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Li X, Wang Y, Zhang Y, Ma Y, Pan F, Laslett L, Cai G. Longitudinal associations of body mass index and abdominal circumference with back pain among community-dwelling adults: data from the Osteoarthritis Initiative. Spine J 2023; 23:1007-1014. [PMID: 37030576 DOI: 10.1016/j.spinee.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 04/10/2023]
Abstract
BACKGROUND CONTEXT Back pain is the most common musculoskeletal problem in both developed and developing countries. The prevalence and burden of back pain increases with age, and the management of back pain becomes increasingly important in the context of global aging. There is increasing evidence that obesity is a modifiable risk factor for musculoskeletal pain in different locations. Understanding the role of obesity in back pain holds great potential for improving understanding of the mechanisms of back pain and for developing new preventive and therapeutic approaches. PURPOSE To evaluate the role of weight, body mass index (BMI) and abdominal circumference (AC) in risk of back pain over 96 months. DESIGN Prospective cohort study. PATIENT SAMPLE The sample was from 4,793 adults in the Osteoarthritis Initiative (OAI) database who had or were at increased risk for knee Osteoarthritis. OUTCOME MEASURES Outcome variables included the presence, severity, and frequency of back pain, using the past 30 days as the time frame. METHODS Longitudinal analysis of data from 4,793 participants enrolled in the Osteoarthritis Initiative, assessed every 12 or 24 months for weight, BMI (kg/m2), AC (cm), and presence, severity (none, mild, moderate, severe), and frequency (none, rarely, sometimes, often, always) of back pain. BMI and AC were decomposed into between-person and with-person components. Data analyses were performed using mixed-effects logistic (for presence of back pain) or ordered logistic regression (for severity and frequency of back pain) models. RESULTS Back pain was reported in 58% of participants at baseline; 70% of those without back pain had incident back pain over 96 months. Both between-person (average value across a participant's all measurements) and within-person (deviations from the participant's average) effects of weight and BMI increased risk of presence, severity, and frequency of back pain (Odds radios (OR) per kg/m2: 1.010-1.046, p<.05) in females but not males, with statistically significant weight*sex and BMI*sex interactions. Similar findings were observed for between-person effects of AC on back pain, and the within-person effect of AC was only associated with back pain severity (OR per cm: 1.009, 95% confidence interval 1.002-1.017, p=.019) in females. CONCLUSIONS Greater average weight and BMI and increases in them increased odds of presence, severity, and frequency of back pain over 96 months in middle aged and older women but not men. Only average AC increased odds of back pain over time, in women. These findings suggest that preventing obesity and slowing weight gain is important for the management of back pain.
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Affiliation(s)
- Xiaoxi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yining Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Youyou Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Laura Laslett
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, Tasmania, Australia
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Chen J, Liao Y, Luo M, Tang S, Huang J, Chen R, Xiao Z. Environmental polycyclic aromatic hydrocarbon exposure is associated with low back pain. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023:10.1007/s10653-023-01567-y. [PMID: 37069329 DOI: 10.1007/s10653-023-01567-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 04/05/2023] [Indexed: 06/19/2023]
Abstract
Several studies have assessed the influence of several often-ignored environmental factors on low back pain (LBP), but the effects of environmental polycyclic aromatic hydrocarbon (PAH) exposure on LBP are unclear. During the 2001-2004 cycle of the National Health and Nutrition Examination Survey (NHANES), our study was given to a representative sample of US participants older than 20 (N = 2743). Environmental PAH exposure was calculated using urinary PAH metabolite concentrations. Weighted logistic regression was performed to assess the connection between PAH levels and LBP, with mediation analysis utilised to explore the underlying mechanism. Levels of 1-hydroxynaphthalene (1-OHNa), 2-hydroxynaphthalene (2-OHNa) and total PAHs had a statistically significant positive association with LBP. The odds ratios per 1-unit increase for log-transformed levels of urinary 1-OHNa, 2-OHNa, and total PAHs with LBP were 1.01 (95% CI 1.02-1.19), 1.19 (95% CI 1.04-1.36) and 1.16 (95% CI 1.03-1.32), respectively. The results revealed a strong dose-response association between 1-OHNa, 2-OHNa, total PAHs, and LBP risk. Subgroup analysis indicated that 2&3-OHPh may increase the risk of LBP in the lower family income subgroup. Gamma-glutamyl transaminase (GGT), known as a biomarker of oxidative stress, was strongly related to PAHs. The relationship between total PAHs and LBP was mediated in part by GGT. Our study demonstrates associations between environmental PAH exposure and LBP that need more research to determine the precise effects of various PAH compounds on LBP.
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Affiliation(s)
- Jiang Chen
- Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Yangjie Liao
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Mingjiang Luo
- Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Siliang Tang
- Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Jinshan Huang
- Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | | | - Zhihong Xiao
- Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China.
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Watanabe M, Tomiyama C, Nikaido T, Takeda T, Mandai N. Mental status is significantly associated with low back pain: a survey-based cross-sectional study among Japanese women. BMC Res Notes 2023; 16:8. [PMID: 36717870 PMCID: PMC9885655 DOI: 10.1186/s13104-023-06276-4] [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: 09/29/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Low back pain (LBP) is a highly prevalent condition that poses significant patient burden. This cross-sectional study identified factors associated with LBP occurrence and developed a strategy to identify, prevent, and reduce LBP-related burden on patient health. A web-based questionnaire-answering system was used to assess the potential effects of LBP on mental health, assessing five domains (physical features, demographics, lifestyle, diet, and mental status) conceptually associated with hie, a common disease state traditionally described in the Japanese culture as a chilly sensation. RESULTS Of 1000 women, 354 had and 646 did not have LBP. The Chi test identified 21 factors, and subsequent multivariate logistic regression indicated eight factors significantly associated with LBP: age, history of physician consultation regarding anemia, history of analgesic agents, dietary limitations, nocturia, sauna use, hie, and fatigue. Furthermore, women with LBP exhibited a significantly lower body temperature (BT) in the axilla/on the forehead than women without LBP. LBP and hie are subjective and potentially affected by patient mental status. Stress reduces blood circulation, causing hypothermia and possibly worsening LBP. Therefore, mental-health support is important for patients with LBP to reduce physiological stress. Hyperthermia therapy, a traditionally prescribed intervention, is a potential intervention for future studies.
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Affiliation(s)
- Mayumi Watanabe
- grid.449550.90000 0004 0615 8394Faculty of Health Sciences, Kansai University of Health Sciences, Osaka, Japan ,grid.443595.a0000 0001 2323 0843Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Chikako Tomiyama
- grid.260975.f0000 0001 0671 5144Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Takuya Nikaido
- grid.411582.b0000 0001 1017 9540Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tokimasa Takeda
- grid.449550.90000 0004 0615 8394Faculty of Health Sciences, Kansai University of Health Sciences, Osaka, Japan ,grid.258799.80000 0004 0372 2033Zinbunken, Kyoto University, Kyoto, Japan
| | - Nozomu Mandai
- grid.460070.50000 0004 4666 2624Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Japan ,grid.411486.e0000 0004 1763 7219Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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Taylor KA, Schwartz SW, Alman AC, Goode AP, Dagne GA, Sebastião YV, Foulis PR. Nightmare disorder and low back pain in veterans: cross-sectional association and effect over time. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2022; 3:zpac030. [PMID: 36387301 PMCID: PMC9648406 DOI: 10.1093/sleepadvances/zpac030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/29/2022] [Indexed: 12/15/2022]
Abstract
Low back pain (LBP) disproportionately impacts US military veterans compared with nonveterans. Although the effect of psychological conditions on LBP is regularly studied, there is little published to date investigating nightmare disorder (NMD) and LBP. The purpose of this study was to (1) investigate whether an association exists between NMD and LBP and (2) estimate the effect of NMD diagnosis on time to LBP. We used a retrospective cohort design with oversampling of those with NMD from the Veterans Health Administration (n = 15 983). We used logistic regression to assess for a cross-sectional association between NMD and LBP and survival analysis to estimate the effect of NMD on time to LBP, up to 60-month follow-up, conditioning on age, sex, race, index year, Charlson Comorbidity Index, depression, anxiety, insomnia, combat exposure, and prisoner of war history to address confounding. Odds ratios (with 95% confidence intervals [CIs]) indicated a cross-sectional association of 1.35 (1.13 to 1.60) and 1.21 (1.02 to 1.42) for NMD and LBP within 6 months and 12 months pre- or post-NMD diagnosis, respectively. Hazard ratios (HRs) indicated the effect of NMD on time to LBP that was time-dependent-HR (with 95% CIs) 1.27 (1.02 to 1.59), 1.23 (1.03 to 1.48), 1.19 (1.01 to 1.40), and 1.10 (0.94 to 1.29) in the first 3, 6, 9, and 12 months post-diagnosis, respectively-approximating the null (1.00) at >12 months. The estimated effect of NMD on LBP suggests that improved screening for NMD among veterans may help clinicians and researchers predict (or intervene to reduce) risk of future back pain.
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Affiliation(s)
- Kenneth A Taylor
- Corresponding author. Kenneth A. Taylor, Duke Clinical Research Institute, 300 West Morgan Street, Ste 800, Durham, NC 27701, USA.
| | - Skai W Schwartz
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Adam P Goode
- Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA,Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA,Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Getachew A Dagne
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Yuri V Sebastião
- Division of Global Women’s Health, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Philip R Foulis
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA,Pathology and Laboratory Medicine, James A. Haley Veterans’ Hospital, Tampa, FL, USA
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Lumley MA, Yamin JB, Pester BD, Krohner S, Urbanik CP. Trauma matters: psychological interventions for comorbid psychosocial trauma and chronic pain. Pain 2022; 163:599-603. [PMID: 34338244 PMCID: PMC8799778 DOI: 10.1097/j.pain.0000000000002425] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, MI, United States
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Tani N, Ohta M, Higuchi Y, Yamamoto R, Akatsu J. Does difficulty in chewing induce subjective musculoskeletal symptoms? A case-control study. BMJ Open 2022; 12:e053360. [PMID: 35318231 PMCID: PMC8943742 DOI: 10.1136/bmjopen-2021-053360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Risk factors associated with the development of musculoskeletal disorders and symptoms remain an important issue worldwide. This study aimed to investigate the relationship between oral health problems such as difficulty chewing and the occurrence of stiff neck/shoulders (SN/S) and low back pain (LBP). DESIGN Case-control study. SETTING AND PARTICIPANTS This study was conducted from 1 April 2018 to 31 March 2020. The subjects were 77 341 workers among 646 281 workers from several employers in Japan. OUTCOME MEASURES Participants were asked to evaluate their subjective SN/S and LBP symptoms using a self-administered questionnaire. METHODS We defined the chewing condition using a questionnaire, and workers who responded with 'I can chew anything' were classified as the good condition group (GCG), and those who responded with 'Sometimes I have difficulty chewing due to problems with the teeth, gums, or bite' or 'I can hardly chew' were classified as the poor condition group (PCG). Setting the year 2018 as the baseline, we performed a logistic regression model using propensity score and inverse probability weighting (IPW) methods and chewing condition groups as explanatory variables and SN/S and LBP as objective variables. RESULTS The IPW-adjusted logistic regression model showed that the OR of SN/S was approximately 1.25 (95% CI 1.17 to 1.33) times higher in the PCG than that in the GCG (p<0.001). Similarly, the OR of LBP was about 1.37 (95% CI 1.27 to 1.48) times higher in the PCG than that in the GCG in the IPW-adjusted logistic regression model (p<0.001). CONCLUSIONS Our study suggests that the occurrence of SN/S and LBP symptoms in workers could be predicted depending on the presence of difficulty in chewing. Therefore, oral health and health guidance are gaining importance for the prevention of subjective musculoskeletal symptoms.
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Affiliation(s)
- Naomichi Tani
- Department of Health Information Analysis and Research, The Association for Preventive Medicine of Japan, Fukuoka, Japan
| | - Masanori Ohta
- Graduate School of Health and Environmental Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Yoshiyuki Higuchi
- Department of Health and Physical Education, University of Teacher Education Fukuoka, Fukuoka, Japan
| | - Ryoko Yamamoto
- Department of Occupational health, The Association for Preventive Medicine of Japan, Fukuoka, Japan
| | - Junichi Akatsu
- Wellbeing Mori Clinic, The Association for Preventive Medicine of Japan, Tokyo, Japan
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Gao S, Zhou H, Luo S, Cai X, Ye F, He Q, Huang C, Zheng X, Li Y, Du Z, Wang Y, Qi Z, Wang Z. Investigating the Causal Relationship Between Physical Activity and Chronic Back Pain: A Bidirectional Two-Sample Mendelian Randomization Study. Front Genet 2021; 12:758639. [PMID: 34987546 PMCID: PMC8721110 DOI: 10.3389/fgene.2021.758639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/25/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Recent observational studies have reported a negative association between physical activity and chronic back pain (CBP), but the causality of the association remains unknown. We introduce bidirectional Mendelian randomization (MR) to assess potential causal inference between physical activity and CBP. Materials and Methods: This two-sample MR used independent genetic variants associated with physical activity and CBP as genetic instruments from large genome-wide association studies (GWASs). The effects of both directions (physical activity to CBP and CBP to physical activity) were examined. Inverse variance-weighted meta-analysis and alternate methods (weighted median and MR-Egger) were used to combine the MR estimates of the genetic instruments. Multiple sensitivity analyses were conducted to examine the robustness of the results. Results: The MR set parallel GWAS cohorts, among which, those involved in the primary analysis were comprised of 337,234 participants for physical activity and 158,025 participants (29,531 cases) for CBP. No evidence of a causal relationship was found in the direction of physical activity to CBP [odds ratio (OR), 0.98; 95% CI, 0.85-1.13; p = 0.81]. In contrast, a negative causal relationship in the direction of CBP to physical activity was detected (β = -0.07; 95% CI, -0.12 to -0.01; p = 0.02), implying a reduction in moderate-vigorous physical activity (approximately 146 MET-minutes/week) for participants with CBP relative to controls. Conclusion: The negative relationship between physical activity and CBP is probably derived from the reduced physical activity of patients experiencing CBP rather than the protective effect of physical activity on CBP.
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Affiliation(s)
- Shaowei Gao
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Huaqiang Zhou
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Siyu Luo
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Xiaoying Cai
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Fang Ye
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Qiulan He
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Chanyan Huang
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Xiaoyang Zheng
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Ying Li
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Zhanxin Du
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Yaqing Wang
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Zhihui Qi
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Zhongxing Wang
- Department of Anesthesia, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
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Fraction and Number of Unemployed Associated with Self-Reported Low Back Pain: A Nation-Wide Cross-Sectional Study in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010760. [PMID: 34682501 PMCID: PMC8536185 DOI: 10.3390/ijerph182010760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/09/2021] [Accepted: 10/10/2021] [Indexed: 11/24/2022]
Abstract
This study examined a cross-sectional association between self-reported low back pain (LBP) and unemployment among working-age people, and estimated the impact of self-reported LBP on unemployment. We used anonymized data from a nationally representative survey (24,854 men and 26,549 women aged 20–64 years). The generalized estimating equations of the multivariable Poisson regression models stratified by gender were used to estimate the adjusted prevalence ratio (PR) and 95% confidence interval (CI) for unemployment. The population attributable fraction (PAF) was calculated using Levin’s method, with the substitution method for 95% CI estimation. The prevalence of self-reported LBP was 9.0% in men and 11.1% in women. The prevalence of unemployment was 9.3% in men and 31.7% in women. After adjusting for age, socio-economic status, lifestyle habits, and comorbidities, the PR (95% CI) for the unemployment of the LBP group was 1.32 (1.19–1.47) in men and 1.01 (0.96–1.07) in women, compared with the respective non-LBP group. The PAF (95% CI) of unemployment associated with self-reported LBP was 2.8% (1.6%, 4.2%) in men. Because the total population of Japanese men aged 20–64 in 2013 was 36,851 thousand, it was estimated that unemployment in 1037 thousand of the Japanese male working population was LBP-related.
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Tong H, Lung Y, Lin SL, Kobayashi KM, Davison KM, Agbeyaka S, Fuller-Thomson E. Refugee status is associated with double the odds of psychological distress in mid-to-late life: Findings from the Canadian Longitudinal Study on Aging. Int J Soc Psychiatry 2021; 67:747-760. [PMID: 33176526 DOI: 10.1177/0020764020971003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Psychological distress is associated with a range of negative outcomes including lower quality of life and an increased risk of premature all-cause mortality. The prevalence of, and factors associated with, psychological distress among middle-aged and older Canadians are understudied. Using the Canadian Longitudinal Study on Aging (CLSA) baseline data, this study examined factors associated with psychological distress among adults between 45 and 85 years, including refugee status and a wide range of sociodemographic, health-related and social support characteristics. Psychological distress was measured by Kessler's Psychological Distress Scale-K10 scores. Bivariate and multivariable binary logistic regression analyses were conducted. The prevalence of psychological distress was significantly higher among the 244 refugees (23.8%), compared to 23,149 Canadian-born Canadians (12.8%) and 4,765 non-refugee immigrants (12.6%), despite the fact that the average time the refugees had lived in Canada was more than four decades. The results of the binary logistic regression analysis indicated refugees had twice the age-sex adjusted odds of psychological distress (OR = 2.31, 95% CI: 1.74, 3.07). Even after further adjustment for 16 potential risk factors, a significant relationship remained between refugee status and psychological distress (OR = 1.56; 95% CI = 1.12, 2.17). Other significant factors associated with psychological distress included younger age, female gender, visible minority status, lower household income, not having an undergraduate degree, multimorbidities, chronic pain, and lack of social support. Policies and interventions addressing psychological distress among Canadians in mid- to later life should target refugees and other vulnerable groups.
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Affiliation(s)
| | - Yu Lung
- University of Toronto, Toronto, ON, Canada
| | | | | | - Karen M Davison
- Kwantlen Polytechnic University and University of Hawai'I, Surrey, BC, Canada
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Smuck M, Schneider BJ, Ehsanian R, Martin E, Kao MCJ. Smoking Is Associated with Pain in All Body Regions, with Greatest Influence on Spinal Pain. PAIN MEDICINE 2021; 21:1759-1768. [PMID: 31578562 DOI: 10.1093/pm/pnz224] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Examine the interrelationship between smoking and pain in the US population. DESIGN A cross-sectional population-based study. SETTING Nationwide survey. METHODS Comprehensive pain reports categorically defined as head, spine, trunk, and limb pain; smoking history; demographics; medical history from a total of 2,307 subjects from the 2003-2004 National Health and Nutrition Examination Survey obtained from the Centers for Disease Control were analyzed. Unpaired t tests were used to analyze independent continuous variables, and chi-square tests were used to analyze categorical variables between smoker and nonsmoker groups. Weighted multivariate logistic regression analyses determined the association of current smoking with the presence of pain in various body regions. RESULTS Smoking is most strongly associated with spine pain (odds ratio [OR] = 2.89, 95% confidence interval [CI] = 2.21-3.77), followed by headache (OR = 2.47, 95% CI = 1.73-3.53), trunk pain (OR = 2.17, 95% CI = 1.45-2.74), and limb pain (OR = 1.99, 95% CI = 1.45-2.73). CONCLUSIONS Current smoking is associated with pain in every region of the body. This association is strongest for spine and head pain. Given that pain is a strong motivator and that current smoking was associated with pain in all body regions, we recommend that these results be used to further raise public awareness about the potential harms of smoking.
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Affiliation(s)
- Matthew Smuck
- Physical Medicine and Rehabilitation, Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Byron J Schneider
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee.,Vanderbilt University Medical Center, Center for Musculoskeletal Research
| | - Reza Ehsanian
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee.,Department of Neurosurgery, Stanford University, Palo Alto, California.,Division of Physical Medicine and Rehabilitation, Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Elizabeth Martin
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee.,Division of Physical Medicine and Rehabilitation, Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Ming-Chih J Kao
- Physical Medicine and Rehabilitation, Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University, Stanford, California
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Carlesso LC, Tousignant-Laflamme Y, Shaw W, Larivière C, Choinière M. Exploring pain phenotypes in workers with chronic low back pain: Application of IMMPACT recommendations. CANADIAN JOURNAL OF PAIN-REVUE CANADIENNE DE LA DOULEUR 2021; 5:43-55. [PMID: 33987523 PMCID: PMC7951157 DOI: 10.1080/24740527.2020.1870103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Chronic low back pain (CLBP) is a major cause of disability globally. Stratified care has been proposed as a means to improve prognosis and treatment but is generally based on limited aspects of pain, including biopsychosocial drivers. Aims: Following Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations, the present study explored pain phenotypes with a sample of workers with CLBP, a population for which no pain phenotypes have been derived to date. Methods: A cross-sectional design was used with a sample of 154 workers with CLBP attending a rehabilitation clinic, recruited in person and from social media. Latent class analysis was used to identify subgroups of patients with different pain profiles based on ten pain indicators (pain variability, pain intensity, pain quality, somatization, sleep quality, depression, fatigue, pain catastrophizing, neuropathic pain, and central sensitization). Results: The majority of the sample (85%) were recruited through social media. Both the two-class and three-class solutions were found to be satisfactory in distinguishing phenotypes of workers with CLBP. Three variables proved particularly important in distinguishing between the pain phenotypes—pain quality, fatigue, and central sensitization—with higher scores on these indicators associated with pain phenotypes with higher pain burden. Increased chronic pain self-efficacy, work-related support, and perceived work abilities were protective risk factors for being in a higher pain burden class. Conclusions: The present study is the first to explore IMMPACT recommendations for pain phenotyping with workers with CLBP. Future prospective research will be needed to validate the proposed pain phenotypes.
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Affiliation(s)
- Lisa C Carlesso
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation, Université de Montréal, Montréal, Quebec, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,Clinical Research of the Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Quebec, Canada
| | - William Shaw
- Division of Occupational and Environmental Medicine, Departments of Medicine and Public Health Sciences, University of Connecticut Health Center, Farmington, CT
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montreal, Quebec, Canada
| | - Manon Choinière
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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12
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Palmer AJ, Poveda JL, Martinez-Laguna D, Reyes C, de Bont J, Silman A, Carr AJ, Duarte-Salles T, Prieto-Alhambra D. Childhood overweight and obesity and back pain risk: a cohort study of 466 997 children. BMJ Open 2020; 10:e036023. [PMID: 32948552 PMCID: PMC7500301 DOI: 10.1136/bmjopen-2019-036023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess the association between age, sex, socioeconomic group, weight status and back pain risk in a large general population cohort of children. DESIGN AND SETTING A dynamic cohort of children aged 4 years in the Information System for Research in Primary Care (SIDIAP) electronic primary care records data in Catalonia. Multivariable Cox models were fitted to explore the association between back pain and weight status categories according to the WHO 2007 growth reference groups (body mass index for age z-score). Models were adjusted for age, sex, socioeconomic status and nationality. PARTICIPANTS Children seen at age 4 years at paediatric primary care clinics between 1 January 2006 and 31 December 2013 and followed up until 31 December 2016 or age 15 years. OUTCOME MEASURES Incident back pain registered by paediatricians at primary care using the International Statistical Classification of Diseases and Health Related Problems, 10th Edition code M54. RESULTS 466 997 children were followed for a median 5.0 years (IQR 5.1). In multivariable models, overweight and obesity increased back pain risk, with adjusted HRs of 1.18 (95% CI 1.09 to 1.27) and 1.34 (95%CI 1.19 to 1.51) for overweight and obesity, respectively. Females were at greater risk of back pain than males with adjusted HR 1.40 (95%CI 1.35 to 1.46). Adjusted HR was 1.43 (95%CI 1.33 to 1.55) for back pain in children from the most deprived socioeconomic groups compared with the least deprived socioeconomic groups. CONCLUSIONS Maintaining a healthy weight from an early age may reduce the prevalence of back pain in both children and adults. Overweight female children from deprived socioeconomic groups are at greatest risk of back pain and represent a target population for intervention.
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Affiliation(s)
- Antony J Palmer
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jose Luis Poveda
- GREMPAL Research Group, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol) and CIBERFes, Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Instituto de Salud Carlos III, Barcelona, Spain
| | - Daniel Martinez-Laguna
- GREMPAL Research Group, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol) and CIBERFes, Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Instituto de Salud Carlos III, Barcelona, Spain
| | - Carlen Reyes
- GREMPAL Research Group, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol) and CIBERFes, Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Instituto de Salud Carlos III, Barcelona, Spain
| | - Jeroen de Bont
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Alan Silman
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, Oxfordshire, UK
| | - Andrew J Carr
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, Oxfordshire, UK
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, Oxfordshire, UK
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13
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Tani N, Ohta M, Higuchi Y, Akatsu J, Kumashiro M. Lifestyle and subjective musculoskeletal symptoms in young male Japanese workers: A 16-year retrospective cohort study. Prev Med Rep 2020; 20:101171. [PMID: 32904206 PMCID: PMC7452148 DOI: 10.1016/j.pmedr.2020.101171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/14/2020] [Accepted: 07/30/2020] [Indexed: 12/02/2022] Open
Abstract
The SN/S and LBP risk was higher in the PL than in the GL group. Four positive predictors (life satisfaction, hours of sleep, exercise habits, physical fitness) are important factors. Health staff should advise on workers’ individual lifestyle.
This longitudinal study was conducted from 2002 to 2018 and aimed to investigate predictive lifestyle factors for the occurrence of subjective musculoskeletal symptoms. The participants came from several employers in Japan. Setting 2002 as the baseline, we performed logistic regression analyses using lifestyle questionnaire items as explanatory variables and Stiff neck/shoulders (SN/S) and Lower back pain (LBP) as objective variables (n = 16,748). Workers who responded positively to good lifestyle items with an odds ratio < 1.0 and those who did not were classified in the Good (GL) and Poor lifestyle groups (PL), respectively. The survival period between the groups was compared using the log-rank test and Cox hazard regression analysis with propensity score matching (n = 3,593). Based on the Cox hazard regression analysis results, the risk of SN/S was about 2.54 (95% confidence interval [CI]: 1.80–3.59) times higher for PL than for GL (p < 0.001). Similarly, after propensity score matching, the risk was about 2.33 (95% CI: 1.07–5.10) times higher for PL than for GL (p < 0.05). Further, LBP risk was about 2.45 (95% CI: 1.67–3.58) times higher for PL than for GL (p < 0.001). Similarly, after propensity score matching, the risk was about 3.50 (95% CI: 1.60–7.68) times higher for PL than for GL (p < 0.01). This study highlighted that workers with four good lifestyle factors (life satisfaction, hours of sleep, exercise habits, and physical fitness) presented reduced risk of subjective musculoskeletal symptom occurrence. To prevent musculoskeletal symptoms, physicians and occupational health staff should advise on workers’ individual lifestyle.
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Affiliation(s)
- Naomichi Tani
- OH Solution Group, The Association for Preventive Medicine of Japan, Fukuoka, Japan
| | | | | | - Junichi Akatsu
- Wellbeing Mori Clinic, The Association for Preventive Medicine of Japan, Tokyo, Japan.,University of Occupational and Environmental Health, Japan
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14
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Gedin F, Alexanderson K, Zethraeus N, Karampampa K. Productivity losses among people with back pain and among population-based references: a register-based study in Sweden. BMJ Open 2020; 10:e036638. [PMID: 32792439 PMCID: PMC7430424 DOI: 10.1136/bmjopen-2019-036638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Back pain is the leading cause for years lived with disability globally and among the main reasons for sickness absence (SA) and disability pension (DP). The objective of this study was to explore the occurrence of SA and DP and to estimate productivity losses among individuals with back pain compared with among matched population-based references. DESIGN Explorative prospective cohort study using register microdata. PARTICIPANTS AND SETTING A total of 23 176 people, aged 19-60 years, with a first visit to inpatient or specialised outpatient healthcare for back pain (International Statistical Classification of Diseases and Related Health Problems code M54) in 2010 in Sweden and a matched population-based reference group (n=115 880). OUTCOMES Long-term SA (in SA spells >14 days) and DP and productivity losses, measured in € (2018 prices) by multiplying the SA and DP net days by the societal cost of each such day. RESULTS In the back-pain group, 42% had SA or DP days; in the reference group, the corresponding proportion was 15%. Productivity loss per patient with back pain was €8928 during the 12-month follow-up period; in the reference group, it was €3499 (p<0.0001). CONCLUSIONS SA and DP, leading to excess productivity losses among people with back pain, reflect the challenges these patients are facing to maintain their work capacity. Interventions to promote that individuals with back pain remain in paid work should be a priority in order to address the high costs.
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Affiliation(s)
- Filip Gedin
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | | | - Niklas Zethraeus
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Korinna Karampampa
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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15
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Heyn J, Luchting B, Azad SC. Smoking Associated T-Cell Imbalance in Patients With Chronic Pain. Nicotine Tob Res 2020; 22:111-117. [PMID: 30247701 DOI: 10.1093/ntr/nty199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/18/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Smoking is associated with several diseases and affects the immune system. Recently, published data demonstrate an involvement of T helper 17 cells (Th17) and regulatory T cells (Tregs) in the pathogenesis of chronic pain and pain intensity. The role of these T-cell subsets in smoking patients with chronic pain is nebulous so far. We therefore analyzed Th17 cells and Tregs in smokers and nonsmokers with chronic pain. METHODS Analyses of T-cell subsets, mRNA expression and T-cell related cytokine profiles were done in 44 patients with chronic pain. Twenty-two of these patients were smokers. Numbers of T-cell subsets were quantified by flow cytometry. mRNA expression of the Th17- (RAR-related orphan receptor gamma) and Treg (forkhead box protein P3)-specific transcription factors was determined by quantitative real-time PCR, and levels of cytokines were measured by Human Cytokine Multiplex Immunoassay. RESULTS Compared to nonsmokers, smokers showed significantly enhanced pain levels. On cellular basis, the number of pro-inflammatory Th17 cells (smokers: 2.2 ± 2.5% vs. nonsmokers: 0.5 ± 0.4%; p = .04) was increased, whereas the number of anti-inflammatory Tregs (smokers: 2.5 ± 0.9% vs. nonsmokers: 3.1 ± 1.1%; p = .02) was significantly decreased, resulting in an altered Th17/Treg ratio (Th17/Treg ratio: 0.9 ± 1.0 in smokers vs. 0.2 ± 0.1 in nonsmokers; p < .01). These findings were confirmed by quantitative real-time PCR. Analyses of cytokines revealed only marginal changes. CONCLUSIONS In patients with chronic pain, smoking is associated with enhanced pain levels together with an imbalance of the Th17/Treg ratio. The shift of the Th17/Treg ratio toward inflammation may explain in part the increased pain intensity in these patients. IMPLICATIONS Smoking is associated with increased pain levels and a pro-inflammatory Th17/Treg shift. The altered Th17/Treg ratio in smoking patients with chronic pain may partly explain their increased pain intensity. GERMAN CLINICAL TRIAL REGISTER (DRKS) Registration Trial DRKS00005954.
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Affiliation(s)
- Jens Heyn
- Department of Anaesthesiology, University of Munich (LMU), Munich, Germany
| | - Benjamin Luchting
- Department of Anaesthesiology, University of Munich (LMU), Munich, Germany
| | - Shahnaz C Azad
- Department of Anaesthesiology, University of Munich (LMU), Munich, Germany
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16
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Garcia-Cebrian A, Gandhi P, Demyttenaere K, Peveler R. The association of depression and painful physical symptoms–a review of the European literature. Eur Psychiatry 2020; 21:379-88. [PMID: 16797937 DOI: 10.1016/j.eurpsy.2005.12.003] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
AbstractObjective:The presence of painful physical symptoms may confound the diagnosis of major depressive disorder and may worsen patient prognosis. Epidemiological literature was reviewed to investigate the association between depression and painful physical symptoms.Method:MEDLINE and EMBASE database searches were conducted. Studies where a definable organic basis for pain was given were excluded. The search was unrestricted by language but limited to European studies and countries. After filters were applied, 70 eligible studies were reviewed.Results:The majority of studies reviewed showed an association between depression and painful physical symptoms. Over 40% of all studies examining the association between pain and depression were carried out in pain clinics in secondary care. Very few studies were conducted in psychiatric settings.Conclusion:The findings of this review suggest that painful physical symptoms may be an important part of the depressive syndrome. Although the relationship between depression and painful physical symptoms is not yet fully understood, findings suggest that diagnosis and treatment of depression should involve investigating and treating the full spectrum of symptoms (emotional and physical). Further research in psychiatric and generalist settings is needed to elucidate the relationship between depression and painful physical symptoms as experienced by patients and at the clinical level.
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Affiliation(s)
- A Garcia-Cebrian
- European Health Outcomes Research, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey GU20 6PH, UK.
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17
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Dose-response associations of clinical markers of obesity and duration of exposure to excess weight with chronic musculoskeletal pain: cross-sectional analysis at baseline of ELSA-Brasil Musculoskeletal cohort. Rheumatol Int 2020; 40:881-891. [PMID: 32236646 DOI: 10.1007/s00296-020-04557-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/14/2020] [Indexed: 02/03/2023]
Abstract
The objective of this study is to investigate the association of clinical markers of obesity and weight trajectories with chronic musculoskeletal pain (CMP). This is a cross-sectional study using baseline data from ELSA-Brasil MSK cohort. CMP was evaluated at nine body sites (neck, shoulders, upper back, elbows, lower back, wrists/hands, hips/thighs, knees, ankles/feet), and defined as pain lasting > 6 months in the past year. General and abdominal obesity levels were classified according to accepted cut-offs for body mass index (BMI), waist circumference (WC) and waist-height ratio (WHtR). Binomial and multinomial logistic regressions tested for associations with CMP at any site, at ≥ 3 sites (multisite) and in upper + lower limbs + axial skeleton (generalized). A total of 2899 participants (mean age 56.0 ± 8.93) were included, 55.0% reported CMP, 19.1% had multisite, and 10.3% had generalized CMP. After adjustments for sex, age, education, physical activity and depressive symptoms, nearly all the investigated markers of obesity were associated with any CMP, multisite and generalized CMP, with strongest associations being observed for general obesity level II/III: OR 2.08 (95% CI 1.45-2.99), OR 3.19 (95% CI 2.06-4.94) and OR 3.65 (2.18-6.11), respectively. Having excess weight currently or both at age 20 and currently was also associated with all CMP presentations. Associations of greater magnitude were consistently observed at higher obesity levels and longer exposures to excess weight (dose-response). These results may support the contribution of obesity-derived mechanical and inflammatory mechanisms of CMP, and indicate a role for the accumulation of exposure to excess weight across the adult life course.
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18
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Beynon AM, Hebert JJ, Hodgetts CJ, Boulos LM, Walker BF. Chronic physical illnesses, mental health disorders, and psychological features as potential risk factors for back pain from childhood to young adulthood: a systematic review with meta-analysis. 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 2020; 29:480-496. [PMID: 31907659 DOI: 10.1007/s00586-019-06278-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 08/27/2019] [Accepted: 12/29/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To report evidence of chronic physical illnesses, mental health disorders, and psychological features as potential risk factors for back pain in children, adolescents, and young adults. METHODS This systematic review and meta-analysis included cohort and inception cohort studies that investigated potential risk factors for back pain in young people. Potential risk factors of interest were chronic physical illnesses, mental health disorders (e.g. depression, anxiety), and other psychological features (e.g. coping, resistance). Searches were conducted in MEDLINE, Embase, CINAHL, and Scopus from inception to July 2019. RESULTS Nineteen of 2167 screened articles were included in the qualitative synthesis, and data from 12 articles were included in the meta-analysis. Evidence from inception cohort studies demonstrated psychological distress, emotional coping problems, and somatosensory amplification to be likely risk factors for back pain. Evidence from non-inception cohort studies cannot distinguish between risk factors or back pain triggers. However, we identified several additional factors that were associated with back pain. Specifically, asthma, headaches, abdominal pain, depression, anxiety, conduct problems, somatization, and 'feeling tense' are potential risk factors or triggers for back pain. Results from the meta-analyses demonstrated the most likely risk factors for back pain in young people are psychological distress and emotional coping problems. CONCLUSION Psychological features are the most likely risk factors for back pain in young people. Several other factors were associated with back pain, but their potential as risk factors was unclear due to risk of bias. Additional high-quality research is needed to better elucidate these relationships. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Amber M Beynon
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia.
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia.,Faculty of Kinesiology, University of New Brunswick, 3 Bailey Drive, Fredericton, NB, E3B 5A3, Canada
| | - Christopher J Hodgetts
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia
| | - Leah M Boulos
- Maritime SPOR SUPPORT Unit, 5790 University Avenue, Halifax, NS, B3H 1V7, Canada
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia
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19
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Ouchi K, Watanabe M, Tomiyama C, Nikaido T, Oh Z, Hirano T, Akazawa K, Mandai N. Emotional Effects on Factors Associated with Chronic Low Back Pain. J Pain Res 2019; 12:3343-3353. [PMID: 31908519 PMCID: PMC6925544 DOI: 10.2147/jpr.s223190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 11/22/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Although chronic low back pain (CLBP) has profound effects on patients, society, and economy, its causes are difficult to identify. Psychogenic effects or social stress is known to affect CLBP; hence, investigation of its underlying causes requires a multifactorial approach. We determined the factors associated with CLBP by using an Internet-based survey. To prevent CLBP, we need to understand its cause and background. PATIENTS AND METHODS A total of 1000 participants either with (+) or without (-) CLBP answered the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), which assesses five domains of CLBP: low back pain, lumbar function, walking ability, social life function and mental health. We also administered a new questionnaire for participants, that comprised five different domains: Body, Lifestyle, Emotion, Diet, and Social. To evaluate psychogenic effects on CLBP, we added two original factors, namely outshout and HIE, which have not yet been studied. HIE is a traditional concept (sense) of "feeling cold" or "chilly." All participants completed both questionnaires. RESULTS Multivariate logistic regression analysis extracted four factors (sleep, room temperature, outshout, and HIE) that were associated with CLBP. The mental health domain was assessed using the JOABPEQ for each of these factors. The factors outshout and HIE differed between CLBP (+) and CLBP (-) patients. CLBP (-) participants also showed a difference in Sleep and HIE factors. CONCLUSION Among psychogenic effects, Emotion was common to all the four extracted factors. There was no common physical divisor. Therefore, we hypothesized that acute low back pain might develop into CLBP in the presence of psychological stress or other emotional factors such as outshout or HIE. Hence, we need to consider both physical and psychogenic effects in the prevention and treatment of CLBP. Furthermore, appropriate evaluation and treatment of psychological stress may be effective in reducing CLBP.
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Affiliation(s)
- Koichi Ouchi
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Mayumi Watanabe
- Faculty of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
- Center for Humanities and Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
- Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Chikako Tomiyama
- Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Takuya Nikaido
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Zaigen Oh
- Faculty of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Toru Hirano
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kohei Akazawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Nozomu Mandai
- Center for Humanities and Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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20
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Laumet G, Ma J, Robison AJ, Kumari S, Heijnen CJ, Kavelaars A. T Cells as an Emerging Target for Chronic Pain Therapy. Front Mol Neurosci 2019; 12:216. [PMID: 31572125 PMCID: PMC6749081 DOI: 10.3389/fnmol.2019.00216] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 08/26/2019] [Indexed: 11/13/2022] Open
Abstract
The immune system is critically involved in the development and maintenance of chronic pain. However, T cells, one of the main regulators of the immune response, have only recently become a focus of investigations on chronic pain pathophysiology. Emerging clinical data suggest that patients with chronic pain have a different phenotypic profile of circulating T cells compared to controls. At the preclinical level, findings on the function of T cells are mixed and differ between nerve injury, chemotherapy, and inflammatory models of persistent pain. Depending on the type of injury, the subset of T cells and the sex of the animal, T cells may contribute to the onset and/or the resolution of pain, underlining T cells as a major player in the transition from acute to chronic pain. Specific T cell subsets release mediators such as cytokines and endogenous opioid peptides that can promote, suppress, or even resolve pain. Inhibiting the pain-promoting functions of T cells and/or enhancing the beneficial effects of pro-resolution T cells may offer new disease-modifying strategies for the treatment of chronic pain, a critical need in view of the current opioid crisis.
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Affiliation(s)
- Geoffroy Laumet
- Department of Physiology, Michigan State University, East Lansing, MI, United States.,Laboratories of Neuroimmunology, Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jiacheng Ma
- Laboratories of Neuroimmunology, Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Alfred J Robison
- Department of Physiology, Michigan State University, East Lansing, MI, United States
| | - Susmita Kumari
- Laboratories of Neuroimmunology, Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Cobi J Heijnen
- Laboratories of Neuroimmunology, Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Annemieke Kavelaars
- Laboratories of Neuroimmunology, Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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21
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Øiestad BE, Hilde G, Tveter AT, Peat GG, Thomas MJ, Dunn KM, Grotle M. Risk factors for episodes of back pain in emerging adults. A systematic review. Eur J Pain 2019; 24:19-38. [PMID: 31433541 DOI: 10.1002/ejp.1474] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVE The transition from adolescence to adulthood is a sensitive period in life for health outcomes, including back pain. The objective was to synthesize evidence on risk factors for new episodes of back pain in emerging adults (18-29 years). METHODS The protocol was registered in PROSPERO (CRD42016046635). We searched Medline; EMBASE; AMED and other databases up to September 2018 for prospective cohort studies that estimated the association between risk factor(s) and self-reported back pain. Risk factors could be measured before or during the age range 18-29 years, and back pain could be measured during or after this age range, with at least 12 months between assessments. Risk factors assessed in ≥3 studies were summarized. Risk of bias was assessed using a 6-item checklist. RESULTS Forty-nine studies were included with more than 150 different risk factors studied. Nine studies had low risk of bias, 26 had moderate and 14 had high risk of bias. Age, sex, height, body mass index (BMI), smoking, physical activity level, a history of back pain, job satisfaction and structural imaging findings were investigated in three or more studies. History of back pain was the only risk factor consistently associated with back pain after adjustment (nine studies). CONCLUSION There is moderate quality evidence that a history of back pain is a risk factor for back pain. There are inconsistent associations for age, sex, height, BMI, smoking and activity level. No associations were found between job satisfaction and structural imaging findings and back pain. SIGNIFICANCE Emerging adulthood is a transitional period of life with changes in life style, potentially influencing future musculoskeletal health. This systematic review included 49 articles evaluating more than 150 potential risk factors for back pain, one of the most prevalent musculoskeletal disorders. No consistent results were found for life style factors such as physical activity level or BMI, both highlighted as important risk factors in previous literature. Importantly, a previous episode of back pain was a consistent risk factor for a new episode of back pain across several studies, and further investigation of risk factors for the first back pain episode is needed.
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Affiliation(s)
- Britt Elin Øiestad
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Gunvor Hilde
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Anne Therese Tveter
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - George G Peat
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Martin J Thomas
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
| | - Kate M Dunn
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Margreth Grotle
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway.,FORMI, Clinic for Surgery and Neurology, Oslo University Hospital, Oslo, Norway
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Brady SRE, Urquhart DM, Hussain SM, Teichtahl A, Wang Y, Wluka AE, Cicuttini F. High baseline fat mass, but not lean tissue mass, is associated with high intensity low back pain and disability in community-based adults. Arthritis Res Ther 2019; 21:165. [PMID: 31277706 PMCID: PMC6612201 DOI: 10.1186/s13075-019-1953-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022] Open
Abstract
Objectives Low back pain is the largest contributor to disability worldwide. The role of body composition as a risk factor for back pain remains unclear. Our aim was to examine the relationship between fat mass and fat distribution on back pain intensity and disability using validated tools over 3 years. Methods Participants (aged 25–60 years) were assessed at baseline using dual-energy X-ray absorptiometry (DXA) to measure body composition. All participants completed the Chronic Pain Grade Scale at baseline and 3-year follow-up. Of the 150 participants, 123 (82%) completed the follow-up. Results Higher baseline body mass index (BMI) and fat mass (total, trunk, upper limb, lower limb, android, and gynoid) were all associated with high intensity back pain at either baseline and/or follow-up (total fat mass: multivariable OR 1.05, 95% CI 1.01–1.09, p < 0.001). There were similar findings for all fat mass measures and high levels of back disability. A higher android to gynoid ratio was associated with high intensity back pain (multivariable OR 1.04, 95% CI 1.01–1.08, p = 0.009). There were no associations between lean mass and back pain. Conclusions This cohort study provides evidence for the important role of fat mass, specifically android fat relative to gynoid fat, on back pain and disability.
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Affiliation(s)
- Sharmayne R E Brady
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia.
| | - Sultana Monira Hussain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Andrew Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
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Alzahrani H, Mackey M, Stamatakis E, Zadro JR, Shirley D. The association between physical activity and low back pain: a systematic review and meta-analysis of observational studies. Sci Rep 2019; 9:8244. [PMID: 31160632 PMCID: PMC6547713 DOI: 10.1038/s41598-019-44664-8] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/17/2019] [Indexed: 12/21/2022] Open
Abstract
The aim of this review was to investigate the association between total and domain-specific physical activity (PA) and non-specific low back pain (LBP) in adults. Seven databases were searched for cohort and cross-sectional studies. Pooled estimates of the association of medium and high levels PA and LBP, using the generic inverse-variance method with fixed- and random-effects models were calculated. Twenty-four studies (15 cohort and nine cross-sectional; 95,796 participants) were included. The pooled fully adjusted risk ratios (RR) from cohort studies comparing medium with lowest activity levels were 0.90 (95%CI 0.85 to 0.96) for total PA, and 0.90 (95%CI 0.85 to 0.96) for leisure-time PA (LTPA). The pooled RR comparing highest with lowest activity levels were 1.00 (95%CI 0.92 to 1.08) for total PA, and 1.01 (95%CI 0.93 to 1.10) for LTPA. The pooled fully adjusted odds ratios (OR) from cross-sectional studies comparing medium with lowest activity levels were 0.93 (95%CI 0.65 to 1.32) for total PA, and 0.77 (95%CI 0.62 to 0.96) for LTPA. The pooled OR comparing highest with lowest activity levels were 1.05 (95%CI 0.89 to 1.23) for total PA, and 0.85 (95%CI 0.79 to 0.93) for LTPA. PA seems to be associated with lower prevalence of LBP.
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Affiliation(s)
- Hosam Alzahrani
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, 2141, Australia. .,Department of Physiotherapy, College of Applied Medical Sciences, Taif University, Taif, 21974, Saudi Arabia.
| | - Martin Mackey
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, 2141, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, 2006, Australia
| | - Joshua Robert Zadro
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, 2050, Australia
| | - Debra Shirley
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, 2141, Australia
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Longitudinal profiles of back pain across adulthood and their relationship with childhood factors: evidence from the 1946 British birth cohort. Pain 2019; 159:764-774. [PMID: 29408834 PMCID: PMC5895120 DOI: 10.1097/j.pain.0000000000001143] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Supplemental Digital Content is Available in the Text. In a British birth cohort study, 4 distinct long-term back pain profiles were identified, each of which was associated with different early life risk factors. This study aimed to (1) characterise long-term profiles of back pain across adulthood and (2) examine whether childhood risk factors were associated with these profiles, using data from 3271 participants in the Medical Research Council National Survey of Health and Development. A longitudinal latent class analysis was conducted on binary outcomes of back pain at ages 31, 36, 43, 53, 60 to 64, and 68 years. Multinomial logistic regression models were used to examine associations between selected childhood risk factors and class membership; adjusted for sex, adult body size, health status and behaviours, socioeconomic position, and family history of back pain. Four profiles of back pain were identified: no or occasional pain (57.7%), early-adulthood only (16.1%), mid-adulthood onset (16.9%), and persistent (9.4%). The “no or occasional” profile was treated as the referent category in subsequent analyses. After adjustment, taller height at age 7 years was associated with a higher likelihood of early-adulthood only (relative risk ratio per 1 SD increase in height = 1.31 [95% confidence interval: 1.05-1.65]) and persistent pain (relative risk ratio = 1.33 [95% confidence interval: 1.01-1.74]) in women (P for sex interaction = 0.01). Factors associated with an increased risk of persistent pain in both sexes were abdominal pain, poorest care in childhood, and poorer maternal health. Abdominal pain and poorest housing quality were also associated with an increased likelihood of mid-adulthood onset pain. These findings suggest that there are different long-term profiles of back pain, each of which is associated with different early life risk factors. This highlights the potential importance of early life interventions for the prevention and management of back pain.
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Course and Contributors to Back Pain in Middle-aged Women Over 9 Years: Data From the Australian Longitudinal Study on Women's Health. Spine (Phila Pa 1976) 2018; 43:1648-1656. [PMID: 29794589 DOI: 10.1097/brs.0000000000002702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Community-based, cohort study. OBJECTIVE Our aim was to determine the course of back pain in middle-aged women over a 9-year period, and assess whether obesity and physical inactivity are associated with more frequent back pain. SUMMARY OF BACKGROUND DATA Back pain is the leading cause of disability worldwide. With minimal effective therapies and rising financial burden, identifying modifiable risk factors remains a key priority. METHODS The Australian Longitudinal Study on Women's Health is a cohort study of community-based, middle-aged women who completed questionnaires every 3 years between 2004 and 2013. Approximately, 10,530 women completed the survey in 2004 (mean age 55.5 yrs), and 9020 completed follow-up 9 years later. Self-reported data on back pain in the last 12 months and other sociodemographic factors were collected at all four surveys. 'Frequent back pain' was defined as back pain reported at ≥ three surveys. RESULTS Back pain was common and persistent, with 48% having back pain in ≥ three out of four surveys. Baseline obesity (relative risk [RR] 1.18, 95% confidence interval [CI] 1.12-1.25), lack of vigorous physical activity (RR 1.17, 95% CI 1.10-1.25), depressive symptoms (RR 1.40, 95% CI 1.33-1.47), and low-education status (RR 1.17, 95% CI 1.12-1.24), were independently associated with an increased risk of frequent back pain (all P < 0.001). Overall, 28% of the risk of frequent back pain could be attributed to these factors, equating to one extra case of frequent back pain for every five women with depressive symptoms, for every 11 obese women, for every 12 women with low-education status, and for every 13 women who do not do vigorous physical activity, at baseline. CONCLUSION Obesity, depressive symptoms, low-education status, and lack of vigorous physical activity are associated with higher risk of frequent back pain over the following 9 years among women in their mid-50 s. Targeting these risk factors may lessen the burden of back pain. LEVEL OF EVIDENCE 2.
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Jamdade B, Shimpi A, Rairikar S, Shyam A, Sancheti P. Factors predisposing to work-related lower back pain in automobile industry workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2018; 27:79-85. [PMID: 30246622 DOI: 10.1080/10803548.2018.1527055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective. This study aimed to assess the presence of lower back pain (LBP) in automobile industrial workers and correlate it with the factors known to be contributing to the development of work-related LBP. Method. Post ethical approval, an analytical cross-sectional assessment was conducted for a correlation study on 317 workers from different automobile industries, garages and service centres, who were then assessed by Nordic musculoskeletal questionnaire for the presence of LBP. Their pain intensity was assessed using a numerical rating scale, their core strength with a pressure biofeedback unit, their flexibility via the sitting and reach test and their work posture with the rapid entire body assessment tool. Pain intensity was correlated with core strength, flexibility and posture in all of the workers using Spearman's correlation coefficient r with α set at p ≤ 0.05 at a 95% confidence interval. Results. There was no significant correlation of the pain intensity with the core strength (r = 0.052, p = 0.424), flexibility (r = 0.020, p = 0.755) or posture (r = 0.002, p = 0.974). Conclusion. The present study indicates that internal factors like core strength and flexibility, and work postures have no correlation with intensity and severity of LBP in automobile industry workers.
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Affiliation(s)
- Bhakti Jamdade
- Department of Community Physiotherapy, Sancheti College of Physiotherapy, India
| | - Apurv Shimpi
- Department of Community Physiotherapy, Sancheti College of Physiotherapy, India
| | - Savita Rairikar
- Department of Community Physiotherapy, Sancheti College of Physiotherapy, India
| | - Ashok Shyam
- Department of Orthopedics, Sancheti Institute for Orthopedics and Rehabilitation, India
| | - Parag Sancheti
- Department of Orthopedics, Sancheti Institute for Orthopedics and Rehabilitation, India
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Abstract
STUDY DESIGN A nationwide cross-sectional study. OBJECTIVES To measure the associations between cigarette smoking (defined as serum cotinine concentration >15 ng/mL) and the 3-month prevalence of spinal pain (neck pain, low back pain, low back pain with pain below knee, and self-reported diagnosis of arthritis/rheumatism) and related limitations, and to verify whether these associations are mediated by serum concentrations of vitamin C. SUMMARY OF BACKGROUND DATA Cigarette smoking has been consistently associated with back pain, but this association has never been explained. Because vitamin C has recently been reported to be associated with spinal pain and related functional limitations, and the metabolism of vitamin C differs between smokers and nonsmokers, we hypothesized that the prevalence of spinal pain and related limitations might be greater among smokers because they are more susceptible to be in a state of hypovitaminosis C. METHODS We conducted secondary analyses of National Health and Nutrition Examination Survey (NHANES) 2003 to 2004 data on 4438 individuals aged ≥20 years. RESULTS Serum concentrations of vitamin C and cotinine were strongly and inversely correlated (r = -0.35, P < 0.0001). Smoking was statistically associated with the prevalence of neck pain [adjusted odds ratio: aOR: 1.25; 95% confidence interval (95% CI): 1.06-1.47], low back pain (aOR: 1.20; 95% CI: 1.04-1.39), and low back pain with pain below knee (aOR: 1.58; 95% CI: 1.13-2.22) and related limitations, with a dose-response relationship (P < 0.05). However, the associations between smoking and spinal pain were not mediated by concentrations of vitamin C. CONCLUSION These results confirm the relationship between smoking and spinal pain, but they do not support a mediating effect of vitamin C on this relationship. LEVEL OF EVIDENCE 2.
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Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J, Smeets RJ, Underwood M. What low back pain is and why we need to pay attention. Lancet 2018; 391:2356-2367. [PMID: 29573870 DOI: 10.1016/s0140-6736(18)30480-x] [Citation(s) in RCA: 2109] [Impact Index Per Article: 351.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/08/2017] [Accepted: 12/13/2017] [Indexed: 02/08/2023]
Abstract
Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.
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Affiliation(s)
- Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Mark J Hancock
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Quinette Louw
- Faculty of Medicine and Health Sciences, Physiotherapy Division and Department of Health and Rehabilitation Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Stéphane Genevay
- Division of Rheumatology, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Jaro Karppinen
- Medical Research Centre Oulu, University of Oulu and University Hospital, Oulu, Finland
| | - Glenn Pransky
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA USA
| | - Joachim Sieper
- Department of Rheumatology, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - Rob J Smeets
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, Netherlands; Libra Rehabilitation and Audiology, Eindhoven, Netherlands
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
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Sribastav SS, Long J, He P, He W, Ye F, Li Z, Wang J, Liu H, Wang H, Zheng Z. Risk Factors Associated with Pain Severity in Patients with Non-specific Low Back Pain in Southern China. Asian Spine J 2018; 12:533-543. [PMID: 29879782 PMCID: PMC6002175 DOI: 10.4184/asj.2018.12.3.533] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/16/2017] [Accepted: 10/26/2017] [Indexed: 12/19/2022] Open
Abstract
STUDY DESIGN A prospective cross-sectional study. PURPOSE To evaluate the risk factors associated with the severity of pain intensity in patients with non-specific low back pain (NSLBP) in Southern China. OVERVIEW OF LITERATURE Low back pain (LBP) is the leading cause of activity limitation and work absence throughout the world, so a firm understanding of the risk factor associated with NSLBP can provide early and prompt interventions that are aimed at attaining long-term results. METHODS Participants were recruited from January 2014 to January 2016 and were surveyed using a self-designed questionnaire. Anonymous assessments included Short Form 36-Item Health Survey (SF-36) and Visual Analogue Scale (VAS). The association between the severity of NSLBP and these potential risk factors were evaluated. RESULTS A total of 1,046 NSLBP patients were enrolled. The patients with primary school education, high body mass index (BMI), those exposed to sustained durations of driving and sitting, smoking, recurrent LBP had increased VAS and Oswestry Disability Index (ODI) scores with lower SF-36 scores (p <0.01). Workers and drivers compared with waiters and patients who lifted >10 kg objects in a quarter of their work time for >10 years had higher VAS and ODI scores with lower SF-36 scores (p <0.01). Multiple logistic regression showed lower levels of education, LBP for 1-7 days, long-lasting LBP in last year, smoking, long duration driving, and higher BMI were associated with more severe VAS score. CONCLUSIONS The severity of NSLBP is associated with lower levels of education, poor standards of living, heavy physical labor, long duration driving, and sedentary lifestyle. Patients with recurrent NSLBP have more severe pain. Reducing rates of obesity, the duration of heavy physical work, driving or riding, and attenuating the prevalence of sedentary lifestyles and smoking may reduce the prevalence of NSLBP.
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Affiliation(s)
- Shilabant Sen Sribastav
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jun Long
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Peiheng He
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei He
- Department of Orthopaedics, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fubiao Ye
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zemin Li
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianru Wang
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hui Liu
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hua Wang
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhaomin Zheng
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Pain Research Center and Department of Physiology, Zhongshan Medical School of Sun Yat-sen University, Guangzhou, China
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Green KT, Wilson SM, Dennis PA, Runnals JJ, Williams RA, Bastian LA, Beckham JC, Dedert EA, Kudler HS, Straits-Tröster K, Gierisch JM, Calhoun PS. Cigarette Smoking and Musculoskeletal Pain Severity Among Male and Female Afghanistan/Iraq Era Veterans. PAIN MEDICINE 2018; 18:1795-1804. [PMID: 28340108 DOI: 10.1093/pm/pnw339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective Cigarette smoking and musculoskeletal pain are prevalent among Department of Veterans Affairs (VA) health care system users. These conditions frequently co-occur; however, there is limited empirical information specific to Afghanistan/Iraq era veterans. The present study sought to examine gender differences in the association between cigarette smoking and moderate to severe musculoskeletal pain in US veterans with Afghanistan/Iraq era service. Methods A random sample of 5,000 veterans with service after November 11, 2001, participated in a survey assessing health care needs and barriers to care. One thousand ninety veterans completed the survey assessing post-traumatic stress disorder (PTSD) symptoms, depressive symptoms, and current pain severity. Multivariate logistic regression was used to examine the association between gender, cigarette smoking status, and current moderate to severe musculoskeletal pain. Results Findings indicated a significant gender by smoking interaction on moderate/severe musculoskeletal pain, adjusting for age, self-reported race/ethnicity and weight status, combat exposure, probable PTSD, depressive symptoms, service-connected injury during deployment, and VA health care service utilization. Deconstruction of the interaction indicated that female veteran smokers, relative to female nonsmokers, had increased odds of endorsing moderate to severe musculoskeletal pain (odds ratio [OR] = 2.73, 95% confidence interval [CI] = 1.16-6.41), whereas this difference was nonsignificant for male veterans (OR = 1.03, 95% CI = 0.69-1.56). Conclusions Survey data from Operation Enduring Freedom/Operation Iraqi Freedom veterans suggest an association between current smoking, gender, and moderate to severe musculoskeletal pain. The stronger relationship between smoking and pain in women supports the need for interventional and longitudinal research that can inform gender-based risk factors for pain in veteran cigarette smokers.
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Affiliation(s)
- Kimberly T Green
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Sarah M Wilson
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Paul A Dennis
- Durham VA Medical Center, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Jennifer J Runnals
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Rebecca A Williams
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Lori A Bastian
- Department of Internal Medicine, Yale University, New Haven, CT, USA.,Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA
| | - Jean C Beckham
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Eric A Dedert
- Durham VA Medical Center, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Harold S Kudler
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Kristy Straits-Tröster
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,Phoenix VA Healthcare System, 650 E. Indian School Road, Phoenix, AZ, USA8
| | - Jennifer M Gierisch
- Center for Health Services Research in Primary Care, Durham VA Medical Center, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Patrick S Calhoun
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,Center for Health Services Research in Primary Care, Durham VA Medical Center, NC, USA
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Schirmer C, Dos Santos GO, Rost JF, Ferreira MBC, Weidlich P. Factors associated with pain and analgesic consumption following non-surgical periodontal therapy under local anaesthesia and carried out by dental students. J Clin Periodontol 2017; 45:68-77. [PMID: 29078012 DOI: 10.1111/jcpe.12833] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2017] [Indexed: 11/26/2022]
Abstract
AIM Evaluate factors associated with pain and analgesic consumption following non-surgical periodontal therapy. MATERIALS AND METHODS The sample consisted of 218 patients with chronic periodontitis, submitted to non-surgical scaling and root planing under local anaesthesia at a public dental service in southern Brazil. The data collection instruments included a demographic questionnaire, as well as State-Trait Anxiety Inventory, Corah's Dental Anxiety Scale, Visual Analogue Scale, Numerical Rating Scale and Verbal Rating Scale. The presence and intensity of pain were evaluated at 2, 6, 12, 24 and 48 hr after scaling and root planing. RESULTS A total of 52.3% of the patients reported mild intensity pain at some point during the 48 hr after scaling and root planing with local anaesthesia. Smoking (PR = 1.47; 95% CI = 1.16-1.65), severe periodontal inflammation (PR = 1.31; 95% CI = 1.09-1.58) and dental anxiety (PR = 1.24; 95% CI = 1.03-1.49) were associated with postoperative pain after adjusting for age, gender and state and trait anxiety scores. Moreover, 46.8% of the subjects used analgesics at some time during the 48-hr follow-up period and dental anxiety was the only factor associated with postoperative analgesic use. CONCLUSIONS Smoking, severe periodontal inflammation and dental anxiety were identified as factors associated with pain after non-surgical scaling and root planing with local anaesthesia. Dental anxiety was also a factor associated with postoperative analgesic use.
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Affiliation(s)
- Caroline Schirmer
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Otero Dos Santos
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Júlia Franciele Rost
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Beatriz Cardoso Ferreira
- Department of Pharmacology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patrícia Weidlich
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Abstract
Back pain brings about one of the heaviest burden of disease. Despite much research, this condition remains poorly understood, and effective treatments are frustratingly elusive. Thus, researchers in the field need to consider new hypotheses. Vitamin C (ascorbic acid) is an essential cofactor for collagen crosslinks, a key determinant of ligament, tendon, and bone quality. Recent studies have reported high frequency of hypovitaminosis C in the general population. We hypothesized that lack of vitamin C contributes to poor collagen properties and back pain. We conducted this study to examine the associations between serum concentration of vitamin C and the prevalence of spinal pain and related functional limitations in the adult general population. This study used nationwide cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2003-2004. Data were available for 4742 individuals aged ≥20 years. Suboptimal serum vitamin C concentrations were associated with the prevalence of neck pain (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.2-2.0), low back pain (aOR: 1.3; 95% CI: 1.0-1.6), and low back pain with pain below knee (aOR: 1.3; 95% CI: 1.0-1.9) in the past 3 months, self-reported diagnosis of arthritis/rheumatism (aOR: 1.4; 95% CI: 1.2-1.7), and related functional limitations' score (adjusted difference of means [aB]: 0.03; 95% CI: 0.00-0.05). The prevalence of hypovitaminosis C in the general population is high. Our study shows associations between vitamin C and spinal pain that warrant further investigation to determine the possible importance of vitamin C in the treatment of back pain patients.
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Abstract
STUDY DESIGN A retrospective review. OBJECTIVE The purpose of this study was to investigate the clinical outcomes in adolescents diagnosed with psychogenic low-back pain and hysterical paralysis and to evaluate the efficacy of differential diagnosis methods. SUMMARY OF BACKGROUND DATA The incidence of low-back pain in adolescence is similar to that in adults, but the causes of low-back pain are difficult to determine in most cases. For these patients, a definitive diagnosis of psychogenic low-back pain and hysterical paralysis as well as adequate treatment are clinically important to avoid unnecessary surgical treatment. METHODS Eleven patients (3 males and 8 females; mean age, 16.5 years; range, 13-19 y) diagnosed with psychogenic low-back pain and hysterical paralysis were followed up for 2-10.25 years (mean, 4.67 y). Nonorganic signs were observed in almost all patients. For the purpose of excluding organic disorders, the thiopentone pain study was used in patients who complained mainly of pain, and motor evoked potentials using transcranial magnetic stimulation were measured in patients experiencing primarily muscle weakness. RESULTS The psychiatric diagnosis was neurosis in 9 patients, whereas it was psychosomatic disorder in 2 patients. Conservative treatment, such as physiotherapy, was performed, and at the final follow-up evaluation, outcomes were regarded as excellent in 7 patients and good in 4 patients. CONCLUSIONS The prognosis of psychogenic low-back pain and hysterical paralysis in adolescence is relatively good. However, it is important to understand the characteristics of psychogenic low-back pain and hysterical paralysis in childhood and young adulthood and to perform accurate diagnosis by screening for nonorganic signs and excluding organic disorders by using the thiopentone pain study and motor evoked potentials obtained using transcranial magnetic stimulation.
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Shiri R, Falah-Hassani K. Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies. Br J Sports Med 2017; 51:1410-1418. [DOI: 10.1136/bjsports-2016-097352] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 11/03/2022]
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Brady SRE, Monira Hussain S, Brown WJ, Heritier S, Wang Y, Teede H, Urquhart DM, Cicuttini FM. Predictors of Back Pain in Middle-Aged Women: Data From the Australian Longitudinal Study of Women's Health. Arthritis Care Res (Hoboken) 2017; 69:709-716. [DOI: 10.1002/acr.22982] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 05/20/2016] [Accepted: 06/28/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Sharmayne R. E. Brady
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Wendy J. Brown
- School of Human Movement and Nutrition Studies, University of Queensland; St. Lucia Queensland Australia
| | - Stephane Heritier
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Helena Teede
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, and Monash Health; Clayton Victoria Australia
| | - Donna M. Urquhart
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Flavia M. Cicuttini
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
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Neuroanatomical variations as a function of experience in a complex daily task: A VBM and DTI study on driving experience. Brain Imaging Behav 2017; 12:653-662. [DOI: 10.1007/s11682-017-9725-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study. Spine (Phila Pa 1976) 2016; 41:1754-1763. [PMID: 27310026 PMCID: PMC5113251 DOI: 10.1097/brs.0000000000001739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective cohort study. OBJECTIVE Activities performed during military operations vary in complexity and physical demand. The risk for mental illness following military combat deployment has been well documented. However, information regarding the possible contribution of back pain to decreased mental and functional health is scarce. To our knowledge, this is the first study to prospectively assess deployment and self-reported recent back pain in a population-based U.S. military cohort. SUMMARY OF BACKGROUND DATA The study consisted of Millennium Cohort participants who were followed for the development of back pain for an average of 3.9 years. METHODS Descriptive statistics and longitudinal analyses were used to assess the temporal relationship of deployment with self-reported recent back pain at follow-up (N = 53,933). RESULTS Recent back pain was self-reported by 8379 (15.5%) participants at follow-up. After adjusting for covariates, deployers with combat experiences had higher odds [odds ratio (OR) = 1.38, 95% confidence interval (95% CI): 1.28-1.50] of recent back pain than noncombat deployers. There was no association between recent back pain and nondeployers compared with noncombat deployers. Service support/supply handlers were at an increased odds of reporting recent back pain (OR = 1.11, 95% CI: 1.02-1.21) than functional support/administration occupations. Occupations associated with a physically demanding work environment had a higher risk of back pain. CONCLUSION Deployers with combat experiences were more likely to report back pain postdeployment. This well-defined group of military personnel may potentially benefit from integrated prevention efforts. LEVEL OF EVIDENCE 3.
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Systematic review with meta-analysis of childhood and adolescent risk and prognostic factors for musculoskeletal pain. Pain 2016; 157:2640-2656. [DOI: 10.1097/j.pain.0000000000000685] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Dolphens M, Vansteelandt S, Cagnie B, Vleeming A, Nijs J, Vanderstraeten G, Danneels L. Multivariable modeling of factors associated with spinal pain in young adolescence. 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 2016; 25:2809-21. [PMID: 27278392 DOI: 10.1007/s00586-016-4629-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 01/03/2023]
Abstract
PURPOSE To investigate the factors related to the 1-month period prevalence of low back pain (LBP), neck pain (NP) and thoracic spine pain (TSP) in young adolescents, thereby considering potential correlates from the physical, sociodemographic, lifestyle, psychosocial and comorbid pain domains. METHODS In this cross-sectional baseline study, 69 factors potentially associated with spinal pain were assessed among 842 healthy adolescents before pubertal peak growth. With consideration for possible sex differences in associations, multivariable analysis was used to simultaneously evaluate contributions of all variables collected in the five domains. RESULTS A significantly higher odds of LBP was shown for having high levels of psychosomatic complaints (odds ratio: 4.4; 95 % confidence interval: 1.6-11.9), a high lumbar lordotic apex, retroversed pelvis, introverted personality, and high levels of negative over positive affect. Associations with a higher prevalence and odds of NP were found for psychosomatic complaints (7.8; 2.5-23.9), TSP in the last month (4.9; 2.2-10.8), backward trunk lean, high levels of negative over positive affect and depressed mood. Having experienced LBP (2.7; 1.3-5.7) or NP (5.5; 2.6-11.8) in the preceding month was associated with a higher odds of TSP, as were low self-esteem, excessive physical activity, sedentarism and not achieving the Fit-norm. CONCLUSIONS Psychosomatic symptoms and pain comorbidities had the strongest association with 1-month period prevalence of spinal pain in young adolescents, followed by factors from the physical and psychosocial domains. The role that "physical factors" play in non-adult spinal pain may have been underestimated by previous studies.
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Affiliation(s)
- Mieke Dolphens
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000, Ghent, Belgium.
| | - Stijn Vansteelandt
- Department of Applied Mathematics, Computer Science and Statistics, Faculty of Sciences, Ghent University, Ghent, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000, Ghent, Belgium
| | - Andry Vleeming
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000, Ghent, Belgium
- Department of Anatomy, Center for Excellence in the Neurosciences, Medical Faculty, University of New England, Biddeford, ME, USA
| | - Jo Nijs
- Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Guy Vanderstraeten
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000, Ghent, Belgium
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000, Ghent, Belgium
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Brady SRE, Hussain SM, Brown WJ, Heritier S, Billah B, Wang Y, Teede H, Urquhart DM, Cicuttini FM. Relationships Between Weight, Physical Activity, and Back Pain in Young Adult Women. Medicine (Baltimore) 2016; 95:e3368. [PMID: 27175634 PMCID: PMC4902476 DOI: 10.1097/md.0000000000003368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Back pain causes enormous financial and disability burden worldwide, which could potentially be reduced by understanding its determinants to develop effective prevention strategies. Our aim was to identify whether modifiable risk factors, weight and physical activity, are predictive of back pain in young adult women.Women born between 1973 and 1978 were randomly selected from the national health insurance scheme database to participate in The Australian Longitudinal Study of Women's Health. Self-reported data on back pain in the last 12 months, weight, height, age, education status, physical activity, and depression were collected in 2000, 2003, 2006, 2009, and 2012. In 2000, 9688 women completed the questionnaire and 83% completed follow-up 12 years later.At baseline, median age was 24.6 years and 41% had self-reported back pain. For every 5 kg higher weight at baseline, there was a 5% (95% confidence interval [CI] 4%-6%) increased risk of back pain over the next 12 years. Higher weight at each survey also predicted back pain risk 3 years later (P < 0.001). The effects of weight on back pain were most significant in those with BMI ≥25 kg/m and were observed at all levels of physical activity. Inadequate physical activity and depression were independent predictors of back pain over the following 12 years (both P < 0.001), after adjusting for age, weight, height, and education status.Back pain is common in community-based young adult women. Higher weight, inadequate levels of physical activity, and depression were all independent predictors of back pain over the following decade. Furthermore, the adverse effects of weight on back pain were not mitigated by physical activity. Our findings highlight the role of both higher weight and physical inactivity in back pain among young women and suggest potential opportunities for future prevention.
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Affiliation(s)
- Sharmayne R E Brady
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria (SREB, SMH, SH, BB, YW, DMU, FMC); School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland (WJB); Monash Center for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University (HT); and Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Victoria, Australia (HT)
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Gouveia N, Rodrigues A, Eusébio M, Ramiro S, Machado P, Canhão H, Branco JC. Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey. Rheumatol Int 2015; 36:183-97. [PMID: 26661091 DOI: 10.1007/s00296-015-3398-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/14/2015] [Indexed: 01/05/2023]
Abstract
To determine the prevalence of active chronic low back pain (CLBP) in the adult Portuguese population; to compare the active CLBP population with the population without CLBP; and to explore factors associated with active CLBP. The present study was conducted under the scope of EpiReumaPt a population-based study. Active CLBP was self-reported and considered if present on the day of the interview and for ≥90 days. Prevalence estimates were calculated. Association of active CLBP with quality of life, functional ability and healthcare consumption were evaluated. Factors associated with active CLBP were identified through logistic regression. Among 10.661 EpiReumaPt subjects, 1487 self-reported active CLBP. The prevalence of active CLBP was 10.4 % (95 % CI 9.6; 11.9 %). After adjustment, active CLBP subjects had a higher likelihood for anxiety symptoms (OR 2.77), early retirement due to disease (OR 1.88) and more physician visits (β = 2.65). Factors significantly and independently associated with the presence of active CLBP were: female gender (OR 1.34), overweight/obesity (OR 1.27), presence of self-reported rheumatic musculoskeletal disease (RMD) (OR 2.93), anxiety symptoms (OR 2.67), age (OR 1.02) and higher number of self-reported comorbidities (OR 1.12). Active CLBP is highly prevalent in the Portuguese population and is associated with disability and with a high consumption of healthcare resources. Female gender, older age, anxiety symptoms, overweight/obesity, the presence of other RMD and the number of comorbidities were independently associated with the presence of active CLBP. These factors should be taken into account when new cohort prospective studies will be developed.
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Affiliation(s)
- Nélia Gouveia
- EpiReumaPt Research Team - Portuguese Society of Rheumatology, Lisbon, Portugal.
- CEDOC - Chronic Diseases of Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa (NMS/UNL), Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.
- EpiDoc Unit - Epidemiology of Chronic Diseases Unit (CEDOC, NMS/UNL), Lisbon, Portugal.
| | - Ana Rodrigues
- EpiReumaPt Research Team - Portuguese Society of Rheumatology, Lisbon, Portugal
- EpiDoc Unit - Epidemiology of Chronic Diseases Unit (CEDOC, NMS/UNL), Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | | | - Sofia Ramiro
- EpiReumaPt Research Team - Portuguese Society of Rheumatology, Lisbon, Portugal
- CEDOC - Chronic Diseases of Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa (NMS/UNL), Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
- Leiden University Medical Center, Leiden, The Netherlands
| | - Pedro Machado
- EpiReumaPt Research Team - Portuguese Society of Rheumatology, Lisbon, Portugal
- Clínica Universitária de Reumatologia, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
- Centre for Rheumatology Research & MRC Centre for Neuromuscular Diseases, University College London, London, UK
| | - Helena Canhão
- EpiReumaPt Research Team - Portuguese Society of Rheumatology, Lisbon, Portugal
- EpiDoc Unit - Epidemiology of Chronic Diseases Unit (CEDOC, NMS/UNL), Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Unit of Hospital de Santa Maria - Centro Hospitalar Lisboa Norte (CHLN-E.P.E), Lisbon, Portugal
| | - Jaime C Branco
- EpiReumaPt Research Team - Portuguese Society of Rheumatology, Lisbon, Portugal
- CEDOC - Chronic Diseases of Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa (NMS/UNL), Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
- EpiDoc Unit - Epidemiology of Chronic Diseases Unit (CEDOC, NMS/UNL), Lisbon, Portugal
- Rheumatology Unit of Hospital Egas Moniz - Centro Hospitalar Lisboa Ocidental (CHLO- E.P.E.), Lisbon, Portugal
- Programa Nacional Contra as Doenças Reumáticas (2004-2014), Direcção Geral da Saúde, Lisbon, Portugal
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Frilander H, Solovieva S, Mutanen P, Pihlajamäki H, Heliövaara M, Viikari-Juntura E. Role of overweight and obesity in low back disorders among men: a longitudinal study with a life course approach. BMJ Open 2015; 5:e007805. [PMID: 26297359 PMCID: PMC4550727 DOI: 10.1136/bmjopen-2015-007805] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course. DESIGN A longitudinal and cross-sectional study. SETTING A nationwide health survey supplemented with data from records of prior compulsory military service. PARTICIPANTS Premilitary health records (baseline) were searched for men aged 30-50 years (n=1385) who participated in a national health examination survey (follow-up). METHODS AND OUTCOME MEASURES Height and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica. RESULTS Baseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m(2)) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m(2)). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP. CONCLUSIONS Our findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented.
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Affiliation(s)
- Heikki Frilander
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
- Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Svetlana Solovieva
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
- Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Pertti Mutanen
- Department of Statistics and Health Economics, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Harri Pihlajamäki
- Department of Orthopaedics and Trauma Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
- University of Tampere, Seinäjoki, Finland
| | - Markku Heliövaara
- Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Eira Viikari-Juntura
- Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
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Cigarette Smoking Is Associated with a Lower Concentration of CD105(+) Bone Marrow Progenitor Cells. BONE MARROW RESEARCH 2015; 2015:914935. [PMID: 26346476 PMCID: PMC4546741 DOI: 10.1155/2015/914935] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 07/06/2015] [Accepted: 07/22/2015] [Indexed: 12/20/2022]
Abstract
Cigarette smoking is associated with musculoskeletal degenerative disorders, delayed fracture healing, and nonunion. Bone marrow progenitor cells (BMPCs), known to express CD105, are important in local trophic and immunomodulatory activity and central to musculoskeletal healing/regeneration. We hypothesized that smoking is associated with lower levels of BMPC. Iliac bone marrow samples were collected from individuals aged 18–65 years during the first steps of pelvic surgery, under IRB approval with informed consent. Patients with active infectious or neoplastic disease, a history of cytotoxic or radiation therapy, primary or secondary metabolic bone disease, or bone marrow dysfunction were excluded. Separation process purity and the number of BMPCs recovered were assessed with FACS. BMPC populations in self-reported smokers and nonsmokers were compared using the two-tailed t-test. 13 smokers and 13 nonsmokers of comparable age and gender were included. The average concentration of BMPCs was 3.52 × 105/mL ± 2.45 × 105/mL for nonsmokers versus 1.31 × 105/mL ± 1.61 × 105/mL for smokers (t = 3.2, P = 0.004). This suggests that cigarette smoking is linked to a significant decrease in the concentration of BMPCs, which may contribute to the reduced regenerative capacity of smokers, with implications for musculoskeletal maintenance and repair.
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Orhurhu VJ, Pittelkow TP, Hooten WM. Prevalence of smoking in adults with chronic pain. Tob Induc Dis 2015; 13:17. [PMID: 26185492 PMCID: PMC4504349 DOI: 10.1186/s12971-015-0042-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 07/08/2015] [Indexed: 11/10/2022] Open
Abstract
Introduction Cigarette smoking is common among adults with chronic pain. The primary objective of this study was to determine the period prevalence of smoking in patients with chronic pain. A secondary objective was to determine the prevalence of smoking among patients with commonly occurring pain diagnoses including fibromyalgia, low back pain, and headache. Methods This population study included 5350 patients (1256 smokers, 4094 nonsmokers) admitted to the Mayo Comprehensive Pain Rehabilitation Center from January 1998 through December 2012. Smoking status was determined using a self-report questionnaire. Results During the 15 year study period, the overall prevalence of smoking was 23.5 % (95 % CI 22.4 – 24.6). The prevalence of smoking in 2000, 2005, and 2010 was 24.2, 25.7, and 28.3 % respectively. The overall prevalence of smoking in patients with fibromyalgia, low back pain, and headache was 25.2 % (95 % CI 22.8 – 28.3), 22.8 % (95 % CI 21.3 – 25.9), and 21.2 % (95 % CI 17.9 – 24.7), respectively. In a multiple variable logistic model adjusted for age and sex, opioid use was significantly associated with status as a current smoker. Conclusion The prevalence of smoking in patients with chronic pain has not declined when compared to the general population. The higher prevalence of smoking was consistently observed in commonly occurring pain diagnoses including fibromyalgia, back pain, and headache. Further research is needed to identify the potential factors that contribute to the high prevalence of smoking in this patient population.
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Affiliation(s)
| | - Thomas P Pittelkow
- Department of Anesthesiology, Division of Pain Medicine, Mayo Graduate School of Medicine, Rochester, MN 55902 USA
| | - W Michael Hooten
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905 USA
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Manchikanti L, Hirsch JA. What can be done about the increasing prevalence of low back pain and associated comorbid factors? Pain Manag 2015; 5:149-52. [DOI: 10.2217/pmt.15.10] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Laxmaiah Manchikanti
- Pain Management Center of Paducah, 2831 Lone Oak Rd, Paducah, KY 42003, USA & University of Louisville, Louisville, KY 40292, USA
| | - Joshua A Hirsch
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
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Saes MDO, Soares MD, Mucillo-Baisch A, Soares MCF. Fatores associados à dor musculoesquelética em escolares da rede pública municipal no extremo sul do Brasil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2014. [DOI: 10.1590/s1519-38292014000300002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivos: identificar os fatores associados à dor musculoesquelética (DME) em escolares da rede municipal de ensino na cidade de Rio Grande, extremo sul do Brasil, entre junho e dezembro de 2010. Métodos: trata-se de um estudo seccional conduzido em uma amostra aleatória de 625 escolares entre seis e 18 anos de idade. A DME foi pesquisada utilizando o Questionário Nórdico de Sintomas Osteomusculares (QNSO) e informações demográficas, biológicas, forma de transporte do material escolar e de estilo de vida obtidas via questionário padronizado. As razões de prevalência bruta e ajustada da associação da DME com os fatores investigados foi estimada em um modelo de regressão de Poisson. Resultados: a prevalência de DME foi de 37,6%. Idade entre 11 e 18 anos (RP=1,70; IC95%=1,36- 2,11; p<0,001), sexo feminino (RP=1,47; IC95%=1,19-1,81; p<0,001) e histórico familiar de distúrbio na coluna (RP=0,78; IC95%=0,64-0,96; p=0,020) estiveram associados ao desfecho. Não praticar esportes de competição foi um fator de proteção (RP=0,65; IC95%=0,51-0,81; p<0,001). Conclusão: estes resultados confirmam a influência negativa de diferentes fatores presentes no ambiente escolar sobre a saúde dos estudantes. Considera-se como medida importante a implantação de programas de promoção da saúde nas escolas, que estimulem entre os estudantes a adoção de práticas saudáveis que minimizem os efeitos deletérios da DME.
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Moreira RFC, Sato TO, Foltran FA, Silva LCCB, Coury HJCG. Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors. Braz J Phys Ther 2014; 18:323-33. [PMID: 25054385 PMCID: PMC4183257 DOI: 10.1590/bjpt-rbf.2014.0026] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 02/17/2014] [Indexed: 11/22/2022] Open
Abstract
Objective : This cross-sectional study aimed at analyzing: 1. the main musculoskeletal
symptoms (MSS) presented by hospital nursing workers and; 2. personal,
occupational, and health factors related to MSS among them. Method : Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed
practical nurses (LPNs) (response rate 95%) associated with direct patient care
sectors from a hospital. These questionnaires were: the standardized version of
the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15
demographic independent variables potentially related to outcomes from the NMQ.
Univariate analyses and binary logistic regression analyses were performed to
identify which variables would explain the occurrence of MSS in different body
regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most
affected regions. The logistic regression analysis showed that low back symptoms
in the last 12 months were significantly associated with LPN activities (OR=2.36;
CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking
was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8)
and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective
effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was
significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the
upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS.
Previous history of sick leave was strongly associated with the presence of
symptoms in various body regions. These results indicate the need for preventive
programs in the hospital environment in order to control more severe MSS in
nursing professionals.
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Affiliation(s)
- Roberta F C Moreira
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - Tatiana O Sato
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - Fabiana A Foltran
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - Luciana C C B Silva
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - Helenice J C G Coury
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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Holle D, Heber A, Naegel S, Diener HC, Katsarava Z, Obermann M. Influences of smoking and caffeine consumption on trigeminal pain processing. J Headache Pain 2014; 15:39. [PMID: 24928141 PMCID: PMC4068369 DOI: 10.1186/1129-2377-15-39] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 05/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background Many human and animal studies have shown the influence of nicotine and caffeine on pain perception and processing. This study aims to investigate whether smoking or caffeine consumption influences trigeminal pain processing. Methods Sixty healthy subjects were investigated using simultaneous recordings of the nociceptive blink reflex (nBR) and pain related evoked potentials (PREP) following nociceptive electrical stimulation on both sides of the forehead (V1). Thirty subjects were investigated before and after smoking a cigarette, as well as before and after taking a tablet of 400 mg caffeine. Results After smoking PREP showed decreased N2 and P2 latencies indicating central facilitation at supraspinal (thalamic or cortical) level. PREP amplitudes were not changed. NBR showed a decreased area under the curve (AUC) indicating central inhibition at brainstem level. After caffeine intake no significant changes were observed comparing nBR and PREP results before consumption. Conclusions Smoking influences trigeminal pain processing on supraspinal and brainstem level. In the investigated setting, caffeine consumption does not significantly alter trigeminal pain processing. This observation might help in the further understanding of the pathophysiology of pain disorders that are associated with excessive smoking habits such as cluster headache. Previous smoking has to be taken into account when performing electrophysiological studies to avoid bias of study results.
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Affiliation(s)
- Dagny Holle
- Department of Neurology, University of Duisburg-Essen, Hufeland street 55, Essen 45147, Germany.
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Frankenburg FR, Fitzmaurice GM, Zanarini MC. The use of prescription opioid medication by patients with borderline personality disorder and axis II comparison subjects: a 10-year follow-up study. J Clin Psychiatry 2014; 75:357-61. [PMID: 24500123 PMCID: PMC4019694 DOI: 10.4088/jcp.13m08557] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 09/19/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The first purpose was to determine the rate of use of prescription opioid medication reported by patients with borderline personality disorder and to compare that to the rate reported by Axis II comparison subjects during a 10-year period of prospective follow-up. The second purpose was to determine the most clinically relevant predictors of prescription opioid use among borderline patients. METHOD The medical conditions and Axis I disorders of 264 borderline patients and 63 Axis II comparison subjects were assessed at 6-year follow-up and 5 contiguous follow-up waves that were 2 years apart. These assessments were conducted between July 1998 and December 2010. Family history of psychiatric disorder was assessed at baseline by interviewers blind to the diagnostic status of the subjects. All 3 areas were assessed using semistructured interviews with proven psychometric properties: the Medical History and Services Utilization Interview (MHSUI), the Structured Clinical Interview for DSM-III-R Axis I Disorders (SCID-I), and the Revised Family History Questionnaire. RESULTS Borderline patients were significantly more likely to report the use of prescription opioid medication over time than Axis II comparison subjects (OR = 1.79; 95% CI, 1.01-3.17). The best predictors of opioid use among borderline patients were the time-varying presence of back pain (OR = 1.95; 95% CI, 1.41-2.70), fibromyalgia (OR = 3.29; 95% CI, 1.70-6.36), and osteoarthritis (OR =3.32; 95% CI, 2.08-5.29) as well as a baseline history of drug abuse (OR= 1.89; 95% CI, 1.27-2.81). CONCLUSIONS The sustained use of prescription opioids is common among and discriminating for patients with borderline personality disorder. The results also suggest that these borderline patients may be particularly sensitive to physical pain-mirroring their well-known heightened sensitivity to emotional pain.
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Affiliation(s)
- Frances R. Frankenburg
- Laboratory for the Study of Adult Development, McLean Hospital, Boston University School of Medicine,Edith Nourse Rogers Memorial Veterans Hospital
| | - Garrett M. Fitzmaurice
- Laboratory for the Study of Adult Development, McLean Hospital, Boston University School of Medicine,Harvard Medical School
| | - Mary C. Zanarini
- Laboratory for the Study of Adult Development, McLean Hospital, Boston University School of Medicine,Harvard Medical School
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Ibraimi Z, Murtezani A, Haxhiu B, Mustafa A, Martinaj M. Prevalence and pharmacologic treatment of patients with low back pain treated at kosovo energetic corporation. Med Arch 2013; 67:410-3. [PMID: 25568510 PMCID: PMC4272453 DOI: 10.5455/medarh.2013.67.410-413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/11/2013] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Low back pain (LBP) is a common complaint among the general population with a subgroup developing chronic and disabling symptoms generating large societal costs. Recurrences and functional limitations can be minimized with appropriate conservative management, including medications, physical therapy modalities, exercise and patient education. OBJECTIVES The purpose of this study was to determine the prevalence of low back complaints in industrial workers, to investigate whether individual risk factors involved in the occurrence of LBP, and to determine the most frequent used drug in LBP treatment. MATERIALS AND METHODS Data for this study were provided from Kosovo Energetic Corporation. A cross-sectional study design was utilized. Self-administered questionnaires were distributed among 228 industrial workers. Patient with LBP underwent a comprehensive clinical, radiological and biochemical evaluation. RESULTS showed that LBP occurred in 63.5% of workers. Individual factors did not show significant associations with LBP. Age (OR=0.99/95% Cl 0.95-1.03), weight (OR=1.13/95% Cl 0.99-1.06), height (OR=0.97/95% Cl 0.91-1.02), and work experience (OR=1.01/95% Cl 0.97-1.05) increase odds for LBP but not significantly. The most frequently used drugs in patients included in this study are NSAIDs. In 33 (55.0%) patients for the treatment of LBP two types of drugs are administered. CONCLUSION Increased physical activity, health promotion and reduced body weight can prevent morbidity from LBP. A continuous consultation with the Clinical Pharmacist demonstrates effective way of dosage and drug re-evaluation for the patients with LBP.
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Affiliation(s)
- Zana Ibraimi
- Department of Pharmacy, Faculty of Medicine, University of Kosovo
| | - Ardiana Murtezani
- Physical Medicine and Rehabilitation Clinic, University Clinical Center of Kosovo
| | - Bekim Haxhiu
- Physical Medicine and Rehabilitation Clinic, University Clinical Center of Kosovo
| | - Aziz Mustafa
- Physical Medicine and Rehabilitation Clinic, University Clinical Center of Kosovo
| | - Merita Martinaj
- Physical Medicine and Rehabilitation Clinic, University Clinical Center of Kosovo
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