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Nasir A, Afridi OK, Ullah S, Khan H, Bai Q. Mitigation of sciatica injury-induced neuropathic pain through active metabolites derived from medicinal plants. Pharmacol Res 2024; 200:107076. [PMID: 38237646 DOI: 10.1016/j.phrs.2024.107076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
Sciatica characterized by irritation, inflammation, and compression of the lower back nerve, is considered one of the most common back ailments globally. Currently, the therapeutic regimens for sciatica are experiencing a paradigm shift from the conventional pharmacological approach toward exploring potent phytochemicals from medicinal plants. There is a dire need to identify novel phytochemicals with anti-neuropathic potential. This review aimed to identify the potent phytochemicals from diverse medicinal plants capable of alleviating neuropathic pain associated with sciatica. This review describes the pathophysiology of sciatic nerve pain, its cellular mechanisms, and the pharmacological potential of various plants and phytochemicals using animal-based models of sciatic nerve injury-induced pain. Extensive searches across databases such as Medline, PubMed, Web of Science, Scopus, ScienceDirect, and Google Scholar were conducted. The findings highlights 39 families including Lamiaceae, Asteraceae, Fabaceae, and Apocyanaceae and Cucurbitaceae, effectively treating sciatic nerve injury-induced pain. Flavonoids made up 53% constituents, phenols and terpenoids made up 15%, alkaloids made up 13%, and glycosides made up 6% to be used in neuorpathic pain. Phytochemicals derived from various medicinal plants can serve as potential therapeutic targets for both acute and chronic sciatic injury-induced neuropathic pain.
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Affiliation(s)
- Abdul Nasir
- Department of Anesthesiology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Medical Research Center, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Sami Ullah
- Department of Biochemistry, Abdul Wali Khan University, Mardan, Pakistan
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, Pakistan.
| | - Qian Bai
- Department of Anesthesiology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Medical Research Center, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Tsatsaraki E, Bouloukaki I, Kontakis G, Vakis AF, Basta M. Associations between Combined Psychological and Lifestyle Factors with Pain Intensity and/or Disability in Patients with Chronic Low Back Pain: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2928. [PMID: 37998420 PMCID: PMC10671559 DOI: 10.3390/healthcare11222928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Chronic low back pain (CLBP) is common in primary care, causing disability and economic burden globally. We aimed to compare socio-demographic, health, lifestyle, and psychological factors in people with and without CLBP and correlate them with clinical outcomes in people with CLBP. A total of 253 volunteers with and 116 without CLBP provided sociodemographic information, daily habits, medical history, subjective sleep complaints (Penn State Sleep Questionnaire), low back pain intensity, and disability (Quebec Back Pain Disability Scale), as well as the Zung Self-Rating Scale for self-assessment of depression and Self-Rating Anxiety Scale. CLBP diagnosis was linked with female gender and older age, as well as a higher level of sleep complaints such as sleepiness, OSA and insomnia symptoms, and a higher prevalence of moderate to severe depressive symptoms. The combination of moderate to severe depressive symptoms with obstructive sleep apnea or insomnia symptoms was the most important predictive factor for functional disability in CBLP patients (OR 13.686, 95% CI 4.581-40.885; p < 0.001). In conclusion, depressive symptoms and subjective sleep complaints appear to relate to greater CLBP intensity and/or CLBP-related disability in people with CLBP. A holistic approach is crucial for treating chronic CLBP patients, including psychological and sleep issue assessment and management, to improve their quality of life.
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Affiliation(s)
- Eirini Tsatsaraki
- Nursing Department, University Hospital of Heraklion, University of Crete, 70013 Heraklion, Greece;
| | - Izolde Bouloukaki
- Department of Social and Family Medicine, University of Crete, 70013 Heraklion, Greece;
| | - Georgios Kontakis
- Department of Orthopaedics and Traumatology, University Hospital of Heraklion, University of Crete, 71110 Heraklion, Greece
| | - Antonis F. Vakis
- Department of Neurosurgery, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Maria Basta
- Division of Psychiatry and Behavioral Science, School of Medicine, University of Crete, 70013 Heraklion, Greece
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Billis E, Fousekis K, Tsekoura M, Lampropoulou S, Matzaroglou C, Gliatis J, Sinopidis C, Hill J, Strimpakos N. Cross-cultural validation of the start back screening tool in a Greek low back pain sample. Musculoskelet Sci Pract 2021; 53:102352. [PMID: 33714780 DOI: 10.1016/j.msksp.2021.102352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Keele STarT Back Screening Tool (SBST) is a popular 9-item prognostic recovery questionnaire for low back pain (LBP) with validation studies in several cultural settings, but not Greek. OBJECTIVES The cross-cultural adaptation and validation of the SBST into Greek among LBP and LBP-associated leg pain patients. METHODS A five-stage forward-backward translation procedure developed the Greek SBST. LBP and sciatica patients completed SBST, Roland-Morris Disability Questionnaire (RMDQ), Hospital Anxiety and Depression Scale (HADS), Short-form Health Survey (SF-12), Sciatica Bothersomeness Index (SBI), numeric pain rating scale (NPRS) and body chart pain location sites. Measurement properties (internal consistency, content, construct and discriminatory validity) were explored. Test-retest reliability was explored by re-administering SBST after 7-10 days across patients whose symptoms remained unchanged. RESULTS 124 LBP patients (75 females, 49.1 ± 14.2 years-old) 43.5% of whom had sciatica completed Greek SBST. No floor/ceiling effects were detected. Mean score distributions were statistically different across SBST groups. Moderate to strong correlations were found for SBST (total and psychosocial scores) with RMDQ, SBI, HADS and SF-12 (Spearman's ρ = 0.42-0.60). Most associations between individual SBST items and reference standards were moderately correlated (ρ = 0.32-0.49). Greek SBST yielded acceptable discriminant validity with RMDQ (AUC of 0.80). Items 1, 3, 4, and 9 yielded acceptable discrimination against reference standards. Test-retest reliability was satisfactory for total score (ICC2,2 = 0.93) and individual items (kappa = 0.59-0.88). Cronbach's α was 0.70 (total score) and 0.76 (psychosocial subscale). CONCLUSIONS The Greek SBST was comprehensible, valid and reliable and may thus, be used across Greek cross-cultural rehabilitation research and practice.
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Affiliation(s)
- Evdokia Billis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece.
| | - Konstantinos Fousekis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - Maria Tsekoura
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - Sofia Lampropoulou
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - Charalampos Matzaroglou
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - John Gliatis
- Orthopaedic Department, University Hospital of Patras, Greece
| | | | | | - Nikolaos Strimpakos
- Department of Physiotherapy, School of Health Sciences, University of Thessaly, Greece
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Role of diffusion tensor imaging of sciatic nerve in symptomatic patients with inconclusive lumbar MRI. Eur J Radiol 2020; 131:109249. [DOI: 10.1016/j.ejrad.2020.109249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/08/2020] [Accepted: 08/17/2020] [Indexed: 11/19/2022]
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Liu CH, Kung YY, Lin CL, Yang JL, Wu TP, Lin HC, Chang YK, Chang CM, Chen FP. Therapeutic Efficacy and the Impact of the "Dose" Effect of Acupuncture to Treat Sciatica: A Randomized Controlled Pilot Study. J Pain Res 2019; 12:3511-3520. [PMID: 32021387 PMCID: PMC6942513 DOI: 10.2147/jpr.s210672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 11/29/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose To investigate the required sample size for and feasibility of a full-scale randomized controlled trial examining the impact of the “dose” effect of acupuncture in treating sciatica. Patients and methods Fifty-seven patients with sciatica, aged 35–70 years, were recruited and screened. Thirty-one participants were randomly assigned to receive “low-dose” manual acupuncture (MAL) (n= 15) or “high-dose” manual acupuncture (MAH) (n=16). The acupuncture treatment was administered twice weekly for 4 weeks. The primary outcome was the visual analog scale (VAS) score at baseline and after 4 weeks of acupuncture treatment. Secondary outcomes included the Roland Disability Questionnaire for Sciatica (RDQS), the Sciatica Bothersomeness Index (SBI), and the World Health Organization Quality of Life in the Brief Edition (WHOQOL-BREF) scores at baseline and after 4 weeks of acupuncture treatment. Results Thirty patients completed the study. For all patients, acupuncture achieved significant improvement in the VAS (5.48±2.0, p<0.001), RDQS (3.18±2.83, p=0.004), and SBI (2.85±3.23, p=0.008) scores, but not in the WHOQOL-BREF scores. In the between-group analysis, the assessed scales showed no significant differences between the MAL and MAH groups. However, based on the level of chronicity, the MAH group demonstrated greater improvement in the outcomes and a significant benefit in the physical subscale of the WHOQOL-BREF (p<0.05). Conclusion Results of this pilot study indicate that acupuncture is safe and may effectively relieve symptoms and disability in patients with non-acute sciatica. MAL was as effective as MAH in treating sciatica. A subsequent trial with a larger sample size (estimated at n=96) is required to confirm whether patients with a high level of chronicity would benefit from MAH treatment. Trial registration NCT03489681.
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Affiliation(s)
- Ching-Hsiung Liu
- Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan, Republic of China.,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Yen-Ying Kung
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.,Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Chun-Liang Lin
- Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan, Republic of China
| | - Jen-Lin Yang
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.,Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Ta-Peng Wu
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Hong-Chun Lin
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Yang-Kai Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Ching-Mao Chang
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.,Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Fang-Pey Chen
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.,Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
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Mas RR, López-Jiménez T, Pujol-Ribera E, Martín MIFS, Moix-Queraltó J, Montiel-Morillo E, Rodríguez-Blanco T, Casajuana-Closas M, González-Moneo MJ, Juárez EN, Juárez MN, Roura-Olivan M, Martin-Peñacoba R, Pie-Oncins M, Balagué-Corbella M, Muñoz MÁ, Violan C, Berenguera A. Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial. BMC Health Serv Res 2019; 19:962. [PMID: 31831074 PMCID: PMC6909445 DOI: 10.1186/s12913-019-4810-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 12/04/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Low back pain (LBP) is a multifactorial condition with individual and societal impact that affects populations globally. Current guidelines for the treatment of LBP recommend pharmacological and non-pharmacological strategies. The aim of this study was to compare usual clinical practice with the effectiveness of a biopsychosocial multidisciplinary intervention in reducing disability, severity of pain and improving quality of life in a working population of patients with subacute (2-12 weeks), non-specific LBP. METHODS Longitudinal cluster randomized clinical trial conducted in 39 Primary Health Care Centres (PHCC) of Barcelona, with patients aged 18-65 years (n = 501; control group = 239; 26 PHCC, intervention group = 262; 13 PHCC). The control group received usual clinical care. The intervention group received usual clinical care plus a biopsychosocial multidisciplinary intervention, which consisted of physiotherapy, cognitive-behavioural therapy and medication. The main outcomes were changes in the Roland Morris Disability Questionnaire (RMDQ), and the minimal clinically important differences. Secondary outcomes were changes in the McGill Pain (MGPQ) and Quality of Life (SF-12) questionnaires. Assessment was conducted at baseline, 3 and 12 months. Analysis was by intention-to-treat and analyst-blinded. Multiple imputations were used. RESULTS Of the 501 enrolled patients, 421 (84%) provided data at 3 months, and 387 (77.2%) at 12 months. Mean age was 46.8 years (SD: 11.5) and 64.7% were women. In the adjusted analysis of the RMDQ outcome, only the intervention group showed significant changes at 3 months (- 1.33 points, p = 0.005) and at 12 months (- 1.11 points, p = 0.027), but minimal clinically important difference were detected in both groups. In the adjusted analysis of the RMDQ outcome, the intervention group improvement more than the control group at 3 months (- 1.33 points, p = 0.005) and at 12 months (- 1.11 points, p = 0.027). The intervention group presented a significant difference. Both groups presented a minimal clinically important difference, but more difference in the intervention group. The intervention group presented significant differences in the MGPQ scales of current pain intensity and VAS scores at 3 months. No statistically significant differences were found in the physical and mental domains of the SF-12. CONCLUSIONS A multidisciplinary biopsychosocial intervention in a working population with non-specific subacute LBP has a small positive impact on disability, and on the level of pain, mainly at short-term, but no difference on quality of life. TRIAL REGISTRATION ISRCTN21392091 (17 oct 2018) (Prospectively registred).
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Affiliation(s)
- Romina Raczy Mas
- Gerència Territorial de Barcelona, Catalan Institute of Health, c/ Sardenya, 375, Entl, 08025 Barcelona, Spain
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
- Department of Paediatrics, Gynaecology and Obstetrics and Preventive Medicine, Universitat Autònoma de Barcelona Faculty of Medicine-Bellaterra, 08193 (Cerdanyola del Vallès), Spain
| | - Tomàs López-Jiménez
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
- Department of Paediatrics, Gynaecology and Obstetrics and Preventive Medicine, Universitat Autònoma de Barcelona Faculty of Medicine-Bellaterra, 08193 (Cerdanyola del Vallès), Spain
| | | | - Jenny Moix-Queraltó
- Department of Basic, Evolutionary and Educational Psychology, Universitat Autònoma de Barcelona Faculty of Psychology, Building B. Campus de la UAB, Bellaterra, 08193 Barcelona, Spain
| | | | - Teresa Rodríguez-Blanco
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
| | - Marc Casajuana-Closas
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
- Department of Paediatrics, Gynaecology and Obstetrics and Preventive Medicine, Universitat Autònoma de Barcelona Faculty of Medicine-Bellaterra, 08193 (Cerdanyola del Vallès), Spain
| | | | - Ester Núñez Juárez
- SAP Support to Diagnosis and Treatment, Gerència Territorial de Barcelona, Catalan Institute of Health, 08001 Barcelona, Spain
| | - Montse Núñez Juárez
- Unit of Functional Rehabilitation, Department of Rheumatology, Hospital Clínic Universitari, 08036 Barcelona, Spain
| | | | | | - Magda Pie-Oncins
- Primary Care Centre Sant Martí, SAP Litoral, 08020 Barcelona, Spain
| | - Montse Balagué-Corbella
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
| | - Miguel-Ángel Muñoz
- Gerència Territorial de Barcelona, Catalan Institute of Health, c/ Sardenya, 375, Entl, 08025 Barcelona, Spain
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
- Department of Paediatrics, Gynaecology and Obstetrics and Preventive Medicine, Universitat Autònoma de Barcelona Faculty of Medicine-Bellaterra, 08193 (Cerdanyola del Vallès), Spain
| | - Concepción Violan
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
| | - Anna Berenguera
- Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, 08007 Barcelona, Spain
- Department of Paediatrics, Gynaecology and Obstetrics and Preventive Medicine, Universitat Autònoma de Barcelona Faculty of Medicine-Bellaterra, 08193 (Cerdanyola del Vallès), Spain
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MR-Guided Percutaneous Intradiscal Thermotherapy (MRgPIT): Evaluation of a New Technique for the Treatment of Degenerative Disc Disease in Cadaveric Lumbar Spine. Cardiovasc Intervent Radiol 2019; 43:505-513. [PMID: 31773189 DOI: 10.1007/s00270-019-02382-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Evaluation of MR feasibility and real-time control of an innovative thermoablative applicator for intradiscal thermotherapy and histological analysis of laser annuloplasty in human ex vivo intervertebral discs. MATERIALS AND METHODS We evaluated a new MR-compatible applicator system for MR-guided percutaneous intradiscal thermotherapy (MRgPIT) in an open 1.0-T MRI-system. Needle artefacts and contrast-to-noise ratios (CNR) of six interactive sequences (PD-, T1-, T2w TSE, T1-, T2w GRE, bSSFP) with varying echo-times (TE) and needle orientations to the main magnetic field (B0) were analysed. Additionally, five laser protocols (Nd: YAG Laser, 2-6 W) were assessed in 50 ex vivo human intervertebral discs with subsequent histological evaluation. RESULTS In vitro, we found optimal needle artefacts of 1.5-5 mm for the PDw TSE sequence in all angles of the applicator system to B0. A TE of 20 ms yielded the best CNR. Ex vivo, ablating with 5 W induced histological denaturation of collagen at the dorsal annulus, correlating with a rise in temperature to at least 60 °C. The MRgPIT procedure was feasible with an average intervention time of 17.1 ± 5.7 min. CONCLUSION Real-time MR-guided positioning of the MRgPIT-applicator in cadaveric intervertebral disc is feasible and precise using fast TSE sequence designs. Laser-induced denaturation of collagen in the dorsal annulus fibrosus proved to be accurate.
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He BS, Li Y, Gui T. Preliminary Clinical Evaluation of Acupuncture Therapy in Patients With Postpartum Sciatica. J Midwifery Womens Health 2018; 63:214-220. [DOI: 10.1111/jmwh.12681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/11/2022]
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Billis E, Koutsojannis C, Matzaroglou C, Gliatis J, Fousekis K, Gioftsos G, Papandreou M, McCarthy C, Oldham JA, Tsepis E. Association of low back pain on physical, sociodemographic and lifestyle factors across a general population sample within Greece. J Back Musculoskelet Rehabil 2017; 30:279-290. [PMID: 27689603 DOI: 10.3233/bmr-150484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although low back pain (LBP) is a debilitating problem internationally, there is not a lot of research on its impact on physical, psychosocial and lifestyle factors. Especially in mediterranean countries, such as Greece, it is not sufficiently explored whether physical (pain location, activity limitation etc.), sociodemographic (education, smoking etc.) or lifestyle factors (i.e. quality of life or anxiety) are influenced by LBP. OBJECTIVE To estimate LBP prevalence in the Greek general population and explore its association with particular sociodemographic, physical and lifestyle factors. METHOD A sample of 3125 people of the Greek adult population was randomly selected by stratified sampling encompassing rural and urban representation within the Greek mainland. An extended survey form was developed entailing three sections; personal (sociodemographic) information, questions on symptomatology and physical factors (i.e. pain characteristics, recurrence, physical disability etc.) and 3 self-administered questionnaires (including mostly lifestyle factors); Hospital Anxiety and Depression (HAD) scale for anxiety and depression, SF-12 for quality of life (QoL) and Roland-Morris for disability. RESULTS A total of 471 (15%) people reported LBP (210 males, mean age: 47.04 ± 15.03). Amongst them 60% reported sciatica, 76% suffered recurrent LBP and 70% received specialist care. Low disability levels, moderate to high pain intensity, gender differences and good self-reported QoL and psychosocial status were reported. Sociodemographic characteristics (income, smoking, marital status etc.) were not associated with LBP physical factors, apart from age which correlated with physical disability and wellness (r being 0.446 and 0.405, respectively, p< 0.001). Physical factors (particularly pain intensity and location) correlated with lifestyle factors (QoL) and disability (r ranging between 0.396 and 0.543, p< 0.001). Mental wellness, anxiety and depression (as lifestyle factors) were not associated with sociodemographic or physical factors. CONCLUSIONS Physical parameters were amongst the most prevalent characteristics of the Greek sample, thus offering a direction towards a more targeted treatment and rehabilitation planning. Unlike previous literature, most sociodemographic characteristics were not correlated with any LBP physical or lifestyle factors, thus possibly indicating a different socioeconomic background and aetiology domain to that of the usual non-specific LBP spectrum.
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Affiliation(s)
- E Billis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - C Koutsojannis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - C Matzaroglou
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - J Gliatis
- Orthopaedic Department, University Hospital of Patras, Greece
| | - K Fousekis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - G Gioftsos
- Department of Physiotherapy, Technological Educational Institute (T.E.I) of Sterea Ellada, Greece
| | - M Papandreou
- Department of Physiotherapy, Technological Educational Institute (T.E.I.) of Athens, Greece
| | - C McCarthy
- Imperial College Healthcare NHS Trust, London, UK
| | - J A Oldham
- University of Manchester, Manchester, UK
| | - E Tsepis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
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Nishisho T, Sakai T, Tezuka F, Higashino K, Takao S, Takata Y, Miyagi R, Toki S, Abe M, Yamashita K, Nagamachi A, Sairyo K. Delayed Diagnosis of Primary Bone and Soft Tissue Tumors Initially Treated as Degenerative Spinal Disorders. THE JOURNAL OF MEDICAL INVESTIGATION 2016; 63:274-7. [PMID: 27644571 DOI: 10.2152/jmi.63.274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Symptoms of primary bone and soft tissue tumors located in the trunk mimic those of degenerative spinal disorders such as low back pain or pain or numbness of the legs. Due to their rarity, especially in sarcoma located in the trunk, diagnosis is sometimes delayed. Methods A retrospective review was performed of the records of 383 patients with primary bone and soft tissue tumors who visit our out patient clinic from 2011 to 2013 at a single institution. Patients with delayed diagnosis of primary bone and soft tissue tumors initially treated as degenerative spinal disorders for more than 2 months were identified. Results Of the 383 patients, 5 (1.3%) were initially diagnosed as having degenerative spinal disorders. All 5 patients had bone or soft tissue tumors in the lumbar spine or pelvis. Three patients had a malignant tumor (osteosarcoma, chondrosarcoma, or small round cell sarcoma) at the progressive stage, and 1 died of lung metastasis. Two patients had a benign tumor (aneurysmal bone cyst or simple bone cyst). Conclusions Our findings suggest that when low back pain and leg pain are refractory to conservative treatment, further radiological examination should be conducted. J. Med. Invest. 63: 274-277, August, 2016.
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Affiliation(s)
- Toshihiko Nishisho
- Department of Orthopedics, Institute of Biomedical Sciences Tokushima University Graduate School
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Krekoukias G, Gelalis ID, Xenakis T, Gioftsos G, Dimitriadis Z, Sakellari V. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. J Man Manip Ther 2016; 25:66-73. [PMID: 28559665 DOI: 10.1080/10669817.2016.1184435] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The aim of the study was to examine the efficacy of spinal mobilization in subjects with low back pain (LBP) and associated spinal disk degeneration. METHODS Seventy-five subjects suffering from chronic LBP (>3 months) were randomly allocated into 3 groups of 25 subjects each. Each group received five treatment sessions with the first group receiving manual therapy (MT) (spinal mobilization), the second a sham treatment, and the third conventional physiotherapy (CP) (stretching exercises, transcutaneous electrical nerve stimulation, and massage). Subjects were assessed for their pain intensity using the numerical pain rating scale and for their self-reported disability using the Oswestry and Roland-Morris Questionnaire at baseline and after the completion of the five treatment sessions. RESULTS Paired t-tests showed a significant improvement for all outcome measures in the MT and CP group (p < 0.05). Analysis of covariance revealed that the MT group had significant improvement in all outcome measures in comparison with the sham and CP group (p < 0.05), whereas no significant difference was observed between the sham and CP group (p > 0.05). DISCUSSION MT is preferable to CP in order to reduce the pain intensity and disability in subjects with chronic LBP and associated disk degeneration. The findings of this study may lead to the establishment of spinal mobilization as one of the most preferable approaches for the management of LBP due to disk degeneration. LEVEL OF EVIDENCE 1b.
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Affiliation(s)
- Georgios Krekoukias
- Department of Biomechanics, Medical School, University of Ioannina, Ioannina, Greece
| | - Ioannis D Gelalis
- Department of Biomechanics, Medical School, University of Ioannina, Ioannina, Greece.,Department of Orthopedic Surgery, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece
| | - Theodoros Xenakis
- Department of Biomechanics, Medical School, University of Ioannina, Ioannina, Greece
| | - Georgios Gioftsos
- Department of Physiotherapy, School of Health and Caring Professions, Technological Educational Institute of Central Greece, Lamia, Greece
| | - Zacharias Dimitriadis
- Department of Physiotherapy, School of Health and Caring Professions, Technological Educational Institute of Athens, Athens, Greece
| | - Vasiliki Sakellari
- Department of Physiotherapy, School of Health and Caring Professions, Technological Educational Institute of Central Greece, Lamia, Greece
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12
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Wáng YXJ, Wáng JQ, Káplár Z. Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quant Imaging Med Surg 2016; 6:199-206. [PMID: 27190772 DOI: 10.21037/qims.2016.04.06] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Female sex hormones play an important role in the etiology and pathophysiology of a variety of musculoskeletal degenerative diseases. Postmenopausal women show accelerated disc degeneration due to relative estrogen deficiency. This literature review aims to validate or falsify this hypothesis, i.e., while overall females have higher prevalence of low back pain (LBP) across all age groups, this male vs. female difference in LBP prevalence further increases after female menopause age. The literature search was performed on PubMed on January 2, 2016. The search word combination was (low back pain) AND prevalence AND [(males OR men) AND (females OR women)]. The following criteria were taken to include the papers for synthetic analysis: (I) only English primary literatures on nonspecific pain; (II) only prospective studies on general population, but not population with occupational LBP causes, of both males and female subjects studied using the same LBP criterion, ages-specific information available, and males and female subjects were age-matched; (III) studies without major quality flaws. In total 98 studies with 772,927 subjects were analyzed. According to the information in the literature, participant subjects were divided into four age groups: (I) school age children group: 6-19 years; (II) young and middle aged group: 20-50 years; (III) mixed age group: data from studies did not differentiate age groups; (IV) elderly group: ≥50 years old. When individual studies were not weighted by participant number and each individual study is represented as one entry regardless of their sample size, the median LBP prevalence ratio of female vs. males was 1.310, 1.140, 1.220, and 1.270 respectively for the four age groups. When individual studies were weighted by participant number, the LBP prevalence ratio of female vs. males was 1.360, 1.127, 1.185, and 1.280 respectively for the four groups. The higher LBP prevalence in school age girls than in school age boys is likely due to psychological factors, female hormone fluctuation, and menstruation. Compared with young and middle aged subjects, a further increased LBP prevalence in females than in males was noted after menopause age.
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Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Jùn-Qīng Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Zoltán Káplár
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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13
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Shiri R, Falah-Hassani K. The Effect of Smoking on the Risk of Sciatica: A Meta-analysis. Am J Med 2016; 129:64-73.e20. [PMID: 26403480 DOI: 10.1016/j.amjmed.2015.07.041] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 07/17/2015] [Accepted: 07/29/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The role of smoking in sciatica is unknown. This study aimed to estimate the effect of smoking on lumbar radicular pain and clinically verified sciatica. METHODS Comprehensive literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar, and ResearchGate databases from 1964 through March 2015. We used a random-effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses with regard to study design, methodological quality of included studies, and publication bias. RESULTS Twenty-eight (7 cross-sectional [n = 20,111 participants], 8 case control [n = 10,815], and 13 cohort [n = 443,199]) studies qualified for a meta-analysis. Current smokers had an increased risk of lumbar radicular pain or clinically verified sciatica (pooled adjusted odds ratio [OR] 1.46; 95% confidence interval [CI], 1.30-1.64, n = 459,023). Former smokers had only slightly elevated risk compared with never smokers (pooled adjusted OR 1.15; 95% CI, 1.02-1.30, n = 387,196). For current smoking the pooled adjusted OR was 1.64 (95% CI, 1.24-2.16, n = 10,853) for lumbar radicular pain, 1.35 (95% CI, 1.09-1.68, n = 110,374) for clinically verified sciatica, and 1.45 (95% CI, 1.16-1.80, n = 337,796) for hospitalization or surgery due to a herniated lumbar disc or sciatica. The corresponding estimates for past smoking were 1.57 (95% CI, 0.98-2.52), 1.09 (95% CI, 1.00-1.19), and 1.10 (95% CI, 0.96-1.26). The associations did not differ between men and women, and they were independent of study design. Moreover, there was no evidence of publication bias, and the observed associations were not due to selection or detection bias, or confounding factors. CONCLUSIONS Smoking is a modest risk factor for lumbar radicular pain and clinically verified sciatica. Smoking cessation appears to reduce, but not entirely eliminate, the excess risk.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Kobra Falah-Hassani
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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14
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Nucci-Martins C, Martins DF, Nascimento LF, Venzke D, Oliveira AS, Frederico MJS, Silva FRMB, Brighente IMC, Pizzolatti MG, Santos ARS. Ameliorative potential of standardized fruit extract of Pterodon pubescens Benth on neuropathic pain in mice: Evidence for the mechanisms of action. JOURNAL OF ETHNOPHARMACOLOGY 2015; 175:273-286. [PMID: 26386380 DOI: 10.1016/j.jep.2015.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/31/2015] [Accepted: 09/05/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The medicinal plant Pterodon pubescens Benth has been traditionally used for a long time to treat rheumatic diseases due to its anti-inflammatory and analgesic activities. The present study aims to evaluate the antinociceptive effect of ethanolic extract from P. pubescens fruits (EEPp) in a model of neuropathic pain in mice. MATERIALS AND METHODS The phytochemical analysis of EEPp was performed through GC-MS, HPLC and colorimetric analysis. The antinociceptive effects of EEPp (30-300 mg/kg, i.g.) were evaluated on mechanical and thermal (cold or heat) hyperalgesia in neuropathic pain induced by partial sciatic nerve ligation (PSNL) in mice. We also investigated the effects of EEPp on the nociceptive response induced by intrathecal injection (i.t.) of ionotropic (AMPA, NMDA and kainate) and metabotropic (trans-ACPD) glutamate receptor agonists, proinflammatory cytokines such as IL-1β and TNF-α, as well as TRPV1 and TRPA1 agonists. In addition, we also investigated the safety profile of prolonged treatment with EEPp in mice. RESULTS The phytochemical analysis showed a higher amount terpenes, being nine sesquiterpenes and seven diterpenes with vouacapan skeletons, as well as a small amount of phenols and flavonoids. The exact mechanism by which EEPp promotes its antinociceptive effect is not yet fully understood, but its oral administration causes significant inhibition of glutamate-, kainate-, NMDA-, trans-ACPD-induced biting responses, as well as of proinflammatory cytokines (TNF-α and IL-1β) and TRPV1 and TRPA1 channels activators (capsaicin and cinnamaldehyde, respectively). These results may indicate, at least in part, some of the mechanisms that are involved in this effect. In particular, EEPp decreases neuropathic pain and clearly shows, for the first time, a thermal and mechanical hyperalgesia reduction in the model of partial sciatic nerve ligation (PSNL), without inducing tolerance. Furthermore, the prolonged treatment with EEPp (300 mg/kg, i.g.) showed a cumulative effect over 24h, in the 15th day, after last treatment. In addition, the open-field test showed that doses up to 300 mg/kg in both treatments, acute and/or prolonged, did not affect the motor activity of mice. Also, EEPp showed no toxicity according to the serum levels of the renal and hepatic injury indicators or observed macroscopic organs, after PSNL. CONCLUSIONS Taken together, these results provide the first experimental evidence of the significant antinociceptive effect of EEPp on neuropathic pain without causing side effects, such as sedation or locomotor dysfunction. Moreover, these results appear to be mediated, at least in part, by the inhibition of glutamatergic receptors, TRPV1 and TRPA1 channels and proinflammatory cytokines. Thus, this study adds new scientific evidence and highlights the therapeutic potential of the medicinal plant P. pubescens in the development of phytomedicines for the management of neuropathic pain.
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Affiliation(s)
- Catharina Nucci-Martins
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina, Trindade, Florianópolis, SC 88040-900, Brazil; Graduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Daniel F Martins
- Laboratory of Experimental Neuroscience, Graduate Program in Health Sciences, University of Southern Santa Catarina, Pedra Branca, Palhoça, SC 88137-270, Brazil
| | - Leandro F Nascimento
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina, Trindade, Florianópolis, SC 88040-900, Brazil; Graduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Dalila Venzke
- Department of Chemistry, Center of Physical and Mathematical Sciences, Federal University of Santa Catarina, Trindade Florianópolis, SC 88040-900, Brazil
| | - Aldo S Oliveira
- Department of Chemistry, Center of Physical and Mathematical Sciences, Federal University of Santa Catarina, Trindade Florianópolis, SC 88040-900, Brazil
| | - Marisa J S Frederico
- Graduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil; Department of Biochemistry, Center of Biological Sciences, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Fátima R M B Silva
- Department of Biochemistry, Center of Biological Sciences, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Inês M C Brighente
- Department of Chemistry, Center of Physical and Mathematical Sciences, Federal University of Santa Catarina, Trindade Florianópolis, SC 88040-900, Brazil
| | - Moacir G Pizzolatti
- Department of Chemistry, Center of Physical and Mathematical Sciences, Federal University of Santa Catarina, Trindade Florianópolis, SC 88040-900, Brazil
| | - Adair R S Santos
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina, Trindade, Florianópolis, SC 88040-900, Brazil; Graduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil.
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Shi Y, Zong M, Xu X, Zou Y, Feng Y, Liu W, Wang C, Wang D. Diffusion tensor imaging with quantitative evaluation and fiber tractography of lumbar nerve roots in sciatica. Eur J Radiol 2015; 84:690-5. [DOI: 10.1016/j.ejrad.2015.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/03/2015] [Accepted: 01/06/2015] [Indexed: 11/28/2022]
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Thiese MS, Hegmann KT, Wood EM, Garg A, Moore JS, Kapellusch J, Foster J, Ott U. Prevalence of low back pain by anatomic location and intensity in an occupational population. BMC Musculoskelet Disord 2014; 15:283. [PMID: 25146722 PMCID: PMC4153910 DOI: 10.1186/1471-2474-15-283] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 08/15/2014] [Indexed: 01/07/2023] Open
Abstract
Background Low Back Pain (LBP) is a common and costly problem, with variation in prevalence. Epidemiological reports of rating of pain intensity and location within the low back area are rare. The objective is to describe LBP in a large, multi-center, occupational cohort detailing both point and 1-month period prevalence of LBP by location and intensity measures at baseline. Methods In this cross-sectional report from a prospective cohort study, 828 participants were workers enrolled from 30 facilities performing a variety of manual material handling tasks. All participants underwent a structured interview detailing pain rating and location. Symptoms in the lower extremities, demographic and other data were collected. Body mass indices were measured. Outcomes are pain rating (0–10) in five defined lumbar back areas (i) LBP in the past month and (ii) LBP on the day of enrollment. Pain ratings were reported on a 0–10 scale and subsequently collapsed with ratings of 1–3, 4–6 and 7–10 classified as low, medium and high respectively. Results 172 (20.8%) and 364 (44.0%) of the 828 participants reported pain on the day of enrollment or within the past month, respectively. The most common area of LBP was in the immediate paraspinal area with 130 (75.6%) participants with point prevalence LBP and 278 (77.4%) with 1-month period prevalence reported having LBP in the immediate paraspinal area. Among those 364 reporting 1-month period prevalence pain, ratings varied widely with 116 (31.9%) reporting ratings classified as low, 170 (46.7%) medium and 78 (21.4%) providing high pain ratings in any location. Among the 278 reporting 1-month period prevalence pain in the immediate paraspinal area, 89 (32.0%) reported ratings classified as low, 129 (46.4%), medium and 60 (21.6%) high pain ratings. Conclusions Pain ratings varied widely, however less variability was seen in pain location, with immediate paraspinal region being the most common. Variations may suggest different etiological factors related to LBP. Aggregation of different locations of pain or different intensities of pain into one binary classification of LBP may result in loss of information which may potentially be useful in prevention or treatment of LBP. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-283) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthew S Thiese
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational & Environment Health, School of Medicine, University of Utah, 391 Chipeta Way, Suite C, Salt Lake City, UT 84108, USA.
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