Lifetime Prevalence Of Low Back Pain Research Articles

Sex differences in lifetime prevalence of low back pain: A multinational study of opposite-sex twin pairs.

Low back pain (LBP) is more likely to occur in people with a family history of this condition, highlighting the importance of accounting for familial factors when studying the individual risk of LBP. We conducted a study of opposite-sex twin pairs investigating sex differences in LBP while accounting for (genetic and shared environmental) familial factors. We applied a matched co-twin control design to study 795 adult opposite-sex pairs from Australia, Spain, and the United States (US). We used mixed-effects logistic regression to assess the within-pair association between female sex and lifetime prevalence of LBP in unadjusted and adjusted models for body-mass-index, and depression, as well as interactions between female sex and age (<median age vs. ≥median age) in this association. The mean age of the sample was 47.4 years (Standard Deviation = 16.5). The adjusted odds ratio (aOR) of the association between sex and LBP in the merged sample was 1.11 (95% Confidence Interval = 0.88-1.40), with 87.4% of the variance in the studied association explained by between-site heterogeneity (Q test; p = 0.001). Females had 2.37 (95% CI: 1.48-3.78) higher odds of LBP compared to their male co-twins in the Spanish sample (adjusted), but a sex association was not found in the Australian nor US samples. We found no evidence of the association between sex and LBP in our merged sample. Between-population differences (i.e. cultural background or health system characteristics) are likely to be major factors leading to variation in the sex association with LBP when familial factors are accounted for. Our study of adult opposite-sex twin pairs found no evidence of an association between female sex and lifetime prevalence of low back pain after controlling for familial factors in the merged sample from Australia, Spain and USA, contrary to findings from previous studies of unrelated individuals. Our findings indicate potentially relevant between-country genetic, cultural and environmental differences which may need to be considered for optimal and individualized strategies for the prevention and management of low back pain across the lifespan.

Low Back Pain Among Students of Medical University of Tunis.

Low Back Pain (LBP) is the most common musculoskeletal disorder among working adults. It is one of the most prevalent complaints among students. Medical students are among those who are most exposed to this condition; due to stress, numerous hours of studying, and the sedentary lifestyle. Our study aimed to determine the prevalence and associated factors of LBP among the students of Tunis Faculty of Medicine and to assess its impact on student life. This cross-sectional study was carried out on the Tunis Faculty of Medicine students. Data were collected through an online self-administered questionnaire. Sociodemographic, personal, and lifestyle characteristics were collected. LBP was assessed using the Nordic Musculoskeletal Health Questionnaire and Its impact using the Oswestry Disability Index (ODI). One hundred and forty-eight students were included. The mean age was 22.9 ± 2.3 years (19.64-38.21). The sex ratio was 0.29. According to the Nordic questionnaire, the point, annual and lifetime prevalence of LBP were 37.8%, 80.4%, and 90.5%, respectively. The mean ODI score was 10.32 ± 8.48 % (0-32). The ODI score was minimal in 87.3% and moderated in 12.7% of cases. The associated factors with LBP were: young age (p = 0.015), spending more than 4 hours in a sitting position (p = 0.059), second cycle of medical studies (p = 0.006), low screen projection in the amphitheater (p = 0.029) and poor layout of the amphitheatres (p = 0.000). The feeling of depression was significantly higher among LBP students (p = 0.018). In the multivariate analysis, the factors that remained statistically significant were the second cycle of medical studies (OR= 3.41), feeling of depression (OR = 3.7), and the belief in the responsibility for the poor layout of the amphitheaters in the genesis or maintenance of LBP (OR = 7.66). LBP in medical students is multifactorial across both personal and college-life domains.

Survey on Low Back Pain among Cyclists: Prevalence, Risk Factors and Knowledge of Injury Prevention Strategies

The study aimed to determine prevalence of low back pain (LBP), risk factors, and knowledge of injury prevention strategies in recreational cyclists. Materials and methods. This cross-sectional quantitative study included 141 adult recreational cyclists aged 18 to 70. LBP prevalence was determined using a standard Nordic questionnaire. In addition, a validated self-developed questionnaire was used to assess knowledge level, with a high score representing the highest level of knowledge. Frequencies and percentages were used to report the descriptive variables, whereas the Chi-square test was used to determine the association between risk factors and LBP. Results. The study identified that 55.3% of cyclists had a lifetime prevalence of LBP, and 35.5% reported LBP in the past 12 months. However, no significant association (p&gt;0.05) was found between the risk factor and the LBP. Despite this, a low level of knowledge of injury prevention strategies for recreational cyclists was found. Conclusions. This survey found that recreational cyclists have a low level of understanding about crucial bicycle characteristics such as seat height, saddle tilt, and handlebar position to maintain optimal body biomechanics. Recreational cyclists should be educated on the need for appropriate bicycle modifications and ergonomics, effective warm-up, stretching, and cool-down techniques, and some critical injury prevention strategies, especially in the low back.

Prevalence of low back pain in India: A systematic review and meta-analysis.

Although many studies have investigated the prevalence of low back pain (LBP) among Indian subjects, no meta-analysis has been conducted to determine the comprehensive epidemiological point, annual, lifetime prevalence of LBP among Indian subjects. The purpose of this systematic review and meta-analysis was to investigate the point, annual, and lifetime prevalence of LBP in the Indian population. We searched PubMed, Embase, Science Direct, and Cochrane Library databases for relevant studies that reported point, annual, or lifetime prevalence of LBP among Indian subjects. Pooled point, annual and lifetime prevalence rates were calculated. Meta-analysis, subgroup analysis, sensitivity analysis and publication bias assessment were performed. Ninety-seven studies were included in this review. Fifty-four studies included in the review (55.5%) were found to be of higher methodological quality. The pooled point, annual, and lifetime prevalence of LBP in India was 48% (95% CI 40-56%); 51% (95% CI 45-58%), and 66% (95% CI 56-75%), respectively. The pooled prevalence rates were highest among females, the rural population, and among elementary workers. The point, annual, and lifetime prevalence rates of LBP in the Indian population is higher compared to global and other ethnic populations affecting a large proportion of the population, especially among women, rural population and in elementary workers. The findings of this study can be the basis for formulating policy regarding the prevention and treatment of LBP in a large part of the global population.

The intervertebral disc during growth: Signal intensity changes on magnetic resonance imaging and their relevance to low back pain.

Life-time prevalence of low back pain (LBP) in children and adolescents varies from 7% to 72%. Disc changes on magnetic resonance imaging (MRI) have been reported in up to 44% of children with earliest observations around pre-puberty. In this longitudinal cohort study, our objective was to determine the natural history of disc changes from childhood to early adulthood, and the possible association of these changes to LBP. Healthy 8-year-old schoolchildren were recruited for this longitudinal study consisting of a semi-structured interview, a clinical examination, and an MRI investigation at the age of 8-9 (Y8), 11-12 (Y12) and 18-19 (Y19) years. The interview inquired about LBP without trauma. T2-weighted sagittal MRI of the lumbar spine was acquired. Life-long prevalence of LBP was determined, and the disc signal intensity (SI) at the three lowest lumbar levels was assessed both visually using the Schneiderman classification (Bright-Speckled-Dark), and digitally using the disc to cerebrospinal fluid -SI ratio. Possible associations between SI changes and LBP were analyzed. Ninety-four of 208 eligible children were included at Y8 in 1994, 13 and 23 participants were lost to follow-up at Y12 and Y19, respectively. Prevalence of LBP increased after the pubertal growth spurt reaching 54% at Y19. On MRI, 18%, 10% and 38% of participants had disc SI changes at Y8, Y12 and Y19, respectively. No significant associations between self-reported LBP and either qualitative or quantitative disc SI changes were observed at any age. Life-time prevalence of LBP reached 54% by early adulthood. Disc SI changes on MRI traditionally labeled as degenerative were seen earlier than previously reported. Changes in disc SI were not associated with the presence of LBP in childhood, adolescence or early adulthood.

Prevalence and associated risk factors of low back pain among users of a primary health care clinic serving semi-urban and rural settlements in KwaZulu-Natal, South Africa.

Low back pain (LBP) is one of the most frequent musculoskeletal conditions and a common work-related health problem. In South Africa, people from lower socio-economic strata are involved in physical labour and also have unequal access to health services. There is minimal data on the prevalence of LBP in these communities. This study determined the prevalence and associated risk factors of LBP among public sector health care users in a semi-urban/rural area of KwaZulu-Natal, South Africa. The study was conducted at a primary health care clinic in the Umdoni municipality, KwaZulu-Natal, South Africa. Convenience sequential sampling was used. An interviewer-administered questionnaire was utilized due to literacy constraints. Participants (n=400) answered the questionnaire in either English or isiZulu. The lifetime prevalence of LBP was 79.3%. Female gender and lifting heavy objects were associated with LBP. The direct impact of LBP was faced in the work place resulting in absenteeism, often followed by unemployment. In this setting, where the prevalence of LBP was high, specialized treatments for LBP were not available at the primary health care facility. Incorporation of such treatments will be useful, for people in lower socio-economic strata, to overcome the burden of LBP.

Prevalence of Low Back Pain among Primary School Students from the City of Valencia (Spain)

It is well-known that low back pain (LBP) prevalence is high among school-age children. However, literature concerning the initial onset of back pain between the ages of three and eleven years is scarce. The present study aims to analyze the prevalence of LBP in kindergarten and primary school students. A total of 278 (9.9 ± 2.1 years old; 52.2% girls) students from two public kindergartens and primary schools in Valencia (Spain) participated in this cross-sectional study. The Nordic questionnaire on LBP was used to assess the onset and duration of LBP symptoms. The lifetime prevalence of LBP was 47.5% (n = 132), the last year’s prevalence was 44.2% (n = 123), and last week’s prevalence was 18.8% (n = 50). Boys and girls reported a lifetime prevalence of 52.3% (n = 64) and 47.7% (n = 63) (p = 0.186, Fisher’s exact test, 2-sided), respectively. By age group, lifetime episodes of LBP became more prevalent with increasing age (p < 0.001, Fisher’s exact test, 2-sided). In summary, our findings show that LBP increases with age and further strengthens the evidence that LBP onset could start as young as 10 years of age.

Prevalence and associated factors of low back pain in an urban Nigerian community

INTRODUCTION: Low Back Pain (LBP) constitutes a public health problem as almost every individual is expected to experience LBP at least once during their lifetime. OBJECTIVE: This study is done to determine the prevalence of LBP and associated factors in an urban Nigerian community. METHODS AND MATERIALS: This cross-sectional household survey randomly selected 741 subjects using a 4-stage sampling technique. Data were obtained through a self-administered semi-structured questionnaire. Association between categorical variables and LBP was analyzed using the Chi-square test and multiple logistic regression model (?=0.05). RESULTS: Mean age of participants was 41.32 ± 15.24 years. The point, annual, and lifetime prevalence of LBP were 31.2%, 61.1%, and 70.6% respectively. Aged 40 years and above (p=0.006), being an artisan (p=0.005) or trader (p=0.007) compared to being an office worker (p=0.071), and continuously sitting more than 3 to 4 hours (p&lt;0.001) are factors significantly associated with LBP. Others are transport duration to/from work more than or equal to 30 minutes (p&lt;0.001), computer use (p&lt;0.001), trauma history (p=0.045), never attending a health talk on back care (p&lt;0.001), tobacco smoking history (p=0.006) and having an occasional (p=0.002) or no exercise routine (p&lt;0.001). CONCLUSION: LBP is common among individuals in the study area with a point, annual, and lifetime prevalence of 31.2%, 61.1%, and 70.6% respectively. Interventions on LBP prevention should target correction of identified modifiable associated factors such as poor posture, physical inactivity and lack of information on LBP.

Cohort profile: the AUstralian Twin BACK pain and physical activity study (AUTBACK study)

PurposeDespite the growing evidence that physical activity and familial factors play a role in low back pain (LBP), there is a lack of robust longitudinal studies that (1) investigate the...

Mapping evidence on the prevalence, incidence, risk factors and cost associated with chronic low back pain among adults in Sub-Saharan Africa: a systematic scoping review protocol

BackgroundGlobally, low back pain (LBP) is a major public health problem affecting mainly adults of the working class and is the leading cause of disability. The estimated lifetime prevalence of LBP is 50 to 80%. From 1990 to 2015, the years lived with disability caused by LBP have scaled up by 54% with the greatest increase observed in low-middle-income countries (LMICs). LBP poses a significant socio-economic burden to the society regardless of all the technological advancement in diagnosis and intervention approaches in recent years. Despite an increase in the literature of LBP in LMICs, chronic low back pain (CLBP) is poorly investigated yet it is responsible for the largest amount of burden. The purpose of this scoping review is to map the existing evidence on the prevalence, incidence, mortality, risk factors, and cost associated with CLBP among adults in Sub-Saharan Africa (SSA).MethodsWe will conduct a scoping review to explore, describe, and map literature on the prevalence, incidence, mortality, risk factors, and costs associated with CLBP among adults in SSA. The search will be performed using the EBSCOhost platform by searching the following databases within the platform: Academic search complete, health source: nursing/academic edition, CINAHL with full text, Embase, PubMed, MEDLINE, Science Direct databases, Google Scholar, and the World Health Organization library databases. The search will include peer-reviewed, review articles, and gray literature. The first (title and abstract) and the second (full text) screening phases will be performed by two independent reviewers, with the third reviewer employed to adjudicate discrepancies. The reference list of all included articles will also be searched for eligible articles. This scoping review will be reported in accordance to the MOOSE and PRISMA-ScR guidelines. The NVivo 12 data analysis software will be used to generate themes, and a thematic content analysis will be used to give the narrative account of the review.DiscussionThe study anticipates finding relevant literature on the prevalence, incidence, risk factors, mortality, and cost associated with CLBP among adults in SSA. The study outcomes will aid in identifying research gaps, planning, informing policy, commissioning of future research, and funding prioritization.

The Epidemiology of Low Back Pain and Injury in Dance: A Systematic Review.

Dance is a physical pursuit that involves loading the spine through repetitive dynamic movements and lifting tasks. As such, low back pain (LBP) and low back injury (LBI) have been identified as common health problems in contemporary and classical ballet dancers. However, clarity regarding the experience of LBP and LBI in dance is lacking. To systematically review and synthesize the epidemiology of LBP and LBI in dance populations. A comprehensive search of 6 electronic databases, back catalogs of dance science-specific journals, and reference lists of relevant articles and a forward citation search were performed. Fifty full-text articles were included in the final systematic review. There was considerable methodological heterogeneity among the included studies. The median (range) point, yearly, and lifetime prevalence of LBP was 27% (17%-39%), 73% (41%-82%), and 50% (17%-88%), respectively. The lower back contributed to 11% (4%-22%) of time loss and 11% (5%-23%) of medical-attention injuries. Dancers are vulnerable to LBP and LBI. The use of definitions that are sensitive to the complexity of LBP and LBI would facilitate improved understanding of the problem within dance, inform health care strategies, and allow for monitoring LBP-specific intervention outcomes. J Orthop Sports Phys Ther 2019;49(4):239-252. Epub 18 Jan 2019. doi:10.2519/jospt.2019.8609.

Does sedentary behavior increase the risk of low back pain? A population-based co-twin study of Spanish twins

BackgroundThe relationship between sedentary lifestyle and low back pain (LBP) remains unclear and previous research has not accounted for genetic and early environmental factors. PurposeOur aim was to investigate if sedentary behavior is associated with the lifetime prevalence of persistent LBP and the risk of developing persistent LBP, care-seeking due to LBP, and activity limiting LBP when genetics and early environmental factors are accounted for. Study DesignBoth cross-sectional and longitudinal designs with a within-pair twin case-control were implemented. Patient SampleThere were 2,148 twins included in the cross-sectional analysis whereas 1,098 twins free of persistent LBP at baseline were included in the longitudinal analysis. Outcome MeasuresSedentary behavior was the explanatory variable. Lifetime prevalence of LBP was the outcome variable in the cross-sectional analysis. The incidence of persistent LBP, care-seeking due to LBP, and activity limiting LBP were the outcome variables for the longitudinal analysis. MethodsThis observational study was supported by a grant in 2012. No competing interests were declared. ResultsIn the cross-sectional analysis, sedentary behavior was slightly associated with an increased prevalence of persistent LBP in females but not in males. This association was not apparent when genetics and early environmental factors were accounted for. We acknowledge that the small sample included in the co-twin analyses have yielded wide confidence intervals, and that caution should be exercised when interpreting and an association may not be ruled out. In the longitudinal analysis, sedentary behavior did not significantly increase the risk of persistent LBP, care-seeking due to LBP, or activity limiting LBP. ConclusionsSedentary behavior is associated with concurrent LBP. However, this association is weak; it only appears in females and decreases when accounting for genetics. Future studies using a twin design with larger samples should be conducted to further test these findings.

Life history and point prevalence of low back pain in pre-professional and professional dancers

ObjectivesTo investigate lifetime history and point prevalence of low back pain (LBP) in pre-professional and professional dancers and to identify any demographic or physical factors associated with LBP in dancers. DesignCross-sectional study. SettingOne pre-professional ballet school, two pre-professional university dance programs, and a professional nationally touring ballet company. ParticipantsMale and female classical ballet and contemporary dancers aged 12 years old and above. Main outcome measuresLifetime history and point prevalence of LBP. ResultsA total of 110 (n = 19 male) dancers (mean (SD) 17.8 (2.9) years old) participated in the study, which represented 50% of the population invited to participate. A 74% lifetime prevalence of LBP was reported by dancers. Point and 12 month prevalence were 24 and 64%, respectively. No significant association was observed between LBP and any demographic or physical variables. ConclusionPre-professional and professional dancers have an increased vulnerability to LBP. The development of LBP within this population is complex and may not be associated with individual factors measured in this study.

The prevalence of low back pain in Iranian dentists: An epidemiological study.

Objective:Low back pain (LBP) is one of the most common and prevalent work-related conditions. The aim of this study was to estimate the prevalence and risk factors associated with LBP in dentists and to analyze the association between individual and occupational characteristics and LBP.Methods:Following ethical approval, 300 dentists from Tehran Iran have voluntarily participated. Different questionnaires were completed to collect personal, occupational characteristics and the prevalence and risk factors of LBP. Visual analogue scale and Oswestry disability questionnaires were used to determine pain intensity and level of functional disability.Results:The results indicated that point, last month, last six month, last year and lifetime prevalence of LBP were 24.6%, 24.9%, 27.7%, 28.1% and 31.4%, respectively. A significant correlation was found between the prevalence of LBP and preventive strategies, general health condition, having an assistant and job satisfaction. Body mass index, age and gender were not significantly correlated with the prevalence of Low back painConclusions:The prevalence of Low back pain in dentists appears to be high. Further studies focusing on the effectiveness of different preventive strategies are recommended.

Back pain and MRI changes in the thoraco-lumbar spine of youngelite Mogul skiers.

Athletes have a higher prevalence of LBP and spinal abnormalities on Magnetic Resonance Imaging (MRI) compared to non-athletes. The objective of this study was to investigate the amount of spinal MRI abnormalities and the lifetime prevalence of low back pain (LBP) in 16 young elite Mogul skiers compared to 28 non-athletes in the corresponding age in a cross-sectional design. LBP was assessed by a questionnaire consisting of a part regarding previous or present back pain, the Oswestry disability index, and the EuroQol questionnaire. MRI examinations from Th5 to sacrum were conducted to evaluate spinal pathologies. The Mogul skiers had significantly more MRI abnormalities (like disc degeneration) in mean (7.25 vs 3.78, P<0.023) compared to the controls. No significant difference was seen regarding the lifetime LBP prevalence between the groups (50% vs 42%, P=0.555). No correlation could be found between disc degeneration and back pain in this study. Young elite Mogul skiers, compared to an age-matched control group of non-athletes, have an increased risk of developing spinal abnormalities potentially due to the different high loads that they are subjected to in their sport. Future relationship between the MRI abnormalities and LBP cannot be verified by this study design.

The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey.

Low back pain (LBP) is a public health problem commonly seen in all societies. The aim of this study was to determine the prevalence and specific risk factors of low back pain (LBP) in the central and outlying districts of the province of Trabzon, a Black Sea region of Turkey. A random sample of 7897 (4006 men and 3789 women) adults was collected by using sampling techniques of stratification. In this study questionnaires were completed at face-to-face interviews with participants selected on the basis of place of residence, gender and age group. The used variables in this study were: use of cigarettes, status of marriage, level of education, and presence of chronic disease, the prevalence of lifetime LBP and of LBP in the preceding year. Chronic LBP was determined as being present for more than 6 weeks. The lifetime prevalence of LBP in the general population was determined at 62.1%. Prevalence in the preceding year was 46.1%, and that of LBP lasting more than six week was 18.1%. Lifetime prevalence of LBP, prevalence of LBP in the preceding year and prevalence of pain lasting more than six week were all statistically significantly higher in women (p< 0.001). Use of cigarettes, female gender, marriage, a low level of education and presence of chronic disease were identified as independent risk factors for LBP (p< 0.001). Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles.

Genetics and the environment affect the relationship between depression and low back pain: a co-twin control study of Spanish twins.

Although the co-occurrence of low back pain (LBP) and depression is common, the nature of this association remains unclear. We aimed to investigate whether symptoms of depression are associated with LBP after adjusting for various confounders, including genetics. We used cross-sectional data from 2148 twins from the Murcia Twin Registry, Spain. All twins answered questions about lifetime prevalence of LBP (outcome variable) and symptoms of depression, collected through two instruments, deriving 3 measures: (1) self-report feelings of depression and anxiety; (2) state depression, and (3) trait depression. First, associations were investigated using logistic regression analysis of the total sample. We performed subsequent matched within-pair twin case-control analyses with all complete twin pairs discordant for LBP regardless of zygosity, and separately for dizygotic and monozygotic pairs. This sequential analysis allows for more precise estimates of the relationship between variables, as in each step, the impact of early shared environment and genetics is further considered. Symptoms of depression and anxiety were associated with higher prevalence of LBP in the total sample analysis (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.31-2.05), and this relationship was stronger in the subsequent case-control analysis (OR, 1.74; 95% CI, 1.13-2.69) and dizygotic case-control analysis (OR, 2.39; 95% CI, 1.39-4.08) but disappeared when the analysis was conducted for monozygotic twins (OR, 0.92; 95% CI, 0.42-2.05). A similar pattern was found for state and trait depression. The depression-LBP relationship disappears when high levels of control for confounding factors are applied and seems to be driven by genetic or environmental factors that influence both conditions.

Prevalence of Low Back Pain and Associated Risk Factors Among Adama Hospital Medical College Staff, Ethiopia

Back ground: Low back pain (LBP) is one of the most common work–related health problems among hospital workers. Work–related activities such as twisting, bending, sustained posture, repeated movements are regarded as associated risk factors for low back pain. The aim of this study is to assess the prevalence and associated risk factors of Low Back Pain among hospital workers. Methodology: An institution based cross sectional survey design was conducted among employees in Adama Hospital Medical College (AHMC), Adama Ethiopia. Descriptive statistics, bivariate, and multiple regression analyses were performed. p<0.1 in univariate is considered for multivariate analysis and p<0.05 was used to define statistical significance. Result: Of 263, 137(52.1%) were males and 126(47.9%) were females. The result indicated that the mean and median age of the respondents were 33.5 and 33 years respectively. The life time prevalence of LBP was found to be 50.6% and the 12 month LBP prevalence was 41.4%. Staff not participating in any physical activity (exercise) were more likely to report presence of low back pain (AOR (Adjusted Odd Ratio)=1.75, CI, 1.02-3.02). On the other hand, staff who worked sitting more than 6 hours were associated with increased risk of low back pain(AOR=2.78, CI, 1.09-7.07). Perceived stress often increased risk of low back pain (AOR=2.60, CI, 1.06-6.36). Conclusion: LBP was significantly associated with the obesity, stressed often, those worked in seated position more than six hours and those with long year experience; but doing physical exercise has rather a preventive effect. The findings of this study suggest that primary prevention of LBP should be considered.

Chapter 21 - Low-back pain

Low-back pain is one of the most common painful conditions experienced by humans throughout their life. Some occupational risk factors (namely, heavy manual material handling) may also contribute to the development of low-back pain: due to the high prevalence of both low-back pain and manual material handling in the adult working population, it has been estimated that low-back pain is probably the most common occupational disorder worldwide. Lifetime prevalence of low-back pain has been reported to be as high as 84%, depending on the case definition used, and no age group is spared, even children. Although low-back pain is not a lethal condition, it was estimated at the third rank among all diseases by disability-adjusted life-years in 2010 in the USA, after ischemic heart disease and chronic obstructive pulmonary disease, and at the first rank by years lived with disability. It also ranked high (13th) globally for the same year, in disability-adjusted life-years. Low-back pain is currently classified as nonspecific/specific as to putative cause and as acute (lasting less than 6 weeks), subacute (6-12 weeks), or chronic (more than 12 weeks) according to duration of symptoms. The distinction between nonspecific/specific and acute/subacute/chronic low-back pain is useful not only for epidemiologic studies, but also (mainly) for choosing the appropriate strategy for the diagnosis and treatment of the disorder. Workplace risk factors for low-back pain include manual lifting and whole-body vibration exposure. This chapter will provide an overview of modern concepts of low-back pain (in general) and will then outline some distinctive features of work-related low-back pain.

Body mass index is associated with low back pain in childhood and adolescence: a birth cohort study with a 6-year follow-up in Niigata City, Japan

To investigate the successive change of low back pain (LBP) prevalence in childhood and adolescence and to examine the associations between LBP and extracurricular sports activities (ECSA) or body mass index (BMI) using a 6-year birth cohort study. LBP reports of a grade (4,597 pupils at the beginning) were tracked over 6 years (between the ages of 9 and 14 years old), and anonymous questionnaires were distributed to them yearly. After grading the severity of the LBP into three levels and noting the transitions of the point and the lifetime prevalence of LBP, associations between point prevalence of LBP and BMI or ECSA were evaluated. The point prevalence of LBP had a tendency to become significantly higher as the pupils got older until they became 13 years old. The lifetime prevalence of LBP significantly increased as they got older yearly. As for the severity of LBP among students with a lifetime prevalence, the rate of more severe LBP (levels 2 and 3) increased as they got older. Significant positive associations were recognized between BMI and point prevalence of LBP in every years old (p < 0.05) and between ECSA and point prevalence of LBP at 11 (p = 0.001) and 14 years old (p < 0.001). The point and lifetime prevalence of LBP and the rate of more severe LBP increased as the pupils got older. BMI may be associated with LBP in childhood and adolescence.