Back Pain In Women Research Articles

Risk factors for low back pain in women

Low back pain (LBP) is a common problem, with an estimated prevalence of 31% in US populations.1 Approximately 75% to 80% of the population will experience at least one episode of acute LBP during their lifetime. Most patients who experience an episode of LBP will improve over the course of a month.

How Common Is Back Pain in Women With Gastrointestinal Problems?

This study examined the relationship between back pain and gastrointestinal (GI) symptoms in a large scale population study with consideration of possible confounding factors. Cross-sectional analysis of survey data from the Australian Longitudinal Study on Women's Health was conducted using multinomial logistic regression to model 4 frequencies of back pain in relation to number of GI symptoms (including constipation, hemorrhoids, and other bowel problems). A total of 38,050 women from 3 age cohorts were included in analysis. After adjustment for confounding factors, the number of GI symptoms was significantly associated with back pain among all age cohorts. Odds ratios for experiencing back pain "rarely," "sometimes," and "often" increased with the number of GI symptoms. Young, mid-age, and older women who experience 2 or 3 GI symptoms had adjusted odds ratios of 3.3 (2.5 to 4.4), 3.0 (2.5 to 3.7) and 2.8 (2.3 to 3.4), respectively, for "often" having back pain. This study has identified a strong association between back pain and GI symptoms in women. Possible factors that may account for this relationship include referred pain through viscerosomatic convergence, altered pain perception, increased spinal loading when straining during defecation, or reduced support of the abdominal contents and spine secondary to changes in function of the abdominal muscles.

Effects of strontium ranelate on spinal osteoarthritis progression

Objective:The aim of this study was to determine whether a 3-year treatment with strontium ranelate could delay the progression of spinal osteoarthritis (OA).Methods:This study was a post-hoc analysis of pooled...

An Epidemiologic Study of Low Back Pain of Women Working at a General Hospital

Background : The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. Materials and Methods : An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. Results : The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. Conclusion : Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.

Teriparatide reduces the risk of developing moderate or severe back pain in women with postmenopausal osteoporosis,

Teriparatide reduces the risk of developing moderate or severe back pain in women with postmenopausal osteoporosis,

Gender Differences In The Cause Of Low Back Pain In British Soldiers

ObjectivesTo explore gender differences in the cause of low back pain in a population of military personnel who are expected to undertake high levels of sport, exercise and physical military...

Abstract #50: Back Pain in Women With Postmenopausal Osteoporosis Treated with Teriparatide 40 μg/day (TPTD40) or with Alendronate 10 mg/day (ALN10)

Abstract #50: Back Pain in Women With Postmenopausal Osteoporosis Treated with Teriparatide 40 μg/day (TPTD40) or with Alendronate 10 mg/day (ALN10)

A Study on Back Pain, Pain Disability, and Labour Pain of Postpartum Women

【Purpose: The purpose of this study was to look into back pain, pain disability, labour pain, and related areas of pain experienced by postpartum women. Method: A survey about pain including a Visual Analogue Scale (VAS), Oswestry pain disability, and pain drawing was used in a descriptive research method on 98 women 2-3 days after delivery. Result: 57.1% of those surveyed reported experiencing back pain before pregnancy. 75.5% reported experiencing back pain during pregnancy. The average starting time of back pain for pregnant women was 2.9 months into pregnancy. 48.8% reported the most severe back pain in the last trimester of pregnancy, while most women complained of left and right pubic pain and lumbar area pain during pregnancy. Statistical relations were calculated and menstrual symptoms (F=5.938, p=0.004), back pain prior to pregnancy (F=4.714, p=0.000), back pain during pregnancy (F=-3.429, p=0.001), and back pain disability prior to pregnancy (F=-1.994). Conclusion: There is a relation in postpartum women's back pain between back pain prior to pregnancy and back pain during pregnancy. Pelvic examinations early in pregnancy can determine if back pain will change for the worse or relapse. Therefore, the application of a pain relieving nursing intervention is needed.】

Toward optimal health: the experts discuss management of low back pain in women. Interview by Jodi Godfrey Meisler.

Toward optimal health: the experts discuss management of low back pain in women. Interview by Jodi Godfrey Meisler.

Patient-oriented assessment of back pain in pregnancy.

Back pain is a common symptom in women during the last period of pregnancy. Only a few studies using validated patient-oriented tools have been undertaken on this topic. We report on a multicenter study on back pain in women during the last period of pregnancy, which involved seven Italian institutions. Seventy-six women in their 8th and 9th months were studied using the Italian validated version of the Roland questionnaire -- a disease-specific patient-oriented tool for low back pain. Sixty-two percent of the women had gone through at least one previous pregnancy, and clinical data concerning both the period before all pregnancies and the period before the current pregnancy were acquired. The study found that 31% of the women had no back pain symptoms (Roland score 0), 40% scored from 1 to 4, 21% scored from 5 to 10, and 8% scored more than 10. With regard to the predictive factor, history of back pain and sciatica before the pregnancy were found to be associated with occurrence of back pain symptoms during pregnancy. Unexpectedly, our results showed that male sex of the fetus seems to be related to occurrence of back pain symptoms during pregnancy. However, back pain was not associated with having gone through previous pregnancies, nor was the Roland score related to the weight before pregnancy or to increment of weight during pregnancy. Evaluation of the patient's perspective made it possible to identify predictive factors for occurrence of back pain, thereby furnishing important information for the clinical approach to pregnancy.

Physical and psychosocial factors related to low back pain during a 24-year period. A nested case-control analysis.

A retrospective nested case-control study. To identify occupational factors related to low back pain, and to study how interactions between psychosocial and physical factors, and between work-related and leisure-related factors affect low back pain in women and men. A cohort of 484 subjects drawn from the general population was examined in 1969 and 1993, with a focus on occupational working conditions and musculoskeletal disorders. Information about the physical and psychosocial working conditions and low back pain during the period 1970 to 1993 was collected retrospectively. Odds ratios and confidence intervals were calculated for different potential risk factors. During the 24-year period, 46% of the subjects became patients with low back pain. Among women, heavy physical workload, sedentary work, smoking, and the combination of whole-body vibrations and low influence over work conditions were associated with an excess risk of low back pain. Among men, excess risk for low back pain was seen in heavy physical workload, sedentary work, high perceived load outside work, and the combination of poor social relations and overtime. Factors at work were seen to be risk indicators for low back pain among both genders. Low influence over work conditions among women and poor social relations at work among men, in combination with other factors, seem to be of high relevance for the occurrence of low back pain.

Short-term physical risk factors for new episodes of low back pain. Prospective evidence from the South Manchester Back Pain Study.

A prospective population-based cohort study performed in South Manchester, United Kingdom. To determine whether nonoccupational physical activity and indicators of physical stress on the spine predict low back pain in the short term. There is evidence that physical activity outside the workplace helps to protect against low back pain in the long term. However, such activity may injure or stress the spine in the short term. A baseline survey questionnaire identified 2715 adults, aged 18-75 years, with no low back pain at the time of the survey. Information on potential predictors of low back pain also was obtained. New episodes of back pain were identified during the subsequent year. A new low back pain episode occurred in 34% of men and 37% of women. Poor general health at baseline was the strongest predictor of a new episode of pain (men: relative risk (RR) 1.5, 95% confidence intervals (CI) 0.8, 2.7; women: RR 2.2, 95% CI 1.2, 4.0). High weight was associated with subsequent low back pain in women (RR 1.4; 95% CI 1.0, 2.0), but neither height nor weight predicted low back pain in men. A self-rated low level of physical activity was not consistently linked with subsequent low back pain, nor were specific nonoccupational physical activities, apart from home-improvement work in men and regular sports in women. Although some specific activities may be hazardous to the back, physical activity outside the workplace does not increase the short-term risk of low back pain overall. Leisure-time physical activity is not a hazard to the back, whereas poor physical health in both genders and heavier weight in women do increase the risk of new low back pain episodes in the short term.

Back pain in women post-partum is not a unitary concept.

At least half of all pregnant women experience back pain at some time during pregnancy and some of them also have persisting back pain post-partum. The aim of the present study was to identify and classify back problems in women post-partum by use of different pain provocation tests and define their relationship to spinal sagittal configuration and mobility. One hundred and nineteen women with back pain persisting two months after delivery were interviewed and examined, on average 7.2 months post-partum. Ten clinical pain provocation tests were performed. The first was performed to identify hip pain, the second to identify radiating pain and the other eight tests were performed to provoke pain in the areas of the posterior pelvic/sacroiliac joints, the symphysis pubis and the lumbar spine. The spinal sagittal configuration and mobility were measured in the thoracic and lumbar spine, respectively, with Debrunner's kyphometer (Protek AG, Berne, Switzerland). Twenty-seven per cent of women had pain in the area of the posterior pelvic/sacroiliac joints, 18% in the area of the lumbar spine, 39% both in the area of the posterior pelvic/sacroiliac joints and in the lumbar spine, and in 16% no pain could be provoked. There were no statistically significant differences between the four groups with respect to the spinal sagittal configuration or the mobility in the thoracic or lumbar spine. Back pain post-partum is not a unitary concept. Based on the clinical tests, women with back pain post-partum can be separated into groups with different pain localizations. The measuring of the spinal sagittal configuration and mobility did not help to further identify or classify post-partum back pain.

Natural history of low back pain. A longitudinal study in nurses.

Longitudinal study. To assess the natural history of low back pain. Most episodes of low back pain resolve or improve within a few weeks, but chronic or recurrent symptoms are common. Previous studies of natural history have usually relied on people's long-term recall of symptoms, or they have been limited to patients seeking clinical care. Nurses (1,165 women) completed a baseline questionnaire and up to eight follow-up questionnaires 3 months apart. Each questionnaire asked whether they had experienced low back pain in the past month. One-month prevalences of pain at specified follow-ups were calculated according to histories of pain reported on earlier questionnaires. The 1-month prevalence of low back pain at individual follow-ups ranged from 16% to 19%. Of 906 women who completed the baseline questionnaire and at least three follow-up questionnaires, 38 (4.2%) reported pain every time they returned a questionnaire, and 190 (21.0%) reported pain on at least three occasions. The presence or absence of low back pain at baseline was highly predictive of future pain throughout follow-up. The longer that back pain was consistently reported, the more likely it was to be present at the next follow-up. Later risk was lowest in women who reported no back pain at baseline or either of the first two follow-ups. Back pain carried a worse prognosis if it was disabling or associated with sciatica. Our results confirm the importance of back pain duration and the occurrence of associated disability and sciatica as predictors of future symptoms, and allow more reliable quantification of the natural history of back pain in women of working age. In the absence of other information, the differentials in risk associated with a person's history of back pain appear to remain constant for a period of at least 2 years.

Body mechanics during daily tasks to reduce back pain in women who are pregnant

Although pregnancy is a temporary condition, the prevalence of back pain has been estimated to be approximately 49-50% and pain may continue post partum. Often women have to limit or curtail daily living activities because of the pain. The purpose of this paper is to describe physical changes that occur during pregnancy and discuss positioning and body mechanics to prevent or reduce back pain during performance of self-care, homemaking and vocational activities. Suggested guidelines for continuation of various physical job demands and safety based on the American College of Obstreticians and Gynecologists are described.

Is epidural anesthesia in labor associated with chronic low back pain? A prospective cohort study.

The association between epidural anesthesia during labor and subsequent postpartum low back pain remains unclear. The objective of this follow-up cohort study was to determine whether epidural anesthesia was associated with chronic back pain 1 yr after delivery. We contacted 329 women by telephone and asked them to complete a standardized questionnaire 1 yr (+/-1 mo) after delivery. One hundred sixty-four women had received epidural analgesia for labor and delivery, and 165 had not. Subjects were asked to quantify their back pain (yes/no, numeric rating score, and interference with daily activities). Differences between the two groups were tested by using the chi2 test and the Mann-Whitney U-test, and logistic regression was used to control for confounding variables. The response rate was 244 of 329 (74%). Responders and nonresponders were similar in their demographic and clinical characteristics. There was no difference in the prevalence of back pain between women who had received epidural anesthesia (12 of 121, 10%) and those who had not (17 of 123, 14%). The adjusted relative risk of low back pain at 1 yr (epidural versus nonepidural) was 0.63 (95% confidence interval 0.25, 1.56). There were also no differences between the two groups on numeric rating scores or level of interference with activities. This prospective follow-up study demonstrated no association between epidural anesthesia for labor and delivery and chronic back pain 1 yr after delivery. We evaluated the presence of low back pain 1 yr after delivery in two groups of women-those who chose epidural analgesia for labor and those who did not. There was no increased risk of back pain in women who had used epidural analgesia. This finding is consistent with those of other North American studies.

Is Epidural Anesthesia in Labor Associated with Chronic Low Back Pain? A Prospective Cohort Study

The association between epidural anesthesia during labor and subsequent postpartum low back pain remains unclear.The objective of this follow-up cohort study was to determine whether epidural anesthesia was associated with chronic back pain 1 yr after delivery. We contacted 329 women by telephone and asked them to complete a standardized questionnaire 1 yr (+/- 1 mo) after delivery. One hundred sixty-four women had received epidural analgesia for labor and delivery, and 165 had not. Subjects were asked to quantify their back pain (yes/no, numeric rating score, and interference with daily activities). Differences between the two groups were tested by using the chi squared test and the Mann-Whitney U-test, and logistic regression was used to control for confounding variables. The response rate was 244 of 329 (74%). Responders and nonresponders were similar in their demographic and clinical characteristics. There was no difference in the prevalence of back pain between women who had received epidural anesthesia (12 of 121, 10%) and those who had not (17 of 123, 14%). The adjusted relative risk of low back pain at 1 yr (epidural versus nonepidural) was 0.63 (95% confidence interval 0.25, 1.56). There were also no differences between the two groups on numeric rating scores or level of interference with activities. This prospective follow-up study demonstrated no association between epidural anesthesia for labor and delivery and chronic back pain 1 yr after delivery. Implications: We evaluated the presence of low back pain 1 yr after delivery in two groups of women-those who chose epidural analgesia for labor and those who did not. There was no increased risk of back pain in women who had used epidural analgesia. This finding is consistent with those of other North American studies. (Anesth Analg 1997;85:1066-70)

Oral contraceptives and back pain in women in a Swedish community.

Female back pain is a clinical problem-especially low back pain with symptoms from the pelvic posterior region-that is often aggravated in connection with pregnancy and childbirth. Hormones have been suggested as an aetiologic factor. This study is aimed to determine whether additional hormone preparations, i.e. oral contraceptives (OC), may contribute to the increased frequency of such pain. A register study was conducted to investigate the use of drugs and health care use in a female population with known OC consumption. Specifically, we registered the number of primary health care visits for low back pain, comparing OC users with non-OC using age-matched women with otherwise equal circumstances. OC users recorded a significantly higher incidence of low back symptoms during the study period compared to non-users. Pregnancy was not found to be a confounding factor. The intriguing association between OC use and a higher incidence of low back pain, does not enable us to conclude that there is a causal connection, but it should lead to further studies.

Manual handling activities and risk of low back pain in nurses.

To investigate the risk factors for low back pain in hospital nurses, with particular emphasis on the role of specific nursing activities. A cross sectional survey of 2405 nurses employed by a group of teaching hospitals was carried out. Self administered questionnaires were used to collect information about occupational activities, non-occupational risk factors for back symptoms, and history of low back pain. The overall response rate was 69%. Among 1616 women, the lifetime prevalence of back pain was 60% and the one year period prevalence 45%. 10% had been absent from work because of back pain for a cumulative period exceeding four weeks. Rates in men were generally similar to those in women. In women back pain during the previous 12 months was weakly associated with height, and was significantly more common in those who reported frequent non-musculoskeletal symptoms such as headache and low mood. After adjustment for height and non-musculoskeletal symptoms, significant associations were found with frequency of manually moving patients around on the bed, manually transferring patients between bed and chair, and manually lifting patients from the floor. In contrast, no clear increase in risk was found in relation to transfer of patients with canvas and poles, manually lifting patients in and out of the bath, or lifting patients with mechanical aids. Confirmation of these findings is now being sought in a prospective study of the same population. This study confirms that low back pain is highly prevalent among nurses and is associated with a high level of sickness absence. People who often report non-musculoskeletal symptoms were significantly more likely to report low back pain. Specific manual handling tasks were associated with an increased risk of back pain; however, no such association was found with mechanised patient transfers.

Influence of physical, psychological and behavioural factors on consultations for back pain.

Over 34,000 questionnaires were used to study occurrence and consultations for back pain in the community. The 12-month period prevalence was 24% and 13% of the sample consulted a doctor. Elderly women were at greatest risk of back pain. The consultation rate increased in both sexes throughout middle age, but declined in men over the age of 55 yr. Back pain was associated with the Goldberg General Health Health Questionnaire score suggesting psychiatric morbidity [odds ratio (OR) = 2.05; confidence interval (CI) 1.89-2.23], obesity (OR = 1.59; CI 1.40-1.79), and cigarette smoking (OR = 1.52; CI 1.36-1.70). Vigorous daily activity was positively associated with back pain in men aged 18-39 yr (OR = 1.37; CI 1.02-1.85), and women aged 18-39 yr (OR = 1.50; CI 1.08-2.09), but was negatively associated with back pain in women aged over 65 yr (OR = 0.35; CI 0.16-0.76). Alcohol consumption was also negatively associated with back pain (OR = 0.72; CI 0.62-0.85). The prevalence of arthritis, constipation and respiratory disorders was increased in those who consulted for back pain corrected for the other variables. Thus back pain was substantially more common in women compared to men over 55 yr. Psychiatric morbidity, cigarette smoking and obesity were associated with back pain at all ages, but the effect of physical exercise appeared to change with age. Further studies are required to explain the sex differences and nature of the associations.