Abstract
BackgroundChronic low back pain (CLBP) experienced in middle-age may have important implications for vertebral bone health, although this issue has not been investigated as a primary aim previously. This study investigated the associations between CLBP and dual energy X-ray absorptiometry (DXA)-derived vertebral bone mineral measures acquired from postero-anterior and lateral-projections, among community-dwelling, middle-aged adults.MethodsTwenty-nine adults with CLBP (11 male, 18 female) and 42 adults with no history of LBP in the preceding year (17 male, 25 female) were evaluated. Self-reported demographic and clinical data were collected via questionnaires. Areal bone mineral density (aBMD) was measured in the lumbar spine by DXA. Apparent volumetric (ap.v) BMD in the lumbar spine was also calculated. Multiple linear regression models were used to examine associations between study group (CLBP and control) and vertebral DXA variables by gender, adjusting for height, mass and age.ResultsThere was no difference between groups by gender in anthropometrics or clinical characteristics. In the CLBP group, the mean (SD) duration of CLBP was 13.3 (10.4) years in males and 11.6 (9.9) years in females, with Oswestry Disability Index scores of 16.2 (8.7)% and 15.4 (9.1)%, respectively. Males with CLBP had significantly lower adjusted lateral-projection aBMD and lateral-projection ap.vBMD than controls at L3 with mean differences (standard error) of 0.09 (0.04) g/cm2 (p = 0.03) and 0.02 (0.01) g/cm3 (p = 0.04). These multivariate models accounted for 55% and 53% of the variance in lateral-projection L3 aBMD and lateral-projection L3 ap.vBMD.ConclusionsCLBP in males is associated with some lumbar vertebral BMD measures, raising important questions about the mechanism and potential clinical impact of this association.
Highlights
Chronic low back pain (CLBP) experienced in middle-age may have important implications for vertebral bone health, this issue has not been investigated as a primary aim previously
For a proportion of individuals the experience of lifecourse whichLow back pain (LBP) persists beyond three months to become chronic, experienced as either a continuous or episodic course of pain [6]
Participants Participants in the study represent a subset of the Joondalup Spinal Health Study (JSHS) cohort
Summary
Chronic low back pain (CLBP) experienced in middle-age may have important implications for vertebral bone health, this issue has not been investigated as a primary aim previously. Low back pain (LBP) is one of the most common and significant musculoskeletal disorders experienced across the lifecourse and is most common during middle-age [1] It represents an enormous public health issue worldwide owing to the soaring healthcare costs associated with the condition and the societal and personal burdens imposed [2]. For a proportion of individuals (approximately 1020%) the experience of LBP persists beyond three months to become chronic, experienced as either a continuous or episodic course of pain [6] In many such cases, chronic LBP (CLBP) is associated with a myriad of biopsychosocial factors which may have implications for bone health [7]
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