utility score (0.62 vs 0.71), and EQ-5D score (0.68 vs 0.81) (for all, p < 0.001). Respondents with migraine suffering from ≥4 MHDs also reported higher levels of absenteeism from work (14.43% vs 9.46%; p = 0.001), presenteeism (35.52% vs 20.97%), overall work impairment (38.70% vs 23.27%), and activity impairment (44.17% vs 27.75%) than non-migraine controls (for all, p < 0.001). Additionally, HRU was significantly higher for individuals with ≥4 MHDs compared to their matched controls. Consistently, migraine subgroups (4–7 MHDs, 8–14 MHDs and CM) had lower HRQoL, greater overall work and activity impairment, and higher HRU compared to non-migraine controls.

Conclusions

Migraine of ≥4 MHDs was associated with poorer HRQoL, greater work productivity loss, and higher HRU compared with non-migraine controls. The findings of the study suggest that an unmet need exists among individuals suffering from ≥4 MHDs in the EU5 suggesting the need for effective prophylactic treatments to lessen the humanistic and economic burden of migraine.

Association between presenteeism and health-related quality of life among Japanese adults with chronic lower back pain: a retrospective observational study

OBJECTIVES

This study investigated the relationship between presenteeism and health-related quality of life (HRQoL) among Japanese adults with chronic lower back pain (CLBP).

DESIGN

This was a retrospective, cross-sectional study.

SETTING

Data were collected via a self-administered online survey of the Japanese adult general population.

PARTICIPANTS

The present study used 2014 Japan National Health and Wellness Survey (NHWS) data (n=30 000). Specifically, data were included from NHWS respondents who self-reported being employed in the past week and having experienced LBP in the past month, with these symptoms lasting for at least 3 months (n=239). 84 (35.1%) participants in this study were female.

PRIMARY AND SECONDARY OUTCOME MEASURES

Presenteeism and HRQoL were measured using the Work Productivity and Activity Impairment Questionnaire-General Health (categorical (none: 0%, low: 10%-20%, high: ≥30%) and continuous) and Medical Outcomes Study 36-Item Short Form Health Survey, respectively. Covariates included patient demographics, health characteristics, pain characteristics and depression severity (Patient Health Questionnaire).

RESULTS

Presenteeism was reported by 77.4% of respondents. High (vs no) presenteeism related to more severe pain in the prior week (4.9±2.2 vs 3.6±2.1, p=0.001) and currently (5.1±2.1 vs 3.9±3.9, p=0.007), more pain sites (1.9±1.6 vs 1.1±1.4, p=0.004) and greater depression severity (7.5±6.5 vs 3.6±3.6, p<0.001). Adjusting for covariates, high (vs no) presenteeism related to lower mental and physical HRQoL. For low versus no presenteeism, significant HRQoL differences were observed in general health (43.0, 95% CI 40.3 to 45.6 vs 46.9, 95% CI 43.9 to 49.8, p=0.015).

CONCLUSIONS

Most respondents experienced presenteeism. Those with high or low presenteeism had poorer HRQoL than respondents with no presenteeism. Monitoring presenteeism rates may help identify workers with an unmet need for better CLBP-related pain management.

Identification and description of controlled clinical trials published in Physiotherapy journals in Spain

RATIONALE AND OBJECTIVES

The quantity and quality of research in physiotherapy has increased exponentially during the past decades. However, retrieving publications associated with this field of research is difficult. The aim of this study is to identify and describe controlled clinical trials (CCT) published in Spanish physiotherapy journals using electronic and handsearching strategies.

METHOD

Observational study through which we identified eligible journals in order to retrieve CCTs using electronic and handsearching strategies, as proposed by the Cochrane Collaboration. A descriptive analysis of the main characteristics of these CCTs was completed.

RESULTS

Seventy-eight CCTs were identified in 10 eligible journals, none of which were indexed in the major databases. 16.7% of the identified studies were multicentric. Traumatology and orthopaedics was the most studied field (33.3%) followed by neurology (15.4%). The most researched health problems were back pain (17.24%) fibromyalgia, arthrosis and stroke (6.8% each). Measured outcomes varied greatly, including pain control, functional mobility and quality of life. Most CCTs (64.1%) had a high risk of bias.

CONCLUSIONS

The number of CCTs published in Spanish physiotherapy journals is limited. Handsearching these journals is essential, since none is indexed in major databases. In general, the identified CCTs carry a high risk of bias.

Nationwide cross-sectional study of the impact of chronic pain on an individual's employment: relationship with the family and the social support

OBJECTIVES

To determine the prevalence and the factors related to sick leave and job loss among individuals suffering from chronic pain (CP), and to analyse specifically the effect of family and social support on the individual's employment.

DESIGN

Observational cross-sectional study.

SETTING

Data were collected using structured computer-assisted telephone interviews between February and June 2011.

PARTICIPANTS

A nationwide study of 1543 Spanish adults of working age (<65), 213 of whom suffered from CP (pain suffered at least 4 or 5 days a week during the past 3 months, according to the criteria of the International Association for the Study of Pain (IASP)).

MAIN OUTCOME MEASURE

Information was collected regarding the individual's sociodemographic status, pain characteristics, healthcare use and satisfaction, limitations in daily activities, mood status, perception of the impact of pain on their families, and their satisfaction with the family and social support. To identify factors associated with sick leave and job loss among those suffering CP, 2 logistic regression models were generated.

RESULTS

The prevalence of sick leave due to CP in the general Spanish population was 4.21% (95% CI 3.2% to 5.2%). Sick leave were more likely for individuals who considered their family were affected by their pain (OR=2.18), needed help to dressing and grooming (OR=2.98), taking medication (OR=2.18), had a shorter pain duration (OR=0.99) and higher educational level. The prevalence of job loss due to CP was 1.8% (95% CI 1.1% to 2.5%). It was related to feelings of sadness (OR=4.25), being unsatisfied with the care provided by health professionals (OR=2.60) and consulting a doctor more often due to CP (OR=1.09).

CONCLUSIONS

CP is negatively associated with an individual's employment. This detrimental effect could be ameliorated if the factors related to sick leave and job loss provoked by CP are identified, especially those related to the effect of CP on the family and social environment.

Prevalence of Myofascial Pain Syndrome in Chronic Non-Specific Neck Pain: A Population-Based Cross-Sectional Descriptive Study

BACKGROUND

Chronic non-specific neck pain is a frequent complaint. It is a recognized medical and socioeconomic problem and a frequent cause of job absenteeism. In recent years, case reports about myofascial pain syndrome (MPS) are emerging among patients suffering from pain. MPS is a regional pain syndrome characterized by myofascial trigger points (MTrP) in palpable taut bands of skeletal muscle that refer pain to a distance, and that can cause distant motor and autonomic effects.

OBJECTIVE

To assess the prevalence of active and latent MTrPs in subjects suffering from chronic non-specific neck pain.

DESIGN

A population-based cross-sectional descriptive study was carried out from January 2012 to December 2014.

SETTING

Three primary healthcare centers in Alcalá de Henares, Madrid (Spain).

SUBJECTS

Two hundred and twenty-four participants diagnosed by their family doctor with chronic non-specific neck pain.

METHODS

Participants were examined by a physical therapist to determine the presence of MPS. Pain descriptions from the subjects and pain body diagrams guided the physical examination. The subjects were not given any information concerning MPS or other muscle pain syndromes.

RESULTS

All participants presented with MPS. MTrPs of the trapezius muscles were the most prevalent, in 93.75% of the participants. The most prevalent active MTrPs were located right (82.1%) and left (79%) in the nearly-horizontal fibers of the upper trapezius muscle. Furthermore, active MTrPs in the levator scapulae, multifidi, and splenius cervicis muscles reached a prevalence of 82.14%, 77.68%, and 62.5%, respectively.

CONCLUSIONS

MPS is a common source of pain in subjects presenting chronic non-specific neck pain.

Epidemiologie des unspezifischen Rückenschmerzes

Unspezifische Rückenschmerzen zählen zu den häufigsten und kostenintensivsten Erkrankungen. Etwa 80% der Bevölkerung leiden weltweit irgendwann in ihrem Leben unter Rückenschmerzen. Arbeiten zur Epidemiologie sind allerdings schwer zu vergleichen, da oft unterschiedliche Erfassungsweisen und unterschiedliche Prävalenzen genutzt werden. In dem Beitrag werden Daten zur Periodenprävalenz und zur Punktprävalenz chronischer Rückenschmerzen aus der verfügbaren Literatur dargestellt.