Experience Of Low Back Pain Research Articles

The intangible costs of living with low back pain from a patient perspective: a scoping review

Purpose Health-related low back pain costs can be direct monetary, indirect monetary, or intangible, non-monetary. The purpose of this review was to identify the intangible, non-monetary costs of low back pain from the perspective of the individual. Materials and methods A scoping review of literature was undertaken. Four databases were searched up to 6th August 2024. Data were charted and coded using deductively derived categories in line with our purpose; additional categories were developed for text that did not fit these categories. Data were analysed using directed content analysis. Results Forty-six studies met the inclusion criteria. Six categories were derived from the data, which express the experience of the person with low back pain: Perceptions of pain, Experience of healthcare, Becoming defined by low back pain, Life on hold, My social self, and Disrupted work life. Each category explored an aspect of life affected by low back pain. Conclusion This review highlights that low back pain profoundly affects many areas, with implications for peoples’ personal, social, and work lives. Our findings suggest that suffering can be reduced when healthcare practitioners show empathy and legitimise the lived experience of low back pain, acknowledging the restrictions it imposes on peoples’ lives.

Minimally Invasive Spine Surgery for Lumbar Decompression or Disc Herniation

ABSTRACTMany people experience low back pain caused by degenerative disease of the lumbar spine; this includes spinal stenosis, spondylolisthesis, disc degeneration, and disc herniation. Conservative management of degenerative disease, which includes physical therapy, lifestyle modifications, and medications, is the initial approach. If this approach fails, a surgical procedure may be the next step. Previously, open lumbar surgery would have been the planned procedure; today, minimally invasive spine surgery gives patients another choice. Perioperative nurses should understand how minimally invasive spine surgery differs from the open procedure, the steps involved during a minimally invasive procedure, the benefits of this type of procedure, and nursing considerations for patients undergoing minimally invasive spinal procedures.

Assessing the performance of AI chatbots in answering patients’ common questions about low back pain

ObjectivesThe aim of this study was to assess the accuracy and readability of the answers generated by large language model (LLM)-chatbots to common patient questions about low back pain (LBP).MethodsThis...

Investigating basics and principles of ergonomics in the sheet

The development of work-related musculoskeletal disorders depends on the pattern of work and does not belong to a particular industry or occupation. One way to assess the amount of stress and tension on the body is to evaluate posture. The aim of this study was to determine the risk factors for musculoskeletal disorders in cellulose industry workers. Study, 22 stations were examined using RULA method, of which 7 stations were at level 2, 14 stations were at level 3 and one station was at level 4. 14 stations were surveyed using REBA method, among which, 2 stations were at level 1 and 12 stations were at level 2. Also, 38 stations were surveyed using the KIM-LHC method, of which 26 stations were at level 2 and 12 stations were at level 3. Statistical studies showed that there was a significant relationship between low back pain and work experience at the level of 0.01. The prevalence of shoulder, arm, back and leg pain was significantly different between men and women at the level of 0.01. There was also a significant relationship between the prevalence of musculoskeletal disorders in the lumbar and shoulder area over a period of time and the level of risk of work postures. The results of the study showed that the prevalence of musculoskeletal disorders and risk levels calculated by RULA and KIM methods were high in the subjects, but the risk level calculated by REBA method was low and moderate. Therefore, any program to prevent the occurrence of these disorders in the workplace and control the relevant ergonomic risk factors and take corrective measures to improve working conditions at all stages of production, is necessary.

Do individuals' beliefs vary based on low back pain (LBP) experience or health care professional exposure for LBP care?

Background Maladaptive beliefs about low back pain (LBP) are associated with increased pain levels and may impede recovery from LBP episode. The objective of this study was to assess the Saudis' LBP-related beliefs and attitudes related to their LBP experience and health care professional (HCP) exposure. The secondary objective was to examine the psychological distress and health-related quality of life (HRQoL) related to their LBP experience and HCP exposure. Methods This study was a cross-sectional online survey which included Saudis adults with or without LBP. The LBP-related beliefs and attitudes were assessed using the Back Pain Attitudes Questionnaire (Back-PAQ). The psychological status and HRQoL were measured using the Depression, Anxiety and Stress Scale-12 (DASS-12) and 12-item Short Form (SF-12), respectively. Results There were 598 people (median age [IQR]: 30 [16]) responded to the survey invitation (419 of them had LBP). Of those who have LBP, 22% visited HCP for LBP. There were no significant differences found in LBP-related beliefs when comparing people with LBP with those without LBP (p = 0.744). There were no significant differences found in LBP-related beliefs, psychological distress, or HRQoL, when comparing LBP individuals who visited HCPs with those who did not. Compared to those with LBP, people without LBP had significantly better HRQoL and lower psychological distress. Conclusion Respondents experiencing LBP held the same negative beliefs as those who were not experiencing LBP. No differences in LBP-related beliefs were found between people who visited HCP and those who did not seek care.

A Decision Aid for Patients Considering Surgery for Sciatica: Codesign and User-Testing With Patients and Clinicians.

Surgery can help patients with leg pain caused by sciatica recover faster, but by 12 months outcomes are similar to nonsurgical management. For many the decision to have surgery may require reflection, and patient decision aids are an evidence-based clinical tool that can help guide patients through this decision. The aim of this study was to develop and refine a decision aid for patients with sciatica who are deciding whether to have surgery or 'wait and see' (i.e., try nonsurgical management first). Semistructured interviews with think-aloud user-testing protocol. Twenty clinicians and 20 patients with lived experience of low back pain or sciatica. Items from Technology Acceptance Model, Preparation for Decision Making Scale and Decision Quality Instrument for Herniated Disc 2.0 (knowledge instrument). The prototype integrated relevant research with working group perspectives, decision aid standards and health literacy guidelines. The research team refined the prototype through seven rounds of user-testing, which involved discussing user-testing feedback and implementing changes before progressing to the next round. As a result of working group feedback, the decision aid was divided into sections: before, during and after a visit to the surgeon. Across all rounds of user-testing, clinicians rated the resource 5.9/7 (SD = 1.0) for perceived usefulness, and 6.0/7 for perceived ease of use (SD = 0.8). Patients reported the decision aid was easy to understand, on average correctly answering 3.4/5 knowledge questions (SD = 1.2) about surgery for sciatica. The grade reading score for the website was 9.0. Patients scored highly on preparation for decision-making (4.4/5, SD = 0.7), suggesting strong potential to empower patients. Interview feedback showed that patients and clinicians felt the decision aid would encourage question-asking and help patients reflect on personal values. Clinicians found the decision aid acceptable, patients found it was easy to understand and both groups felt it would empower patients to actively engage in their care and come to an informed decision that aligned with personal values. Input from the working group and user-testing was crucial for ensuring that the decision aid met patient and clinician needs. Patients and clinicians contributed to prototype development via the working group.

Supporting self-management of low back pain with an internet intervention with and without telephone support in primary care (SupportBack 2): a randomised controlled trial of clinical and cost-effectiveness

Low back pain is prevalent and a leading cause of disability. We aimed to determine the clinical and cost-effectiveness of an accessible, scalable internet intervention for supporting behavioural self-management (SupportBack). Participants in UK primary care with low back pain without serious spinal pathology were randomly assigned 1:1:1 using computer algorithms stratified by disability level and telephone-support centre to usual care, usual care and SupportBack, or usual care and SupportBack with physiotherapist telephone-support (three brief calls). The primary outcome was low back pain-related disability (Roland Morris Disability Questionnaire [RMDQ] score) at 6 weeks, 3 months, 6 months, and 12 months using a repeated measures model, analysed by intention to treat using 97·5% CIs. A parallel economic evaluation from a health services perspective was used to estimate cost-effectiveness. People with lived experience of low back pain were involved in this trial from the outset. This completed trial was registered with ISRCTN, ISRCTN14736486. Between Nov 29, 2018, and Jan 12, 2021, 825 participants were randomly assigned (274 to usual care, 275 to SupportBack only, 276 to SupportBack with telephone-support). Participants had a mean age of 54 (SD 15), 479 (58%) of 821 were women and 342 (42%) were men, and 591 (92%) of 641 were White. Follow-up rates were 687 (83%) at 6 weeks, 598 (73%) at 3 months, 589 (72%) at 6 months, and 652 (79%) at 12 months. For the primary analysis, 736 participants were analysed (249 usual care, 245 SupportBack, and 242 SupportBack with telephone support). At a significance level of 0·025, there was no difference in RMDQ over 12 months with SupportBack versus usual care (adjusted mean difference -0·5 [97·5% CI -1·2 to 0·2]; p=0·085) or SupportBack with telephone-support versus usual care (-0·6 [-1·2 to 0·1]; p=0·048). There were no treatment-related serious adverse events. The economic evaluation showed that the SupportBack group dominated usual care, being both more effective and less costly. Both interventions were likely to be cost-effective at a threshold of £20 000 per quality adjusted life year compared with usual care. The SupportBack internet interventions did not significantly reduce low back pain-related disability over 12 months compared with usual care. They were likely to be cost-effective and safe. Clinical effectiveness, cost-effectiveness, and safety should be considered together when determining whether to apply these interventions in clinical practice. National Institute for Health and Care Research Health Technology Assessment (16/111/78).

Low back pain patients' experience and expectations: A qualitative study focusing on physiotherapist and physician care.

Low back pain (LBP) is a common and disabling musculoskeletal disorder. LBP experiences and expectations can vary from one person to another and influence their clinical outcomes. Despite the existence of numerous evidence-based treatment recommendations, LBP management in primary care remains challenging. This study aims to investigate the experiences and expectations of patients with LPB in primary care settings. A qualitative study with an inductive thematic analysis was conducted. Semi-structured interviews were performed using individuals who had experienced LBP in the past year and had consulted a family physician (FP) or a physiotherapist (PT). Ten participants with LBP were interviewed (5 women, 5 men, mean age 49±17). Five themes were identified: (1) I am always upset because I can't do anything; (2) I waited to consult; I thought it would go away; (3) I want to see what is going on with my LBP; (4) I want to see the person that will provide the right treatment; (5) I need support to get over it. Participants consulted when their pain was severe and disabling. They expected an imaging test to explain the cause of their LBP and placed more importance on the imaging test results than the FP's or PT's evaluation. Their opinions on care selection and being listened to were important for the participants. This study has highlighted the importance of the patient's point of view in their care. This consideration is important to ensure a comprehensive and collaborative approach with evidence-based practice care.

Quality of Life in Patients with Chronic Low Back Pain and Differences by Sex: A Longitudinal Study.

The experience of chronic low back pain has a significant impact on the quality of life of affected people, resulting in difficulties in performing basic activities of daily living. To study the perceived quality of life of people affected by chronic low back pain and the associated factors by sex. A prospective, longitudinal and observational design was used. A total of 129 people (58.1% women) with chronic low back pain were studied. The mean pain intensity scores were of moderate severity (6.42 points), with a modest improvement at follow-up (6.17 points). Epidural nerve blocks were the most effective therapeutic intervention in reducing the intensity of pain. Participants described a negative perception of their health with regard to quality of life, with low scores for the two constructs both at baseline (health index, 0.444; perception of health, 38.76 points) and at follow-up (health index, 0.447; perception of health, 40.43 points). Participants had severe functional limitation scores (50.79 points). The results were significantly better among men. There was an inverse relationship between the average pain intensity (β = -0.304; p < 0.001), functional limitation (β = -0.466; p < 0.001) and mental health (β = -0.565; p < 0.001) and quality of life. The chronification of low back pain complicates people's biopsychosocial adaptation to life. There is a longitudinal inverse association between pain and functional limitation and health-related quality of life.

Intervertebral disc injury triggers neurogenic inflammation of adjacent healthy discs

BACKGROUND CONTEXTIntervertebral disc degeneration is common and may play an important role in low back pain, but it is not well-understood. Previous studies have shown that the outer layer of the annulus fibrosus of a healthy disc is innervated by nociceptive nerve fibers. In the process of disc degeneration, it can grow into the inner annulus fibrosus or nucleus pulposus and release neuropeptides. Disc degeneration is associated with inflammation that produces inflammatory factors and potentiates nociceptor sensitization. Subsequently neurogenic inflammation is induced by neuropeptide release from activated primary afferent terminals. Because the innervation of a lumbar disc comes from multisegmental dorsal root ganglion neurons, does neurogenic inflammation in a degenerative disc initiate neurogenic inflammation in neighboring healthy discs by antidromic activity? PURPOSEThis study was based on animal experiments in Sprague-Dawley rats to investigate the role of neurogenic inflammation in adjacent healthy disc degeneration induced by disc injury. STUDY DESIGNThis was an experimental study. METHODSSeventy-five 12-week-old, male Sprague-Dawley rats were allocated to 3 groups (sham group, disc injury group and disc injury+TrkA antagonist group). The disc injury group was punctured in the tail disc between the eighth and ninth coccygeal vertebrae (Co8–9) to establish an animal model of tail intervertebral disc degeneration. The sham group underwent only skin puncture and the disc injury+TrkA antagonist group was intraperitoneally injected with GW441756 two days before disc puncture. The outcome measure included quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTSDisc injury induced an increase in aggrecan, NGF, TrkA, CGRP, SP, IL-1β, and IL-6 mRNA levels in the injured (Co8–9) and adjacent discs (Co7–8), which reached a peak on day 1, then gradually decreased, and returned to normal on day 14. After intraperitoneal injection of GW441756 prior to puncture, the mRNA levels of the above indicators were down-regulated in Co7–8 and Co8–9 intervertebral discs on the 1st and 7th days. The protein content of the above indicators in Co7–8 and Co8–9 intervertebral discs showed roughly the same trend as mRNA levels. CONCLUSIONSDegeneration of one disc can induce neurogenic inflammation of adjacent healthy discs in a rat model. CLINICAL SIGNIFICANCEThis model supports a key role of neurogenic inflammation in disc degeneration, and may play a role in the experience of low back pain.

Musculoskeletal physiotherapists' discharge practices for people treated with low back pain: A United Kingdom survey.

Persistent low back pain (LBP) is the leading cause of disability, and a major burden on the healthcare system globally. Many people with LBP experience recurrent pain flares and receive repeated appointments and re-referrals to services such as physiotherapy. However, it is not clear what the criteria are for discharging people with LBP from physiotherapy services. This study aims to describe the current practices for discharging people from physiotherapy for LBP in the United Kingdom (UK). A cross-sectional study using an anonymous online national (UK) survey was conducted among qualified physiotherapists who treat people with LBP in UK musculoskeletal out-patient services. A total of 104 surveys were completed. The majority of respondents reported using (i) a shared decision-making (77%) and (ii) person-physiotherapist goal attainment (74%) approach to discharging people with LBP. Sixty-three percent of respondents reported using a patient-initiated follow-up (PIFU) approach. Only 8% of respondents reported using a graded discharge approach with 'booster' appointments. A PIFU or graded discharge approach was considered most pertinent for people at higher risk of a pain flare (97%; 86%) and with low self-efficacy to self-manage their LBP. This UK survey established that discharge practices for people with LBP after physiotherapy vary. Whilst the majority of people are currently discharged with a PIFU appointment, a graded discharge approach may be more beneficial for people who are less likely to initiate a PIFU appointment. Further consideration on the development of such a pathway is now required.

Distress in the care of people with chronic low back pain: insights from an ethnographic study.

Distress is part of the experiences and care for people with chronic low back pain. However, distress is often pathologised and individualised; it is seen as a problem within the individual in pain and something to be downplayed, avoided, or fixed. To that end, we situate distress as a normal everyday relational experience circulating, affecting, moving in, through, and across bodies. Challenging practices that may amplify distress, we draw on the theorisation of affect as a relational assemblage to analyse physiotherapy clinical encounters in the care of people with chronic low back pain. Adopting a critical reflexive ethnographic approach, we analyse data from a qualitative project involving 15 ethnographic observations of patient-physiotherapist interactions and 6 collaborative dialogues between researchers and physiotherapists. We foreground conceptualisations of distress- and what they make (im)possible-to trace embodied assemblage formations and relationality when caring for people with chronic low back pain. Our findings indicate that conceptualisation matters to the clinical entanglement, particularly how distress is recognised and navigated. Our study highlights how distress is both a lived experience and an affective relation-that both the physiotherapist and people with chronic low back pain experience distress and can be affected by and affect each other within clinical encounters. Situated at the intersection of health sociology, sociology of emotions, and physiotherapy, our study offers a worked example of applying an affective assemblage theoretical framework to understanding emotionally imbued clinical interactions. Viewing physiotherapy care through an affective assemblage lens allows for recognising that life, pain, and distress are emerging, always in flux. Such an approach recognises that clinicians and patients experience distress; they are affected by and affect each other. It demands a more humanistic approach to care and helps move towards reconnecting the inseparable in clinical practice-emotion and reason, body and mind, carer and cared for.

Sciatica in primary care – a case discussion

It is thought that more than half of adults will experience back pain in their life, and practice nurses will often be the first practitioners consulted. Cheryl Johnson and Gerri Mortimore explain what nurses need to know when they encounter this common complaint. Back pain is a common problem encountered in practice. It is estimated that 60% of the adult population experience low back pain throughout their lifetime ( Campbell and Colvin, 2013 ) that over 80% of the population will report low back pain throughout their lifetime (Walker, 2000) with between 13–40% developing sciatica ( NICE, 2022 ). This article will discuss a case study who presented to a community trainee enhanced clinical practitioner (tECP) with symptoms of lumbar radiculopathy. and After clinical examination and further tests a diagnosis of acute sciatica was given. This article will explore how the history taking, clinical examination and special tests led to this diagnosis. Moreover, it will examine the underlying evidence underpinning the examination and tests undertaken.

Women grip strengths and lifetime experiences of low back pain were not influenced by the frequency of lifting family members with severe cerebral palsy rated to GMFCS level IV and V

Women grip strengths and lifetime experiences of low back pain were not influenced by the frequency of lifting family members with severe cerebral palsy rated to GMFCS level IV and V

Analisis Postur Kerja dengan Menggunakan Perbandingan Metode RULA REBA dan OWAS pada Pegawai PT. Surya Segara Safety Marine Paper

PT Surya Segara Safety Marine is a marine equipment trading and maritime security equipment servicing company in Indonesia that has four branches in Balikpapan, Makassar, Banyuwangi, and Bali. In their work, there are workers who have not implemented ergonomic working positions. This research aims to determine the action level value from the comparison scores of the RULA, REBA, and OWAS methods. From the research that has been carried out, it is known from the NBM questionnaire that 77% of workers experience back pain and 70% experience low back pain. Regarding the scoring results, a RULA score of 7 is very high risk, a REBA score of 9 is high risk, and an OWAS score of 2 is moderate risk. Based on the data obtained, the RULA method is most suitable because of the complaints felt by workers in the upper body. So a proposal to improve a table that can rotate and a chair that can be adjusted in height was made, which received a RULA score of 2 out of 7, where this value was better than the initial score before the improvement proposal was given.

General practitioners’ decision-making process to prescribe pain medicines for low back pain: a qualitative study

BackgroundPain medicines are widely prescribed by general practitioners (GPs) when managing people with low back pain (LBP), but little is known about what drives decisions to prescribe these medicines.ObjectivesThe aim...

Self-reported low back pain intensity and interferences among three-wheel drivers in Southwest of Ethiopia: A Community-Based Cross-sectional Study

Introduction: Low back pain is one of the most reported conditions among vehicle drivers. However, there is a paucity of information about low back pain experiences among three-wheel drivers in Ethiopia. This study aimed to determine the low back pain experience among three-wheel drivers in Ethiopia Jimma City, Southwest Ethiopia. Methods: A Community-based cross-sectional study was conducted from March 1-25, 2020 among 396 samples. Computer generated simple random sampling method was employed to get the required sample. An interviewer-administered questionnaire was used to collect the data. The data was checked for completeness, coded, cleaned and entered into Epi-data version 3.1 and exported to SPSS version 23 for analysis. Data was analyzed using mean and standard deviations for continuous and proportions for categorical variables. Binary and multivariable logistic regression was used to see an association between dependent and independent variables. P-value &lt;0.05 at 95% CI was declared statistically significant. Results: Of 396 study participants, 26.26% of them had low back pain at any time among which, 73.1% reported pain in the last 24 hours. Regarding pain intensity in 24 hours, the mean ± standard deviation of worst pain was 5.3 ± 2.5. The independent variables significantly associated with low back pain along with their adjusted odds ratio (95% confidence interval) were: age 3.45 (1.98, 6.03), educational status: 1.96 (1.07, 3.59), physical exercise: 0.52 (0.31, 0.86) drinking alcohol: 2.32 (1.22, 4.39) and working hours: 0.32 (0.13, 0.83). Conclusion: The three-wheel drivers experienced moderate to severe low back pain and moderate to severe functional and emotional interferences. More than half of the participants reported the worst pain experience within 24 hours. Age, educational status, physical exercise, drinking alcohol and working hours were significantly associated with low back pain.

Review of the Concept of Gridhrasi (Sciatica)

Abstract: Conceptual Review on the most prevalent condition today that affects leg movements, especially in middle age, is low back pain that interferes with daily tasks. One of Vataja Nanatmaja Vyadhi is Gridhrasi. It is a pain-dominant lifestyle disorder in which the pain starts from SphikPradesh &amp; radiates down to foot, here piercing type of pain which restricts the movement of the affected leg, make his walking pattern-like bird vulture and put him in disgraceful condition. Gridhrasi (Sciatica). Sciatica can be associated with Gridhrasi in Ayurveda based on its symptoms. 80–90% of people experience low back pain, and 5% of those experience sciatica. Between the ages of 30 and 40, it is typical and affects both sexes. It is a pain-dominant illness that limits people's ability to engage in personal, social, and professional activities. The movement and functions of the body are controlled by Vata, which is one of the diseases classified by Ayurveda as one of them. Vata-Kaphaja Gridhrasi is also caused by Vata-Kapha vitiation. The use of analgesics and physical therapy will help in the treatment of the disease sciatica to some extent, but they are not the ultimate cure. In addition to being expensive, surgery also carries the risk of recurrence. Better options are provided by Ayurveda for treating this painful disorder

"I felt uncertain about my whole future"-a qualitative investigation of people's experiences of navigating uncertainty when seeking care for their low back pain.

Uncertainty pervades low back pain (LBP). This study aimed to explore individuals' experiences of navigating uncertainty when seeking care for their LBP, with a view to better understanding the contexts in which they experience uncertainty and gaining insight into how uncertainty may be better navigated during clinical encounters. We conducted 15 semistructured interviews with people who have experienced LBP. Interviews were audio-recorded, transcribed, and analysed using reflexive thematic analysis. Analysis produced 4 themes. To reflect the unsettled nature of participants' discussions of navigating uncertainty, themes are framed as questions: (1) What will happen over time?; (2) Can clinicians help me? Are they willing to?; (3) What are clinicians talking about?; and (4) Am I being taken seriously? Participants also discussed how clinicians could better navigate these uncertainties. Suggestions included making time to (actively) listen to, and acknowledge, patients' concerns; asking open-ended questions; being honest about uncertainty; creating management plans and returning to them; challenging assumptions; remaining curious about patients' context; and providing guidance on how to manage LBP rather than simply giving certainty that symptoms will worsen, lessen, or continue. These findings indicate that many of the uncertainties individuals with LBP experience are intertwined with relational aspects of their interactions with clinicians. Clinicians therefore may need to consider these broader and relational aspects of care when navigating uncertainty with people who experience LBP, bringing attention to the importance of drawing from knowledge produced outside of the usual hierarchy of evidence (eg, systematic reviews and randomised controlled trials).

“Back pain is part of sport … I'm just gonna have to live with it”: Exploring the lived experience of sport-related low back pain in adolescent athletes

ObjectivesTo examine the lived experience of adolescent athletes reporting an episode of sport-related low back pain (LBP), including effects on daily life, relationships with parent/guardians, teammates, and coaches with relation to LBP, experiences of management/treatment, and understanding of LBP. DesignQualitative interviewing using online video conferencing platforms. ParticipantsAthletes aged 10–19 years old who experienced low back pain within the year prior to interviewing. Main outcome measuresInterview transcripts, Modified Oswestry Disability Index, and International Physical Activity Questionnaire. ResultsThree main themes were developed 1) The culture of normalising LBP in sport negates safeguarding efforts aimed at protecting adolescent athletes against injury and pain 2) LBP changes how athletes are perceived and perceive themselves 3) LBP has broad effects on the well-being of adolescent athletes. ConclusionsThe lived experience of LBP for adolescent athletes is impacted by the culture of tolerance of pain and injury in sport. Further steps should be taken to implement safeguarding measures in a way that adequately protects adolescent athletes who experience pain.