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Geng J, Li L, Liu T, Yan B, Peng L. Management and Nursing Approaches to Low Back Pain: Investigating the Causal Association with Lifestyle-Related Risk Factors. Pain Manag Nurs 2024; 25:300-307. [PMID: 38341339 DOI: 10.1016/j.pmn.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/20/2023] [Accepted: 01/06/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Notwithstanding a plethora of observational studies, the causal implications of obesity, encompassing both body mass index (BMI) and waist circumference (WC), as well as type 2 diabetes (T2D), and lifestyle factors, in relation to the vulnerability to low back pain (LBP), remain enigmatic. AIMS This study was designed to investigate the related causal associations DESIGN: A two-sample Mendelian randomization (MR) analysis. SETTINGS By utilizing genetic variants associated with pertinent factors gleaned from genome-wide association studies (GWASs), We extracted independent genetic variants about exposures such as BMI, WC, T2D, smoking, alcohol consumption, and coffee intake from published GWASs, ensuring their genome-wide significance. PARTICIPANTS/SUBJECTS The GWASs were selected from the most up-to-date and largest publicly accessible databases. METHODS The summary data concerning LBP emanated from a GWAS of European cases and controls, which was based on the esteemed MRC-IEU (Medical Research Council Integrative Epidemiology Unit) consortium. RESULTS Heightened body mass index and waist circumference exhibited odds ratios of 1.003 (95% confidence interval [CI] = 1.002-1.004, p < 0.001) and 1.003 (95% CI = 1.002-1.004, p < 0.001) for LBP, respectively, per each standard deviation (SD) increase. As for smoking initiation and every SD increase in the frequency of alcohol intake, the odds ratios were 1.002 (95% CI = 1.001-1.003, p = 0.003) and 1.002 (95% CI = 1.000-1.003, p = 0.011), respectively, for LBP. Conversely, an increased log odds ratio for T2D, and prevalence of coffee intake, divulged no discernible causal effects on the risk of LBP. CONCLUSION This study provides suggestive evidence to support the causal involvement of obesity, smoking, and the frequency of alcohol intake in the development of LBP, which suggests that implementing measures to mitigate these risk factors may aid in preventing LBP.
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Affiliation(s)
- Jiaojiao Geng
- School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Jiangsu, China.
| | - Le Li
- School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Jiangsu, China
| | - Tingting Liu
- School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Jiangsu, China
| | - Bin Yan
- School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Jiangsu, China
| | - Lili Peng
- Department of Rehabilitation Medicine, Yancheng NO.1 People's Hospital, Jiangsu, China
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Kirsch EP, Yang LZ, Lee HJ, Parente B, Lad SP. Healthcare resource utilization for chronic low back pain among high-utilizers. Spine J 2024; 24:601-616. [PMID: 38081464 DOI: 10.1016/j.spinee.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/26/2023] [Accepted: 11/27/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Chronic low back pain is a leading cause of morbidity and is among the largest cost drivers for the healthcare system. Research on healthcare resource utilization of patients with low back pain who are not surgical candidates is limited, and few studies follow individuals who generate high healthcare costs over time. PURPOSE This claims study aimed to identify patients with high-impact mechanical, chronic low back pain (CLBP), quantify their low back pain-related health resource utilization, and explore associated patient characteristics. We hypothesize that patients in the top quartile of healthcare resource utilization in the second year after initial diagnosis will continue to generate considerable back pain-related costs in subsequent years. STUDY DESIGN/SETTING IBM MarketScan Research Databases from 2009-2019 were retrospectively analyzed. PATIENT SAMPLE Adults in the United States with an initial diagnosis of low back pain between 2010 and 2014 who did not have cancer, spine surgery, recent pregnancy, or inflammatory spine conditions, were identified using the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes. To ensure patients had chronic low back pain, it was required that individuals had additional claims with a low back pain diagnosis 6 to 12 and 12 to 24 months after initial diagnosis. OUTCOME MEASURES Cost and utilization of inpatient visits, outpatient visits, emergency room visits, pharmacologic and nonpharmacologic treatment options and imaging for chronic low back pain. METHODS Annual back pain-related costs and the use of pharmacologic and nonpharmacologic treatments for 5 years were analyzed. Logistic regression was utilized to identify factors associated with persistent high spending. RESULTS Of 16,917 individuals who met the criteria for chronic low back pain, 4,229 met the criteria for having high healthcare utilization, defined as being in the top quartile of back pain-related costs in the 12 to 24 months after their initial diagnosis. The mean and median back pain-related cost in the first year after an initial diagnosis was $7,112 (SD $9,670) and $4,405 (Q1 $2,147, Q3 $8,461). Mean and median back pain related costs in the second year were $11,989 (SD $20,316) and $5,935 (Q1 $3,892, Q3 $10,678). Costs continued to be incurred in years 3 to 5 at a reduced rate. The cumulative mean cost for back pain over the 5 years following the initial diagnosis was $31,459 (SD $39,545). The majority of costs were from outpatient services. Almost a quarter of the high utilizers remained in the top quartile of back pain-related costs during years 3 to 5 after the initial diagnosis, and another 19% remained in the top quartile for 2 of the 3 subsequent years. For these two groups combined (42%), the 5-year cumulative mean cost for back pain was $43,818 (SD $48,270). Patient characteristics associated with a higher likelihood of remaining as high utilizers were diabetes, having a greater number of outpatient visits and pharmacologic prescriptions, and lower utilization of imaging services. CONCLUSION This is one of the first studies to use an administrative claims database to identify high healthcare resource utilizers among a population of United States individuals with nonsurgical, chronic low back pain and follow their utilization over time. There was a population of individuals who continued to experience high costs 5 years beyond their initial diagnosis, and the majority of individuals continued to seek outpatient services. Further longitudinal claims research that incorporates symptom severity is needed to understand the economic implications of this condition.
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Affiliation(s)
- Elayna P Kirsch
- Department of Neurosurgery, Duke University Medical Center, 200 Trent Drive, Blue Zone Durham, NC 27710, USA
| | - Lexie Z Yang
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2424 Erwin Road, Suite 1102, Hock Plaza Box 2721, Durham, NC 27710, USA
| | - Hui-Jie Lee
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2424 Erwin Road, Suite 1102, Hock Plaza Box 2721, Durham, NC 27710, USA
| | - Beth Parente
- Department of Neurosurgery, Duke University Medical Center, 200 Trent Drive, Blue Zone Durham, NC 27710, USA
| | - Shivanand P Lad
- Department of Neurosurgery, Duke University Medical Center, 200 Trent Drive, Blue Zone Durham, NC 27710, USA.
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Alsubaie SF, Alkathiry AA, Aljuaid MI, Alnasser MA. The relationship between chronic diseases and the intensity and duration of low back pain. Eur J Phys Rehabil Med 2024; 60:55-61. [PMID: 38059574 PMCID: PMC10938039 DOI: 10.23736/s1973-9087.23.07649-9] [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: 07/17/2022] [Revised: 07/11/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Low back pain (LBP) is a worldwide problem that affects numerous people and limits their mobility. Several factors, including chronic diseases, increase the risk of developing LBP. To date, the information available about the relationship between chronic diseases and the intensity and duration of LBP is quite limited. AIM The aim of the present study was to address the relationship between chronic diseases and both the intensity and duration of LBP. DESIGN This is an observational cross-sectional study. SETTING The study was conducted in the community of Saudi Arabia. POPULATION 2181 adult participants (aged 18 years or more, mean age of 33 and standard deviation [SD] of ±11, 61% females) from Saudi Arabia with either recent or recurring LBP participated in the study. METHODS The participants of this study were surveyed, and their demographic information was obtained. They were asked whether they had LBP during the past year, and if they had, they were asked about their LBP in terms of the pain intensity on a scale that runs from 0 to 10, where 0 indicates no pain and 10 indicates extreme pain. Further, the participants were asked how long their pain lasted (in days). They were also inquired whether they had any of the following chronic diseases: diabetes mellitus, high blood pressure, hypotension, arthritis, cardiopulmonary diseases, kidney diseases, and hypothyroidism. Logistic regression was used to analyze the relationships between both of LBP's intensity and duration, and the presence of chronic diseases, while adjusting for the potential effect of age and gender. RESULTS A total of 2181 adults with either new onset of or recurrent LBP during the past 12 months participated in the present study. Of these, 356 (16%), who had LBP, suffered from one or more of the said chronic diseases. It was found that having one or more chronic diseases had statistically significant relationship with increased LBP's intensity (P=0.002), as well as prolonged duration (P=0.001). In particular, hypertension, arthritis, and hypothyroidism have statistically significant relationship with increased the intensity of the pain (P<0.05). Only, hypertension and arthritis have statistically significant relationship with increased the duration of pain (P≤0.001). CONCLUSIONS The presence of chronic diseases was associated with a more intense and longer duration of LBP. CLINICAL REHABILITATION IMPACT In view of the results of this study, we expect that those who have chronic diseases will have a longer duration of LBP and more intense pain.
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Affiliation(s)
- Saud F Alsubaie
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia -
| | - Abdulaziz A Alkathiry
- College of Applied Medical Sciences, Department of Physical Therapy and Health Rehabilitation, Majmaah University, Majmaah, Saudi Arabia
| | - Majed I Aljuaid
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Musab A Alnasser
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
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Liu Y, Tang G, Li J. Causations between obesity, diabetes, lifestyle factors and the risk of 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 2024; 33:525-532. [PMID: 38123704 DOI: 10.1007/s00586-023-08069-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Despite numerous observational studies, the causal relationship between obesity-measured by body mass index (BMI) and waist circumference (WC)-as well as type 2 diabetes (T2D), lifestyle habits, and susceptibility to low back pain (LBP) remains obscure. METHODS This investigation employed two-sample Mendelian randomization (MR) analysis to explore causality, using genetic variants linked to relevant factors from genome-wide association studies (GWASs). Specifically, we selected independent genetic variants related to BMI, WC, T2D, smoking, alcohol consumption, and coffee intake from established GWASs, all of which demonstrated genome-wide significance. The comparative data for LBP were derived from a GWAS involving European subjects, under the auspices of the renowned MRC-IEU (Medical Research Council Integrative Epidemiology Unit) consortium. RESULTS Elevated BMI and WC were associated with odds ratios of 1.002 (95% confidence interval [CI] = 1.001-1.004, p < 0.001) and 1.003 (95% CI = 1.002-1.004, p < 0.001) for LBP per standard deviation (SD) increase, respectively. Regarding smoking initiation and coffee consumption, the odds ratios stood at 1.002 (95% CI = 1.001-1.004, p = 0.001) and 1.004 (95% CI = 1.001-1.008, p = 0.034) for LBP, respectively. However, an augmented log odds ratio for T2D and each SD rise in alcohol consumption frequency revealed no significant causal impact on LBP risk. CONCLUSION Our findings indicate a potential causal link between obesity, smoking, and coffee intake in the genesis of LBP, suggesting that mitigating these factors could contribute to LBP prevention.
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Affiliation(s)
- Yi Liu
- Department of Anesthesiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Gang Tang
- Department of Anesthesiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Jinyu Li
- Department of Anesthesiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China.
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Kim S, Lee SM. Dyslipidemia Is Positively Associated with Chronic Low Back Pain in Korean Women: Korean National Health and Nutrition Examination Survey 2010-2012. Healthcare (Basel) 2024; 12:102. [PMID: 38201008 PMCID: PMC10778792 DOI: 10.3390/healthcare12010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the association between chronic low back pain (CLBP) and chronic diseases, such as hypertension, diabetes, and dyslipidemia. METHODS This study was a retrospective analysis using data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2010-2012 and included women who answered a questionnaire in the KNHANES asking whether they had low back pain for ≥3 months. Participants were divided into non-CLBP and CLBP groups. For statistical analysis, the Student's t-test, chi-square test, Fisher's exact test, and logistic regression analysis were performed using SPSS. RESULTS Of 5961 participants, the non-CLBP group comprised 4098 women and the CLBP group comprised 1863. Adjusted logistic regression model revealed that dyslipidemia was positively associated with CLBP (odds ratio, 1.32; 95% confidence interval, 1.140, 1.530; p < 0.001). However, hypertension and diabetes were not associated with CLBP. CONCLUSIONS Our results suggest that proper treatment of dyslipidemia may contribute to lowering the risk of CLBP later in life.
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Affiliation(s)
- Sunmin Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-dong 300, Bundang-gu, Seongnam-si 13620, Republic of Korea;
| | - Seon-Mi Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
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Lekhwani S, Nath B, Gupta SD, Kumari R, Vaswani ND, Pawar N. Musculoskeletal Comorbidities among known Diabetes Patients, their Quality of Life, and Healthcare Costs: A Comparative Study From a Tertiary Care Hospital in Uttarakhand. Indian J Community Med 2024; 49:76-81. [PMID: 38425961 PMCID: PMC10900440 DOI: 10.4103/ijcm.ijcm_832_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/09/2023] [Indexed: 03/02/2024] Open
Abstract
Introduction Diabetes is a chronic disorder with long-term sequelae and multisystem manifestation. Burden of diabetes in on the rise. Presence of other morbidities can not only have a detrimental effect on the disease treatment and recovery course, but also on the financial burden and quality of life. Present study aims to investigate how musculoskeletal conditions affect individuals with diabetes compared to those without the condition. Material and Methods A comparative study was conducted among patients attending the outpatient department of a tertiary care hospital in North India to assess the burden of musculoskeletal disorders in people with and without diabetes. A total of 195 diabetes patients and an equal number of individuals without diabetes were sequentially enrolled from the outpatient department (OPD). Results Burden of musculoskeletal comorbidities was significantly higher (46.2%) among people with diabetes than the comparison group (25.1%). The overall odds ratio (OR) for comorbidities of musculoskeletal system was 2.5 times higher in diabetes cases as compared to individuals without diabetes. The OR for rheumatoid arthritis, chronic backache, and osteoarthritis was found to be 3.6, 2.9, and 1.7 respectively. Poor quality of life and higher direct cost of treatment were found among diabetes cases with musculoskeletal comorbidities as against those without these comorbidities. Conclusion Presence of musculoskeletal comorbidity is high among diabetes patients, and it has an impact on the quality of life and treatment cost. Screening for musculoskeletal comorbidities should be included as part of the diabetes complication assessment to allow for early detection and treatment.
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Affiliation(s)
- Seema Lekhwani
- Department of Biochemistry, Pt BD Sharma, PGIMS, Rohtak, Haryana, India
| | - Bhola Nath
- Department of Community and Family Medicine, AIIMS Raebareli, Uttar Pradesh, India
| | | | - Ranjeeta Kumari
- Department of Community and Family Medicine, AIIMS Rishikesh, Uttarakhand, India
| | | | - Neeraj Pawar
- Department of Community and Family Medicine, AIIMS Raebareli, Uttar Pradesh, India
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Heikkala E, Oura P, Paananen M, Ho E, Ferreira P, Tanguay-Sabourin C, Karppinen J. Chronic disease clusters are associated with prolonged, bothersome, and multisite musculoskeletal pain: a population-based study on Northern Finns. Ann Med 2023; 55:592-602. [PMID: 36773018 PMCID: PMC9930817 DOI: 10.1080/07853890.2023.2177723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Chronic diseases often accumulate with musculoskeletal (MSK) pain. However, less evidence is available on idiosyncratic patterns of chronic diseases and their relationships with the severity of MSK pain in general MSK pain populations. MATERIAL AND METHODS Questionnaire-based data on physician-diagnosed chronic diseases, MSK pain and its dimensions (frequency, intensity, bothersomeness, and the number of pain sites), and confounders were collected from the Northern Finland Birth Cohort 1966 at the age of 46. Latent Class Analysis (LCA) was used to identify chronic disease clusters among individuals who reported any MSK pain within the previous year (n = 6105). The associations between chronic disease clusters, pain dimensions, and severe MSK pain, which was defined as prolonged (over 30 d within the preceding year), bothersome (Numerical Rating Scale >5), and multisite (two or more pain sites) pain, were analyzed using logistic regression and general linear regression models, adjusted for sex and educational level (n for the full sample = 4768). RESULTS LCA resulted in three clusters: Metabolic (10.8% of the full sample), Psychiatric (2.9%), and Relatively Healthy (86.3%). Compared to the Relatively Healthy cluster, the Metabolic and Psychiatric clusters had higher odds for daily pain and higher mean pain intensity, bothersomeness, and the number of pain sites. Similarly, the odds for severe MSK pain were up to 75% (95% confidence interval: 44%-113%) and 155% (81%-259%) higher in the Metabolic and Psychiatric clusters, respectively, after adjustments for sex and educational level. CONCLUSIONS Distinct patterns of chronic disease accumulation can be identified in the general MSK pain population. It seems that mental and metabolic health are at interplay with severe MSK pain. These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.Key messagesThis large study on middle-aged people with musculoskeletal pain aimed to examine the idiosyncratic patterns of chronic diseases and their relationships with the severity of musculoskeletal pain. Latent class cluster analysis identified three chronic disease clusters: Psychiatric, Metabolic, and Relatively Healthy. People with accumulated mental (Psychiatric cluster) or metabolic diseases (Metabolic cluster) experienced more severe pain than people who were relatively healthy (Relatively Healthy cluster). These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.
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Affiliation(s)
- Eveliina Heikkala
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rovaniemi Health Center, Rovaniemi, Finland
| | - Petteri Oura
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Markus Paananen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Western Uusimaa Wellbeing Services County, Social and Health Care Services, Espoo, Finland
| | - Emma Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, Sydney, Australia
| | - Paulo Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Christophe Tanguay-Sabourin
- Alan Edwards Pain Centre for Research on Pain, McGill University, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jaro Karppinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
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Nejadghaderi SA, Mousavi SE, Sullman MJM, Kolahi A, Namazi Shabestari A, Safiri S. The burden of neck pain among adults aged 70 years and older in Iran, 1990-2019. Health Sci Rep 2023; 6:e1477. [PMID: 38028676 PMCID: PMC10630745 DOI: 10.1002/hsr2.1477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/10/2023] [Accepted: 07/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Neck pain is a complex musculoskeletal disorder that can result in substantial morbidity. The present article presents the neck pain burden in Iranians who were at least 70 years old, from 1990 to 2019, by sex, age group, and province. Methods Publicly available information on the prevalence, incidence, and years lived with disability (YLD) caused by neck pain was extracted from the Global Burden of Disease study 2019. The estimates were all provided as counts and age-standardized rates (per 100,000), and included 95% uncertainty intervals. Results The point prevalence of neck pain in 2019 was 8710.6, while the incidence rate was 1334.7 per 100,000 population. That same year, there were number of 27.8 thousand YLDs and an YLD rate of 801.7 per 100,000. The prevalence, incidence, and YLD rates did not change substantially over the measurement period (1990-2019). The highest YLD rate was found in Tehran (960.9 per 100,000), while Kohgiluyeh and Boyer-Ahmad had the lowest (730.5 per 100,000). Females had slightly higher prevalent cases, incident cases, and YLDs, as well as their corresponding rates in 2019. In 2019, the number of prevalent cases, incident cases, and YLDs peaked in the 70-74 age group, for both sexes, and in all cases they reduced with age. In both 1990 and 2019, Iran had a higher YLD rate than that found among elderly adults in the Middle East and North Africa region. Conclusions The burden of neck pain in Iran has decreased slightly over the last three decades, but it still imposes a substantial burden and is higher than that found in the rest of the region. Therefore, preventive programs should be initiated at a young age to reduce the attributable burden later in life.
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Affiliation(s)
- Seyed Aria Nejadghaderi
- Student's Scientific Research Center (SSRC)Tehran University of Medical SciencesTehranIran
- Neurosciences Research Center, Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Systematic Review and Meta‑Analysis Expert Group (SRMEG)Universal Scientific Education and Research Network (USERN)TehranIran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research InstituteTabriz University of Medical SciencesTabrizIran
| | - Mark J. M. Sullman
- Department of Life and Health SciencesUniversity of NicosiaNicosiaCyprus
- Department of Social SciencesUniversity of NicosiaNicosiaCyprus
| | - Ali‐Asghar Kolahi
- Social Determinants of Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | | | - Saeid Safiri
- Neurosciences Research Center, Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Clinical Research Development Unit of Tabriz Valiasr HospitalTabriz University of Medical SciencesTabrizIran
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Suri P, Elgaeva EE, Williams FMK, Freidin MB, Zaytseva OO, Aulchenko YS, Tsepilov YA. Evidence of causal effects of blood pressure on back pain and back pain on type II diabetes provided by a bidirectional Mendelian randomization study. Spine J 2023; 23:1161-1171. [PMID: 37061135 DOI: 10.1016/j.spinee.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/01/2023] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND CONTEXT Cardiovascular risk factors (hypertension, dyslipidemia, and type II diabetes) have been proposed as risk factors for back pain. However, few longitudinal studies have found significant associations between cardiovascular risk factors and back pain, and these may be explained by confounding or reverse causation. PURPOSE To examine potential causal effects of cardiovascular risk factors on back pain, and vice versa. STUDY DESIGN Bidirectional Mendelian randomization (MR) study. PATIENT SAMPLES Genome-wide association studies (GWAS) with sample sizes between 173,082 and 1,028,947 participants. OUTCOME MEASURES Outcomes included (1) back pain associated with health care use (BP-HC) in the forward MR; and (2) seven cardiovascular phenotypes in the reverse MR, including 2 measurements used for the evaluation of hypertension (diastolic blood pressure and systolic blood pressure), 4 phenotypes related to dyslipidemia (LDL cholesterol, HDL cholesterol, total cholesterol, and triglycerides), and type II diabetes. METHODS We used summary statistics from large, publicly available GWAS for BP-HC and the 7 cardiovascular phenotypes to obtain genetic instrumental variables. We examined MR evidence for causal associations using inverse-variance weighted (IVW) analysis, Causal Analysis Using Summary Effect (CAUSE), and sensitivity analyses. RESULTS In forward MR analyses of seven cardiovascular phenotypes, diastolic blood pressure was associated with BP-HC across all analyses (IVW estimate: OR = 1.10 per 10.5 mm Hg increase [1.04-1.17], p-value = .001), and significant associations of systolic blood pressure with BP-HC were also found (IVW estimate: OR = 1.09 per 19.3 mm Hg increase [1.04-1.15], p-value = .0006). In reverse MR analyses, only type II diabetes was associated with BP-HC across all analyses (IVW estimate: OR = 1.40 [1.13-1.73], p-value = .002). CONCLUSIONS These findings from analyses of large, population-based samples indicate that higher blood pressure increases the risk of BP-HC, and BP-HC itself increases the risk of type II diabetes.
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Affiliation(s)
- Pradeep Suri
- Division of Rehabilitation Care Services, VA Puget Sound Health Care System, 1660 S. Columbian Way, 98108, Seattle, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, 1660 S. Columbian Way, 98108, Seattle, USA; Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, 98104, Seattle, USA; Clinical Learning, Evidence, and Research (CLEAR) Center, University of Washington, 325 Ninth Avenue, 98104, Seattle, USA.
| | - Elizaveta E Elgaeva
- Department of Natural Sciences, Novosibirsk State University, Pirogova Street 2, 630090,Novosibirsk, Russia; Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 630090, Novosibirsk, Russia
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, UK
| | - Maxim B Freidin
- Department of Biology, School of Biological and Behavioural Sciences, Queen Mary University of London, Fogg Buliding, Mile End Road, London, UK
| | - Olga O Zaytseva
- Genos Glycoscience Research Laboratory, Borongajska cesta 83H, 10000, Zagreb, Croatia
| | - Yurii S Aulchenko
- Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 630090, Novosibirsk, Russia; PolyOmica, Het Vlaggeschip 61, 5237 PA, 's-Hertogenbosch, the Netherlands
| | - Yakov A Tsepilov
- Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 630090, Novosibirsk, Russia; Kurchatov Genomics Center, Institute of Cytology & Genetics, 630090, Novosibirsk, Russia
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ALMohiza MA, Reddy RS, Alkhamis BA, Alghamdi NH, Alshahrani A, Ponneru BR, Mukherjee D. A Cross-Sectional Study Investigating Lumbar Proprioception Impairments in Individuals with Type 2 Diabetes Mellitus: Correlations with Glycated Hemoglobin Levels. Biomedicines 2023; 11:2068. [PMID: 37509707 PMCID: PMC10377327 DOI: 10.3390/biomedicines11072068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Impaired proprioception is a recognized complication in individuals with type 2 diabetes mellitus (T2DM), contributing to balance deficits and increased risk of falls. However, limited research has focused on lumbar proprioception in this population. This study aimed to investigate lumbar proprioception in individuals with T2DM, as well as healthy individuals. Additionally, this study aimed to examine the correlation between lumbar proprioception and glycated hemoglobin (HbA1c) levels, which is a marker of long-term glycemic control in T2DM. A cross-sectional study was conducted, comparing lumbar joint reposition errors (JRE) between a T2DM group (n = 85) and a healthy group (n = 85). Lumbar JRE was assessed in flexion, extension, lateral bending left, and lateral bending right using a dual inclinometer device. HbA1c levels were measured as an indicator of glycemic control. Significant differences in lumbar JRE were found between the T2DM and healthy groups, with individuals with T2DM exhibiting larger JRE values, indicating impaired lumbar proprioception (p < 0.001). The correlation analysis revealed significant positive associations between HbA1c levels and lumbar JRE. Higher HbA1c levels were correlated with greater joint JRE in flexion (r = 0.49, p < 0.001), extension (r = 0.51, p < 0.001), left lateral bending (r = 0.45, p < 0.001), and right lateral bending (r = 0.48, p < 0.001) in the T2DM group. This study provides evidence of impaired lumbar proprioception in individuals with T2DM, as evidenced by larger lumbar JRE compared to the healthy group.
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Affiliation(s)
- Mohammad A. ALMohiza
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (B.A.A.); (D.M.)
| | - Batool Abdulelah Alkhamis
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (B.A.A.); (D.M.)
| | - Nabeel Hamdan Alghamdi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Adel Alshahrani
- Department of Medical Rehabilitation Sciences-Physiotherapy Program, College of Applied Medical Sciences, Najran University, Najran 55461, Saudi Arabia;
| | - Bhaskar Reddy Ponneru
- Department of Physiotherapy, Janardan Rai Nagar Rajasthan Vidyapeeth University, Udaipur 313001, Rajasthan, India;
| | - Debjani Mukherjee
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (B.A.A.); (D.M.)
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de Luca K, Tavares P, Yang H, Hurwitz EL, Green BN, Dale H, Haldeman S. Spinal Pain, Chronic Health Conditions and Health Behaviors: Data from the 2016-2018 National Health Interview Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5369. [PMID: 37047983 PMCID: PMC10094294 DOI: 10.3390/ijerph20075369] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
Spinal pain and chronic health conditions are highly prevalent, burdensome, and costly conditions, both in the United States and globally. Using cross-sectional data from the 2016 through 2018 National Health Interview Survey (n = 26,926), we explored associations between spinal pain and chronic health conditions and investigated the influence that a set of confounders may have on the associations between spinal pain and chronic health conditions. Variance estimation method was used to compute weighted descriptive statistics and measures of associations with multinomial logistic regression models. All four chronic health conditions significantly increased the prevalence odds of spinal pain; cardiovascular conditions by 58%, hypertension by 40%, diabetes by 25% and obesity by 34%, controlling for all the confounders. For all chronic health conditions, tobacco use (45-50%), being insufficiently active (17-20%), sleep problems (180-184%), cognitive impairment (90-100%), and mental health conditions (68-80%) significantly increased the prevalence odds of spinal pain compared to cases without spinal pain. These findings provide evidence to support research on the prevention and treatment of non-musculoskeletal conditions with approaches of spinal pain management.
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Affiliation(s)
- Katie de Luca
- Discipline of Chiropractic, School of Health, Medical and Applied Science, CQ University, Brisbane, QLD 4701, Australia
| | - Patricia Tavares
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON M2H 3J1, Canada
| | - Haiou Yang
- Center for Occupational and Environmental Health, University of California, Irvine, CA 92093, USA
| | - Eric L. Hurwitz
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii, Mānoa, Honolulu, HI 96822, USA
| | - Bart N. Green
- Employer Based Integrated Primary Care Health Centers, Stanford Health Care, San Diego, CA 92121, USA
- Department of Publications, National University of Health Sciences, Lombard, IL 60148, USA
| | - Hannah Dale
- Discipline of Chiropractic, School of Health, Medical and Applied Science, CQ University, Brisbane, QLD 4701, Australia
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, CA 92093, USA
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The modifier effect of physical activity, body mass index, and age on the association of metformin and chronic back pain: A cross-sectional analysis of 21,899 participants from the UK Biobank. PLoS One 2023; 18:e0282205. [PMID: 36854023 PMCID: PMC9974111 DOI: 10.1371/journal.pone.0282205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 02/10/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND There is growing evidence of the anti-inflammatory effect of the anti-diabetic drug metformin and its use to reduce pain. However, we currently lack studies investigating whether metformin is associated with a reduction in chronic back pain prevalence when considering physical activity levels, body mass index (BMI), and age. OBJECTIVE To investigate whether use of metformin is associated with lower levels of reporting of chronic back pain in a large cohort with type 2 diabetes when stratified for physical activity, BMI, and age. METHODS This is a cross-sectional study of 21,889 participants with type 2 diabetes who were drawn from the UK Biobank database. We investigated whether people using metformin reported a higher prevalence of chronic low back pain than those who did not. Type 2 diabetes, chronic back pain, and metformin were self-reported. Participants were stratified according to their physical activity level (low, moderate and high), BMI (normal, overweight, and obese), and age (40 to <50; 50 to < 60; and ≥60 years). Logistic regression models were built for each physical activity level, BMI and age category to investigate the prevalence of chronic back pain amongst those using and not using metformin. RESULTS Participants who were using metformin and who had low levels of physical activity [OR 0.87, 95%CI 0.78 to 0.96] or who were obese [OR 0.90, 95%CI 0.86 to 0.98] or older [OR 0.85, 95%CI 0.78 to 0.93] had lower odds of reporting chronic back pain than their counterparts. CONCLUSION The anti-diabetic drug metformin might reduce prevalence of chronic low back pain in people who are older, overweight, or less active. These findings should be confirmed in studies using a longitudinal design.
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13
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Television-viewing time and bodily pain in Australian adults with and without type 2 diabetes: 12-year prospective relationships. BMC Public Health 2022; 22:2218. [PMID: 36447213 PMCID: PMC9706940 DOI: 10.1186/s12889-022-14566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Bodily pain is a common presentation in several chronic diseases, yet the influence of sedentary behaviour, common in ageing adults, is unclear. Television-viewing (TV) time is a ubiquitous leisure-time sedentary behaviour, with a potential contribution to the development of bodily pain. We examined bodily pain trajectories and the longitudinal relationships of TV time with the bodily pain severity; and further, the potential moderation of the relationships by type 2 diabetes (T2D) status. METHOD Data were from 4099 participants (aged 35 to 65 years at baseline) in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), who took part in the follow-ups at 5 years, 12 years, or both. Bodily pain (from SF36 questionnaire: a 0 to 100 scale, where lower scores indicate more-severe pain), TV time, and T2D status [normal glucose metabolism (NGM), prediabetes, and T2D] were assessed at all three time points. Multilevel growth curve modelling used age (centred at 50 years) as the time metric, adjusting for potential confounders, including physical activity and waist circumference. RESULTS Mean TV time increased, and bodily pain worsened (i.e., mean bodily pain score decreased) across the three time points. Those with T2D had higher TV time and more-severe bodily pain than those without T2D at all time points. In a fully adjusted model, the mean bodily pain score for those aged 50 years at baseline was 76.9(SE: 2.2) and worsened (i.e., bodily pain score decreased) significantly by 0.3(SE: 0.03) units every additional year (p <0.001). Those with initially more-severe pain had a higher rate of increase in pain severity. At any given time point, a one-hour increase in daily TV time was significantly associated with an increase in pain severity [bodily pain score decreased by 0.69 (SE: 0.17) units each additional hour; p <0.001], accounting for the growth factor (age) and confounders' effects. The association was more-pronounced in those with T2D than in those without (prediabetes or NGM), with the effect of T2D on bodily pain severity becoming more apparent as TV time increases, significantly so when TV time increased above 2.5 hours per day. CONCLUSION Bodily pain severity increased with age in middle-aged and older Australian adults over a 12-year period, and increments in TV time predicted increased bodily pain severity at any given period, which was more pronounced in those with T2D. While increasing physical activity is a mainstay of the prevention and management of chronic health problems, these new findings highlight the potential of reducing sedentary behaviours in this context.
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Jiménez-García R, López-de-Andrés A, de Miguel-Diez J, Zamorano-León JJ, Carabantes-Alarcón D, Noriega C, Cuadrado-Corrales N, Pérez-Farinos N. Time Trends and Sex Differences in the Association between Diabetes and Chronic Neck Pain, Chronic Low Back Pain, and Migraine. Analysis of Population-Based National Surveys in Spain (2014-2020). J Clin Med 2022; 11:jcm11236953. [PMID: 36498528 PMCID: PMC9739053 DOI: 10.3390/jcm11236953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: To assess the time trend in the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine or frequent headache (MFH) among people with diabetes in Spain from 2014 to 2020, this study identified sex differences and compared the prevalence of these pain sites between people with diabetes and age−sex-matched non-diabetic subjects. (2) Methods: The study design included a cross-sectional and a case−control study. The data were obtained from the European Health Interview Surveys for Spain conducted in 2014 and 2020. The presence of diabetes, CNP, CLBP, and MFH was self-reported. Study covariates included sociodemographic characteristics, comorbidities, lifestyles, and pain-related variables. (3) Results: Among people with diabetes, the prevalence of CNP, CLBP, and MFH did not improve from 2014 to 2020. Women with diabetes had a significantly higher prevalence of all the pain sites analyzed than men with diabetes. After matching by sex and age, the prevalence of CNP (26.0% vs. 21.1%; p < 0.001), CLBP (31.2% vs. 25.0%; p < 0.001), and MFH (7.7% vs. 6.5%; p = 0.028) was higher for people with diabetes than for those without diabetes. Self-reported mental disease was independently associated with reporting the three pain sites analyzed in people with diabetes. (4) Conclusions: The prevalence of CNP, CLBP, and MFH has remained stable over time. Remarkable sex differences were found, with a higher prevalence among women than men with diabetes. Diabetes was associated with reporting in all the pain sites analyzed. Self-reported mental disease was associated with reporting CNP, CLBP, and MFH.
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Affiliation(s)
- Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913-941-520
| | - Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain
| | - José J. Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Concepción Noriega
- Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Napoleón Pérez-Farinos
- Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Málaga, 29016 Málaga, Spain
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15
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Elma Ö, Brain K, Dong HJ. The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review. J Clin Med 2022; 11:jcm11195950. [PMID: 36233817 PMCID: PMC9571356 DOI: 10.3390/jcm11195950] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing one’s dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed.
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Affiliation(s)
- Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
- Correspondence:
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Heikkala E, Hagnäs M, Jokelainen J, Karppinen J, Ferreira P, Ferreira ML, Mikkola I. Association of musculoskeletal pain with the achievement of treatment targets for type 2 diabetes among primary care patients. Prim Care Diabetes 2022; 16:531-536. [PMID: 35523651 DOI: 10.1016/j.pcd.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
AIMS To assess the association of diagnosed musculoskeletal (MS) pain (low back, neck, shoulder, and knee pain; and the number of pain sites) with the achievement of targets for glycosylated haemoglobin A1c (HbA1c), low-density-lipoprotein cholesterol (LDL), and systolic blood pressure (SBP) among primary care patients with type 2 diabetes (T2D). METHODS The cross-sectional study population consisted of 3478 patients with a registry-based T2D diagnosis and available registry-based data on MS pain diagnoses, covariates, and outcomes between 2016 and 2019. Logistic regression analysis was used to evaluate the study aims. RESULTS Overall, 22% had at least one of the four types of MS pain, and 73%, 57%, and 51% achieved the treatment targets of HbA1c, LDL, and SBP, respectively. T2D patients with or without MS pain did not differ in their achievement of T2D treatment goals. Of pain locations, low back pain was associated with higher rates of achievement of the LDL target (OR 1.29, 95% CI 1.01-1.65), but the association was attenuated in the adjusted model. CONCLUSIONS MS pain was relatively prevalent among primary care patients with T2D, but did not influence the achievement of T2D treatment goals.
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Affiliation(s)
- Eveliina Heikkala
- Rovaniemi Health Center, Rovaniemi, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Maria Hagnäs
- Rovaniemi Health Center, Rovaniemi, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland; Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
| | - Paulo Ferreira
- School of Health Sciences, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Manuela L Ferreira
- Faculty of Medicine and Health, Kolling Institute, School of Health Sciences, University of Sydney, Sydney, Australia
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Perera RS, Chen L, Ferreira ML, Arden NK, Radojčić MR, Kluzek S. Age- and sex-specific effects of obesity, metabolic syndrome and its components on back pain: The English Longitudinal Study of Ageing. Joint Bone Spine 2022; 89:105366. [DOI: 10.1016/j.jbspin.2022.105366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
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Perera RS, Chen L, Hart DJ, Spector TD, Arden NK, Ferreira ML, Radojčić MR. Effects of body weight and fat mass on back pain - direct mechanical or indirect through inflammatory and metabolic parameters? Semin Arthritis Rheum 2021; 52:151935. [PMID: 35027244 DOI: 10.1016/j.semarthrit.2021.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/05/2021] [Accepted: 11/17/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND While reports indicate the association between obesity and back pain, its mechanism is still unclear. Thus, we aimed to investigate the effects of weight and its components on back pain in middle-aged women while considering direct mechanical and indirect effects via inflammatory and metabolic parameters. METHODS We used data from the Chingford 1000 Women Study, two follow-ups seven years apart. We assessed effects of weight, body mass index (BMI), total fat mass (TFM), total lean mass (TLM) and total bone mineral density (TBMD), measured by dual-energy X-ray absorptiometry, on back pain episode. We used inflammatory (C-reactive protein, interleukin-6, and tumour necrosis factor-alpha) and metabolic parameters (systolic and diastolic blood pressure, triglyceride, high-density lipoprotein cholesterol, and fasting blood glucose) as mediators of indirect effects. We investigated associations of interest cross-sectionally and longitudinally using binary logistic regression and parallel mediation model. RESULTS We included 826 Chingford middle-aged women (mean age=60.7, SD=5.9) from the first used follow-up in cross-sectional and mediation analyses and 645 women that attended the follow-up seven years later, in longitudinal analyses. We found that increased weight was directly associated with increased odds of having back pain episode (OR=1.02; 95% CI 1.01-1.03), similarly as BMI (OR=1.05; 95% CI 1.02-1.08) and TFM (OR=1.03; 95% CI 1.01-1.04) consistently across the cross-sectional and longitudinal models, but not TLM or TBMD. However, we did not find consistent indirect effects of weight or its components through measured inflammatory or metabolic parameters on back pain. CONCLUSIONS Our results show that in middle-aged women, weight, BMI and TFM are directly related to back pain, indicating prominence of mechanical loading effect.
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Affiliation(s)
- Romain S Perera
- Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford OX3 7LD, United Kingdom
| | - Lingxiao Chen
- Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Deborah J Hart
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Nigel K Arden
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, United Kingdom; MRC Environmental Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Maja R Radojčić
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford OX3 7LD, United Kingdom; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, United Kingdom.
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Brain K, Burrows TL, Bruggink L, Malfliet A, Hayes C, Hodson FJ, Collins CE. Diet and Chronic Non-Cancer Pain: The State of the Art and Future Directions. J Clin Med 2021; 10:5203. [PMID: 34768723 PMCID: PMC8584994 DOI: 10.3390/jcm10215203] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022] Open
Abstract
Nutrition plays an important role in pain management. Healthy eating patterns are associated with reduced systemic inflammation, as well as lower risk and severity of chronic non-cancer pain and associated comorbidities. The role of nutrition in chronic non-cancer pain management is an emerging field with increasing interest from clinicians and patients. Evidence from a number of recent systematic reviews shows that optimising diet quality and incorporating foods containing anti-inflammatory nutrients such as fruits, vegetables, long chain and monounsaturated fats, antioxidants, and fibre leads to reduction in pain severity and interference. This review describes the current state of the art and highlights why nutrition is critical within a person-centred approach to pain management. Recommendations are made to guide clinicians and highlight areas for future research.
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Affiliation(s)
- Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Tracy L. Burrows
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Laura Bruggink
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Anneleen Malfliet
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
- Pain in Motion International Research Group, 1000 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Chris Hayes
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Fiona J. Hodson
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Clare E. Collins
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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Tian S, Wang R, Qian M, Liu L, Shao Z, Wu C, Sun J. The association between diabetes mellitus and HRQoL of older people in Shanghai. BMC Geriatr 2021; 21:626. [PMID: 34732146 PMCID: PMC8565009 DOI: 10.1186/s12877-021-02590-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/26/2021] [Indexed: 12/04/2022] Open
Abstract
Background This study aimed to explore the association between diabetes mellitus and health-related quality of life (HRQoL) of older people in Shanghai, China, especially regarding the differences in each aspect of the EQ-5D and how large the score gaps are between older people with and without diabetes. Methods A total of 11,103 people of either sex older than 60 years were enrolled from 17 districts of Shanghai. The EQ-5D-3L was used to assess the HRQoL of older people. The Wilcoxon rank sum test and t-test were used to compare the difference in HRQoL between people with or without diabetes. After univariate regression, multiple linear regression and ordinal logistic regression were conducted to evaluate the influence of diabetes mellitus and other confounding variables on the EQ VAS scores and on the five dimensions of the EQ-5D. Results Twelve percent of all participants had diabetes mellitus, and the proportion was almost the same between men and women. The EQ VAS scores of people with diabetes mellitus were approximately 3.70 points lower than those of people without diabetes (95% CI = -4.40, -2.99, p < 0.001) after adjusting for confounding variables. People with diabetes mellitus had increased problems with mobility (OR = 1.57, 95% CI = 1.33, 1.85), self-care (OR = 1.65, 95% CI = 1.35, 2.01), usual activities (OR = 1.78, 95% CI = 1.51, 2.11), pain/discomfort (OR = 1.42, 95% CI = 1.24, 1.64), and anxiety/depression (OR = 1.33, 95% CI = 1.07, 1.64). Conclusions This study showed that diabetes mellitus was associated with the HRQoL of older people and that older people with diabetes had poorer performance in every aspect of EQ-5D measurements.
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Affiliation(s)
- Shiyin Tian
- Department of Health Management, Navy military medical university, Shanghai, China.,Medical Department, Shanghai Changzheng Hospital, Shanghai, China
| | - Rui Wang
- Department of Health Statistics, Navy Military Medical University, Shanghai, China
| | - Mengxing Qian
- Medical Department, Shanghai Changzheng Hospital, Shanghai, China
| | - Lijuan Liu
- Department of Health Management, Navy military medical university, Shanghai, China
| | - Zhenyi Shao
- Centre for Health Statistics and Information of Shanghai, Shanghai, China
| | - Cheng Wu
- Department of Health Statistics, Navy Military Medical University, Shanghai, China.
| | - Jinhai Sun
- Department of Health Management, Navy military medical university, Shanghai, China.
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21
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Heikkala E, Mikkola I, Jokelainen J, Timonen M, Hagnäs M. Multimorbidity and achievement of treatment goals among patients with type 2 diabetes: a primary care, real-world study. BMC Health Serv Res 2021; 21:964. [PMID: 34521389 PMCID: PMC8442281 DOI: 10.1186/s12913-021-06989-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background Type 2 diabetes (T2D), with its prevalence and disability-causing nature, is a challenge for primary health care. Most patients with T2D are multimorbid, i.e. have one or more long-term diseases in addition to T2D. Multimorbidity may play a role in the achievement of T2D treatment targets, but is still not fully understood. The aims of the present cross-sectional, register-based study were to evaluate the prevalence and the most common patterns of multimorbidity among patients with T2D; and to study the potential associations between multimorbidity and treatment goal achievement, including measurements of glycosylated haemoglobin A1c (HbA1c), low-density lipoprotein (LDL) and systolic blood pressure (sBP). Methods The study population consisted of 4545 primary care patients who received a T2D diagnosis between January 2011 and July 2019 in Rovaniemi Health Centre, Finland. Data on seven long-term concordant (T2D-related) diseases, eight long-term discordant (non-T2D-related) diseases, potential confounders (age, sex, body mass index, prescribed medication), and the outcomes studied were collected from patients’ records. Logistic regression models with odds ratios (ORs) and 95 % confidence intervals (CIs) were assessed to determine the associations between multimorbidity and the achievement of treatment targets. Results Altogether, 93 % of the patients had one or more diseases in addition to T2D, i.e. were considered multimorbid. Furthermore, 21 % had only concordant disease(s) (Concordant subgroup), 8 % had only discordant disease(s) (Discordant subgroup) and 64 % had both (Concordant and discordant subgroup). As either single diseases or in combination with others, hypertension, musculoskeletal (MS) disease and hyperlipidaemia were the most prevalent multimorbidity patterns. Being multimorbid in general (OR 1.32, CI 1.01–1.70) and belonging to the Concordant (OR 1.45, CI 1.08–1.95) and Concordant and discordant (OR 1.31, CI 1.00–1.72) subgroups was associated with achievement of the HbA1c treatment target. Belonging to the Concordant and discordant subgroup was related to meeting the LDL treatment target (OR 1.31, CI 1.00–1.72). Conclusions Multimorbidity, including cardiovascular risk and the musculoskeletal disease burden, was extremely prevalent among the T2D patients who consulted primary health care. Primary care clinicians should survey the possible co-existence of long-term diseases among T2D patients to help maintain adequate treatment of T2D.
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Affiliation(s)
- Eveliina Heikkala
- Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland. .,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland. .,Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland.
| | - Ilona Mikkola
- Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland
| | - Maria Hagnäs
- Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland
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22
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Jacob L, Rathmann W, Koyanagi A, Haro JM, Kostev K. Association between type 2 diabetes and chronic low back pain in general practices in Germany. BMJ Open Diabetes Res Care 2021; 9:9/1/e002426. [PMID: 34266855 PMCID: PMC8286747 DOI: 10.1136/bmjdrc-2021-002426] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Wolfgang Rathmann
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Institute for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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23
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Shahid S, Akhter Z, Sukaina M, Sohail F, Nasir F. Association of Diabetes With Lower Back Pain: A Narrative Review. Cureus 2021; 13:e15776. [PMID: 34295586 PMCID: PMC8291343 DOI: 10.7759/cureus.15776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus with its increasing prevalence is one of the four major non-communicable diseases. It is characterized by hyperglycemia, which may progress to chronic complications such as peripheral vascular disease and neuropathy. This paper highlights the pathophysiology associated with diabetes, which is restricted to not only hyperglycemia but also other comorbidities including chronic lower back pain. Diabetes is a metabolic disorder associated with hypercholesteremia, hypertriglyceridemia, and hypertension. This chain of events leads to free plasma fatty acids and a pro-inflammatory state, therefore promoting calcification of blood vessels, which may block the blood supply to vertebral discs and thereby increase vulnerability in the patients with ongoing inflammatory disease such as osteoarthritis and also causing costochondritis. Functional limitation due to increased load on the weight-bearing joints is a common mechanical complication of diabetes. Obesity in diabetes is more prevalent due to a disturbed metabolism, which is aggravated with a persistent inflammatory state. Moreover, the aim of this review is to encourage further conduction of clinical studies to explore the definite cause and potential therapy for chronic lower back pain in diabetes, thereby investigating the association of lipid metabolism and skeletal muscle atrophy leading to chronic back pain, the role of diabetic medications, and vulnerability in the female gender. Diminished physical activity and depression in diabetic patients disrupt the hypothalamic-pituitary-adrenal axis (HPA), which further contributes to lower back pain. Further clinical investigation and research in this regard will establish substantial data for the linkage between depression in diabetes and back pain. However, despite all the advancements of medical literature, the exact cause of lower back pain in diabetes is arguable. Pain impedes the health status and life quality; therefore, it is essential to maintain the quality of health in patients with diabetes by treating not only hyperglycemia but also other multifactorial causes leading to lower back pain.
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Affiliation(s)
- Shehroz Shahid
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Zohaib Akhter
- Department of Clinical Trials Unit, University of York, York, GBR
| | - Mahnoor Sukaina
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Fatima Sohail
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Faseeha Nasir
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
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24
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Idowu OA, Adeniyi AF, Edo A, Fasanmade A. Graded activity with and without daily-monitored-walking in patients with type 2 diabetes with low back pain: secondary analysis of a randomized-clinical trial. Arch Physiother 2021; 11:10. [PMID: 33853682 PMCID: PMC8048054 DOI: 10.1186/s40945-021-00104-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 03/04/2021] [Indexed: 12/19/2022] Open
Abstract
Background Graded activity is gradually emerging as a preferred choice in improving psychosocial outcomes including pain self-efficacy, fear-avoidance beliefs, and back-pain beliefs in the general population with low back pain (LBP). Such evidence is, however, lacking among patients with concomitant LBP and type-2 diabetes mellitus (T2DM). This secondary analysis of a randomized control trial aimed to compare the efficacy between graded activity augmented with additional daily-monitored-walking and graded activity alone on disability, pain self-efficacy (PSE), fear-avoidance beliefs (FAB), back-pain beliefs (BPB) and glycaemic control (HbA1c) in patients with concomitant LBP and T2DM. Methods Fifty-eight patients with concomitant LBP and T2DM were randomised into two groups, graded activity with daily-monitored-walking group (GAMWG = 29) or (graded activity group (GAG = 29) in this 12-week single-blind trial. Both groups received graded activity (home/work-place visits, back school and sub-maximal exercises) while the GAMWG received additional daily-monitored-walking. Disability and selected psychosocial outcomes were assessed at weeks 0, 4, 8 and 12 using Roland-Morris disability, fear-avoidance behaviour, pain self-efficacy and back belief questionnaires. Glycaemic control was assessed at weeks 0 and 12 using a point-of-care system (In2it, Biorad Latvia). Data were analysed using mean, median, Friedman’s ANOVA, Mann-Whitney test and t-tests. Results Participants’ mean age was 48.3 ± 9.4 years (95%CI: 45.6, 50.9) while 35.3% were males. The GAMWG participants (n = 25) had better outcomes (P < 0.05) than GAG participants (n = 26) on PSE (1.0, 3.0; r = − 0.1) and FAB (0.01, − 2.0; r = − 0.1) at week 4, LBP-related disability (0.01, − 2.0; r = − 0.2) at week 8 and glycaemic control at week 12 (− 0.59 ± 0.51%,-0.46 ± 0.22%). No other between-group comparisons were statistically significant. Conclusion Graded activity with daily-monitored-walking provided earlier improvements on disability, pain self-efficacy, fear-avoidance beliefs, and glycaemic control, but not back pain beliefs, in patients with concomitant LBP and T2DM. Trial registration PACTR201702001728564; 26 July, 2016 (retrospectively registered).
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Affiliation(s)
- Opeyemi Ayodiipo Idowu
- Department of Physiotherapy, College of Medical Sciences, School of Basic Medical Sciences, University of Benin, Benin City, Nigeria.
| | - Ade Fatai Adeniyi
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Andrew Edo
- Deparment of Medicine, University of Benin, Benin City, Nigeria
| | - Adesoji Fasanmade
- Department of Physiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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25
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Ho EKY, Ferreira M, Pinheiro M, Carvalho-E-Silva AP, Madrid-Valero JJ, Zadro J, Ordoñana J, Ferreira P. Factors associated with seeking medical care for low back pain in a twin adult sample. Eur J Pain 2021; 25:1091-1106. [PMID: 33469982 DOI: 10.1002/ejp.1731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 01/10/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Previous studies have only investigated how symptom presentation and socio-demographic factors influence care-seeking for low back pain (LBP). However, the influence of health and lifestyle factors remains unclear, and the potential confounding effects of aggregated familial factors (including genetics and the early shared environment) has not been considered extensively. METHODS A cross-sectional analysis was performed on 1605 twins enrolled in the Murcia Twin Registry (Spain). The outcome was seeking medical care for LBP and various self-reported demographic, health and lifestyle factors were considered predictors. All variables except sleep quality and diabetes were collected in 2013, which were cross-referenced from 2009 to 2010. A multivariate logistic regression model was performed on the total sample, followed by a co-twin case-control analysis. RESULTS The only significant factor found to increase the odds of seeking medical care for LBP without being affected by familial factors was poor sleep quality (total sample OR = 1.58, 95%CI 1.24-2.01; case-control OR = 1.75, 95%CI 1.14-2.69). The factors that were associated with reduced odds of seeking medical care for LBP and not confounded by familial factors were male sex (case-control OR = 0.55, 95%CI 0.33-0.93), alcohol intake (case-control OR = 0.90, 95%CI 0.82-0.99) and a history of diabetes (case-control OR = 0.50, 95%CI 0.25-0.97). No other factors significantly influenced medical care-seeking for LBP. CONCLUSIONS People reporting poor sleep quality are more likely to seek medical care for LBP in the long term, with this relationship being independent from aggregated familial factors. Conversely, males, people reporting higher alcohol intake, and people with a history of diabetes are less likely to seek medical care for LBP. SIGNIFICANCE This is the first study investigating the factors that influence seeking medical care for LBP, while adjusting for the influence of familial factors using a co-twin control design. Poor sleep quality is associated with seeking medical care for LBP in the long term and does not appear to be confounded by familial factors. Early screening for indicators of poor sleep quality and appropriate referral to interventions for improving sleep quality or reducing pain in sleep may improve LBP management.
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Affiliation(s)
- Emma Kwan-Yee Ho
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Manuela Ferreira
- Institute of Bone and Joint Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Marina Pinheiro
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ana Paula Carvalho-E-Silva
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Juan Jose Madrid-Valero
- Department of Human Anatomy and Psychobiology and Murcia Institute for Biomedical Research, (IMIB-Arrixaca-UMU), University of Murcia, Murica, Spain
| | - Joshua Zadro
- The University of Sydney, Institute for Musculoskeletal Health, Sydney School of Public Health, Sydney, NSW, Australia
| | - Juan Ordoñana
- Department of Human Anatomy and Psychobiology and Murcia Institute for Biomedical Research, (IMIB-Arrixaca-UMU), University of Murcia, Murica, Spain
| | - Paulo Ferreira
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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26
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Disentangling comorbidity in chronic pain: A study in primary health care settings from India. PLoS One 2020; 15:e0242865. [PMID: 33253251 PMCID: PMC7703899 DOI: 10.1371/journal.pone.0242865] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The study examined the prevalence, sociodemographic, and clinical correlates of chronic pain among primary care patients in the state of Kerala, India. It also examined the patterns and relationships of chronic physical and mental health conditions with chronic pain. METHODS This study is a cross-sectional survey conducted among 7165 adult patients selected randomly by a multi-stage stratified design from 71 primary health centers. The questionnaires administered included Chronic pain screening questionnaire, self-reported Chronic physical health condition checklist, Patient Health Questionnaire-SADS, The Alcohol Use Disorders Identification Test, Fagerström Test for Nicotine Dependence, WHO Disability Assessment Schedule and WHOQOL- BREF for Quality/Satisfaction with Life. The prevalence and comorbid patterns of chronic pain were determined. Logistic regression analysis and generalized linear mixed-effects model was employed to examine the relationship of chronic pain to socio-demographic variables and examined physical and mental health conditions. RESULTS A total of 1831 (27%) patients reported chronic pain. Among those with chronic pain, 28.3% reported no co-occurring chronic mental or physical illness, 35.3% reported one, and 36.3% reported multi-morbidity. In the multivariate analysis, patients with chronic pain when compared to those without had higher odds of being older, female, having lower education, not living with their family, greater disability, and poor satisfaction with life. Chronic pain was independently associated with both medical (hypertension, diabetes mellitus, tuberculosis, arthritis, and other medical illnesses) and mental health conditions (depressive disorders, anxiety disorders, and tobacco dependence). It showed a varying strength of association and additive effect with increasing number of co-occurring physical and mental illnesses. CONCLUSIONS Chronic pain is a common condition among primary care attendees associated with significant burden of medical and mental health comorbidity. The findings highlight the need to incorporate treatment models that will ensure appropriate management to improve outcomes within the resource constraints.
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27
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Rassas I, Mahfoudh A, Khelil A, Amri C, Chaari N, Henchi A, Khalfallah T, Akrout M, Merchaoui I. Strain-based work-to-family conflict as a predictor of lumbar and cervical pain in Tunisian nursing staff. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 28:856-862. [PMID: 33034264 DOI: 10.1080/10803548.2020.1833507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective. This study aimed to examine the association of the different dimensions and forms of work-family conflict with the occurrence of neck and lower back pain (LBP) in Tunisian nurses. Methods. We conducted a cross-sectional study on nurses assigned to a district hospital in Tunisia. The work-family interface was assessed with the work-family conflict scale of Carlson et al. Psychosocial and organizational constraints at work were assessed through the nursing work index - extended organization in its specific version designed for nurses. Assessment of neck and lumbar pain was carried out with the standardized Nordic musculoskeletal questionnaire. Results. Seventy-two nurses participated in the present study (participation rate = 100%) with a mean age of 42.38 ± 10.85 years. Binary logistic regression analyses retained strain-based work-to-family conflict as a significant determinant of both LBP (p < 10-3; odds ratio [OR] = 5.07; 95% confidence interval [CI] [2.1, 11.7]) and neck pain (p = 0.001; OR = 6.8; 95% CI [2.13, 22]). Conclusions. Strain-based work-to-family conflict was found to predict lumbar and cervical pain more than the other types of conflict in nursing staff. Thus, reducing strain in health-care settings should be a central component of the preventive approach of musculoskeletal disorders in nursing staff.
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Affiliation(s)
- Ines Rassas
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
| | - Aouatef Mahfoudh
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
| | - Amira Khelil
- Grombalia's District Hospital, University of Monastir-Tunisia, Tunisia
| | - Charfeddine Amri
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
| | - Neila Chaari
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
| | - Adnène Henchi
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
| | - Taoufik Khalfallah
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
| | - Mohamed Akrout
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
| | - Irtyah Merchaoui
- Department of Occupational Medicine and Ergonomics-Faculty of Medicine of Monastir, University of Monastir, Tunisia.,Faculty of Medicine of Monastir-Tunisia, GERPE-LR08SP07: Laboratory of Ergonomic Management of Professional Risk and Environment, Tunisia
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28
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Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study. J Clin Med 2020; 9:jcm9092867. [PMID: 32899769 PMCID: PMC7563531 DOI: 10.3390/jcm9092867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 01/02/2023] Open
Abstract
We aimed to assess if subjects with diabetes exhibit higher prevalence of chronic back pain than age-sex-province of residence-matched non-diabetic controls. We also aimed to identify predictors for chronic neck pain (CNP) or chronic low back pain (CLBP) among subjects with diabetes. A case control study was conducted using data obtained from the Spanish National Health Survey 2017. Multivariable conditional and unconditional logistic regression models were constructed. A total of 2095 diabetes sufferers and 2095 non-diabetic matched controls were analyzed. The prevalence of CNP and CLBP was 27.3% and 34.8%, respectively, in diabetes sufferers and 22.1% and 29.0% in non-diabetes controls (both, p < 0.001). After multivariable analysis, the ORs showed significantly higher adjusted risk of CNP (OR 1.34; 95% CI 1.19–1.51) and CLBP (OR 1.19, 95% CI 1.09–1.31) in diabetes cases. Diabetes sufferers with CNP or CLBP showed higher use of pain medication and higher prevalence of migraine/frequent headache than controls. Female sex, worse self-rated health and use of pain medication were predictors for CNP and CLBP in subjects with diabetes. CNP and CLBP are significantly more prevalent in diabetes sufferers than in controls. Current results can help to design better preventive and educational strategies for these highly prevalent and burdensome pains among diabetic patients.
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29
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Hillson R. Pain and diabetes. PRACTICAL DIABETES 2020. [DOI: 10.1002/pdi.2292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Rowan Hillson
- Dr Rowan Hillson, MBE, Past National Clinical Director for Diabetes
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30
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Carvalho-E-Silva AP, Ferreira ML, Ferreira PH, Harmer AR. Does type 2 diabetes increase the risk of musculoskeletal pain? Cross-sectional and longitudinal analyses of UK biobank data. Semin Arthritis Rheum 2020; 50:728-734. [PMID: 32521327 DOI: 10.1016/j.semarthrit.2020.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/22/2020] [Accepted: 05/04/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE We investigated cross-sectional associations and whether type 2 diabetes increases the risk of musculoskeletal pain after adjusting for the presence of important comorbidities. METHODS The study employed data from the UK Biobank participants: 495,327 in cross-sectional (2006-2010) and 16,875 in longitudinal (2014-2016) analyses. Type 2 diabetes was self-reported and subsequently confirmed during an interview. Musculoskeletal pain was diagnosed by the participants' reports of back, knee, hip, or neck/shoulder pain that interfered with usual activities in the last month (recent pain), and for more than 3 months (chronic pain). RESULTS In cross-sectional adjusted logistic regression analyses, type 2 diabetes was associated with recent and chronic neck/shoulder pain [OR 1.14, 95%CI 1.10-1.18; OR 1.15, 95%CI 1.10-1.19] and hip pain [OR 1.13, 95%CI 1.08-1.17; OR 1.14 95%CI 1.09-1.19]; and with chronic knee pain [OR 1.01, 95%CI 1.01-1.01]. In longitudinal adjusted analyses, type 2 diabetes increased the risk of recent and chronic neck/shoulder pain [OR 1.39, 95%CI 1.01-1.91; OR 1.56; 95%CI 1.14-2.19]. CONCLUSION People with type 2 diabetes are more likely to report musculoskeletal pain in shoulder/neck, knee or hip. In addition, people with type 2 diabetes, particularly women, are more likely to present with a future episode of neck/shoulder pain. This study highlights the need to consider musculoskeletal screening among patients with diabetes and also serves as a stimulus for investigation of the mechanisms that explain the relationship between musculoskeletal pain and type 2 diabetes; with a view to prevention or improving future treatment.
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Affiliation(s)
- Ana Paula Carvalho-E-Silva
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney
| | - Paulo H Ferreira
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alison R Harmer
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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31
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Gutefeldt K, Hedman CA, Thyberg ISM, Bachrach-Lindström M, Arnqvist HJ, Spångeus A. Low health-related quality of life is strongly linked to upper extremity impairments in type 1 diabetes with a long duration. Disabil Rehabil 2020; 43:2578-2584. [PMID: 31906725 DOI: 10.1080/09638288.2019.1705924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare health-related quality of life (HRQOL) in type 1 diabetes and non-diabetic controls and possible links to upper extremity impairments (UEIs). Prevalence of sick-leave and causes were investigated. MATERIALS AND METHODS This Swedish population-based case-control study included type 1 diabetes patients <67 years old and with a diabetes duration ≥20 years. Participants completed a postal questionnaire including Short Form 36, and questions regarding UEIs, and sick-leave. RESULTS In total, 773 patients, aged 50 ± 10 years (diabetes duration 35 ± 10 years), and 708 non-diabetic controls, aged 54 ± 9 years, completed the study. Patients reported significantly lower HRQOL compared with controls. The difference was greatest for general health, vitality, and bodily pain. Patients with shoulder or hand but not finger impairments scored significantly lower than asymptomatic patients. The prevalence of sick leave was higher in patients vs. controls (23% vs. 9%, p < 0.001), and nearly half cited impairments from back, muscles, or joints as the main reason. CONCLUSIONS Health-related quality of life is lower in type 1 diabetes than controls and in patients with shoulder and hand impairments than in asymptomatic. Musculoskeletal impairments (back/muscle/joints) have impact on work ability. Identification of UEIs is important for initiating preventative-, therapeutic-, and rehabilitative interventions.Implications for rehabilitationUpper extremity impairments (UEIs) that are common in type 1 diabetes, and associated with reduced health-related quality of life, should preferably be screened for on a regular basis along with other known diabetes complications.Early identification of UEIs is important to improve health by initiating preventive as well as therapeutic multi-professional rehabilitative interventions.Sick leave is higher in type 1 diabetes than in controls. Musculoskeletal impairments, including the back, muscles, and joints, are a common cause for sick leave warranting further studies.
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Affiliation(s)
- Kerstin Gutefeldt
- Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Christina A Hedman
- Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ingrid S M Thyberg
- Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Margareta Bachrach-Lindström
- Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden
| | - Hans J Arnqvist
- Department of Endocrinology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Anna Spångeus
- Department of Medical and Health Sciences and Department of Acute Internal Medicine and Geriatrics, Linköping University, Linköping, Sweden
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Heuch I, Heuch I, Hagen K, Sørgjerd EP, Åsvold BO, Zwart JA. Does diabetes influence the probability of experiencing chronic low back pain? A population-based cohort study: the Nord-Trøndelag Health Study. BMJ Open 2019; 9:e031692. [PMID: 31515434 PMCID: PMC6747649 DOI: 10.1136/bmjopen-2019-031692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) is a major problem in modern society and it is important to study possible risk factors for this disorder. People with diabetes are often affected by LBP, but whether diabetes represents a risk factor for LBP has not been studied in detail. The aim of this study was to explore the association between diabetes and subsequent risk of chronic LBP. DESIGN An 11-year follow-up study. SETTING The Nord-Trøndelag Health Study (HUNT2; 1995-1997) and HUNT3 (2006-2008) surveys of Nord-Trøndelag County in Norway. MAIN OUTCOME MEASURE Chronic LBP, defined as LBP persisting at least 3 months continuously during the last year. PARTICIPANTS A total of 18 972 persons without chronic LBP at baseline in HUNT2, and 6802 persons who reported chronic LBP at baseline in HUNT2. METHODS Associations between diabetes and risk of chronic LBP among individuals aged 30-69 years were examined by generalised linear modelling. RESULTS Men without chronic LBP at baseline showed a significant association between diabetes and risk of chronic LBP (relative risk (RR) 1.43, 95% CI 1.04 to 1.96, p=0.043). In women, no association was found (RR 1.01, 95% CI 0.69 to 1.48, p=0.98). No association could be established between diabetes and recurrence or persistence of chronic LBP after 11 years in either sex. CONCLUSIONS Men with a diagnosis of diabetes may have a higher risk of subsequently experiencing chronic LBP.
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Affiliation(s)
- Ingrid Heuch
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St Olavs University Hospital, Trondheim, Norway
| | - Elin Pettersen Sørgjerd
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Endocrinology, St Olavs University Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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