Impact Of Low Back Pain Research Articles

Prevalence and Risk Factors for Low Back Pain Among Professional Drivers in Kano, Nigeria

This study investigated the prevalence, risk factors, and impact of low back pain (LBP) among professional drivers in Nigeria. Two hundred male drivers aged 19–64 years were recruited in the study. Data regarding prevalence, individual risk factors, and impact of LBP were obtained. The prevalence rate of LBP was 73.5%, and LBP have affected the driving performance of up to 74% drivers. After adjustment for age, LBP prevalence was associated with driving for >15 hours/day (odds ratio [OR]; 95% confidence interval [CI]): (0.04; 0.01, 0.20), driving car (5.52; 1.55, 19.64), and driving bus (10.49; 2.63, 41.82). No association was found between LBP prevalence and years spent driving. The study found that high prevalence of LBP affected the performance of a substantial percentage of the participants.

Low back pain in patients with rheumatoid arthritis: Clinical characteristics and impact of low back pain on functional ability and health related quality of life

The aim of this study was to assess the point prevalence of low back pain (LBP) in patients with rheumatoid arthritis (RA); and to compare radiological and clinical aspects, as well as impact of LBP on health related quality of life (QoL), depression and disability in control patients with mechanical LBP (mLBP). Patients with RA and patients with mLBP of at least 3 months duration were consecutively recruited. All patients were examined and underwent lumbar X-ray and magnetic resonance (MR) imaging. Disc intensity, annulus fibrosis rupture, herniated nucleus pulposus (bulging, protrusion, extrusion or sequestration), stenosis, Schmorl nodes, hemangiomas, Tarlov cysts, Type I or II degeneration, ligamentum flavum hypertrophy and loss of lordosis were assessed on MR. Assessments included QoL and disability scales like RAQoL, Short Form-36, Health Assessment Questionnaire (HAQ) and Oswestry Disability Index (ODI) and depression and anxiety scales as well. Chronic LBP coexisted in 64.5% of patients with RA. Patients with LBP had higher scores on VAS-LBP compared to patients with RA+LBP. Additionally, patients with RA+LBP had the poorest scores on quality of life, functional disability and depression. Patients with mLBP had more frequent clinical manifestations and neurologic deficits. Patients with RA+LBP had more frequent Schmorl nodes compared to patients with mLBP. The association of RA with LBP leads to a significant decrease in the functional capacity and QoL as well as increase in depression risk. Appropriate diagnostic procedures and treatments should be administered to avoid further deterioration in functional disability and QoL.

Back Pain Beliefs Are Related to the Impact of Low Back Pain in 17-Year-Olds

Disability in adults with low back pain (LBP) is associated with negative back pain beliefs (BPBs). Adult BPBs can be positively influenced with education, resulting in reduced LBP disability. By late adolescence, the prevalence of LBP reaches adult levels. The relationship among LBP experience, LBP impact, and BPBs has not been investigated in late adolescence. The aim of this study was to document unknown relationships among LBP experience, LBP impact, and BPBs in 17-year-olds. Design A cross-sectional study design was used. Adolescents (n=1,126) in the Raine Study provided full information on LBP, LBP impact (sought professional advice or treatment, taken medication, missed school or work, interfered with normal activities, interfered with physical activities), BPBs, and a number of covariates. Back pain beliefs were more positive in participants with experience of LBP (X=30.2, SD=5.6) than in those without experience of LBP (X=28.5, SD=5.1). Individuals with LBP without activity modification impacts had more positive BPBs than those with activity modification impacts, even after adjustment for mental well-being and sex. The adjusted difference in BPBs between participants with experience of LBP but no activity modification impacts and those reporting all 3 activity modification impacts was 2.9 points (95% confidence interval=1.7 to 4.2). Participants with no activity modification impacts had more positive BPBs than those with no experience of LBP (adjusted difference=2.2 points, 95% confidence interval=1.4 to 2.9). More positive BPBs also were associated with female sex, lower body mass index, higher family income, better 36-Item Short-Form Health Survey (SF-36) Mental Health scale scores, and more positive primary caregiver beliefs. Limitations Cause and effect cannot be ascertained with the cross-sectional design. Differences in BPBs are associated with different levels of LBP impact at 17 years of age. This finding provides a potential target for intervention early during the life course.

Low back pain in 17 year olds has substantial impact and represents an important public health disorder: a cross-sectional study

BackgroundPrevalence of low back pain (LBP) rises rapidly during adolescence, reaching adult levels by the age of 18. It has been suggested that adolescent LBP is benign with minimal impact, despite limited evidence.MethodsThe aim of this study was to investigate the impact of LBP and the influence of chronicity, gender and presence of other spinal pain comorbidities at age 17. Subjects (n = 1283) were categorised according to experiencing current and chronic LBP, gender and presence of other areas of spinal pain. LBP impact was ascertained via questions regarding seeking professional assistance, using medication, missing school/work, limited normal or recreational physical activity and health related quality of life (HRQOL).Results12.3% of participants reported current but not chronic LBP, while 19.9% reported current chronic LBP. LBP was more commonly reported by females than males. Other spinal pain comorbidities were common in the LBP groups. Impact was greater in subjects with chronic LBP, in females and in those with other spinal pain comorbidities.ConclusionLBP, and particularly chronic LBP, has a significant negative impact at 17 years. It is commonly associated with care seeking, medication use, school absenteeism, and reduced HRQOL. These findings support that adolescent LBP is an important public health issue that requires attention.

Low Back Pain and Comorbidity Clusters at 17 Years of Age: A Cross-sectional Examination of Health-Related Quality of Life and Specific Low Back Pain Impacts

Comorbidities in adults negatively affect the course of low back pain (LBP). Little is known of the presence and/or impact of LBP comorbidities in adolescents. Subjects from the Raine Study cohort at age 17 years (n = 1,391) provided self-report of diagnosed medical conditions/health complaints, health-related quality of life (36-Item Short Form Health Survey [SF-36]), lifetime experience of LBP, and specific LBP impacts (taking medication, missing school/work, interference with normal/physical activities). Latent class analysis was used to estimate clusters of comorbidities based on diagnosed disorders. Profiles of SF-36 and impact were examined between clusters. Four distinct comorbidity clusters were identified: cluster 1: Low probability of diagnosed LBP or any other medical condition (79.7%); cluster 2: High probability of diagnosed LBP and neck/shoulder pain, but a low probability of other diagnosed health conditions (9.6%); cluster 3: Moderate probability of diagnosed LBP and high probability of diagnosed anxiety and depression (6.9%); cluster 4: Moderate probability of diagnosed LBP and high probability of diagnosed behavioral and attention disorders (3.8%). The clusters had different SF-36 and LBP impact profiles, with clusters 3 and 4 having poorer SF-36 scores, and clusters 2 to 4 having greater risk for specific LBP impacts, than cluster 1. Identified comorbidity clusters support adolescent and adult studies reporting associations between LBP, other pain areas, psychological disorders, and disability. Tracking these clusters into adulthood may provide insight into health care utilization in later life, whereas identification of these individuals early in the life span may help optimize intervention opportunities.

Assessing the association between low back pain, quality of life, and life events as reported by schoolchildren in a population-based study

Low back pain (LBP) is prevalent in teenagers but not necessarily detrimental to their quality of life (QoL). This population-based study evaluated a global QoL score and the association between LBP and life events and/or health problems affecting QoL. Schoolchildren were investigated in Fribourg-Switzerland and Barcelona-Spain. In addition to the KIDSCREEN, a health-related QoL questionnaire, two Numerical Rating Scales were used to assess QoL in general, and the influence of LBP on QoL. Open questions explored life events and health problems affecting QoL; responses were submitted to content analysis. Adolescents were stratified: Pain-free, Other pain (OP), isolated LBP (IsoLBP), LBP + other pains (LBP + OP), and LBP + whole-body pain (LBP + WBP). Between-group comparisons were performed using Chi-squared tests and ANOVA. Linear regression analysis was performed to assess between-group differences in the impact of LBP on QoL. Schoolchildren (1,470) (mean age = 15.05 years, 52.6% = boys) completed the questionnaire. LBP lasting >1 day in the last month was reported by 39.8% (N = 560): of them, 242 (43.2%) reported IsoLBP, 268 (47.9%) LBP + OP, and 50 (9.1%) LBP + WBP. QoL was lower in LBP + WBP (mean = 6.44 vs. LBP + OP = 7.8; IsoLBP = 7.6, OP = 7.96, Pain-free = 8.1; p < 0.001). There were 18.5% who reported health problems and 15.3% life events with a perceived impact on QoL. Prevalence was higher in LBP + WBP with >30% of this group identifying life events and/or health problems vs. 10-12% in PFree or IsoLBP groups (p < 0.001). IsoLBP affected QoL marginally (mean = 2.4 ± 2.2) compared to LBP + WBP (mean = 4.9 ± 2.4) (p < 0.001). LBP affected QoL marginally. These results stress the distinction between disease and common life experience. They also indicate the potential value of global QoL assessments in clinical settings.

Beliefs About Back Pain

Beliefs about low back pain (LBP) have been widely studied. Research supports the importance of attitudes and beliefs in the development of disability. However, public opinions about LBP have been the subject of few studies to date and more research into public attitudes has been advocated to inform future public health initiatives. To investigate public attitudes and beliefs about LBP, and the association of these with demographic variables. In addition, to determine whether certain group differences in demographic characteristics were useful in predicting individuals with negative attitudes about LBP. A stratified sample of 3400 households were invited to participate in the Jersey Annual Social Survey. One thousand five hundred and seventy-four (46.3%) responded and 1132 (71.9%) were identified as being of working age. Complete responses to the Back Beliefs Questionnaire were provided by 1023 (65.0%). Respondents were grouped according to pain report: no current pain, current pain not LBP, and current LBP. Significant differences existed between subgroups for most demographic characteristics. Moreover, beliefs about LBP differed significantly between the 3 groups [F (2,1019)=17.72, P<0.001]. Further analyses were carried out for the subgroups separately. For the Current LBP group, beliefs differed significantly by educational level [F(2,186)=14.65, P<0.001], perceived general health [F (2,187)=4.42, P<0.05], acceptability of work absence [F (2,189)=10.69, P<0.001], LBP impact on activity [F (2,186)=6.38, P<0.01], and previous LBP absence [t (185)=4.84, P<0.001]. Multiple regression using these characteristics produced an adjusted R of 0.25 [F (4,181)=16.33, P<0.001] for the prediction of back beliefs. Implications for public health initiatives and future research are discussed.

Exercise for the Primary, Secondary and Tertiary Prevention of Low Back Pain in the Workplace: A Systematic Review

Low back pain (LBP) is one of the most costly conditions to manage in occupational health. Individuals with chronic or recurring LBP experience difficulties returning to work due to disability. Given the personal and financial cost of LBP, there is a need for effective interventions aimed at preventing LBP in the workplace. The aim of this systematic review was to examine the effectiveness of exercises in decreasing LBP incidence, LBP intensity and the impact of LBP and disability. A comprehensive literature search of controlled trials published between 1978 and 2007 was conducted and a total of 15 studies were subsequently reviewed and analyzed. There was strong evidence that exercise was effective in reducing the severity and activity interference from LBP. However, due to the poor methodological quality of studies and conflicting results, there was only limited evidence supporting the use of exercise to prevent LBP episodes in the workplace. Other methodological limitations such as differing combinations of exercise, study populations, participant presentation, workloads and outcome measures; levels of exercise adherence and a lack of reporting on effect sizes, adverse effects, and types of sub-groups, make it difficult to draw definitive conclusions on the efficacy of workplace exercise in preventing LBP. Only two out of the 15 studies reviewed were high in methodological quality and showed significant reductions in LBP intensity with exercise. Future research is needed to clarify which exercises are effective and the dose-response relationships regarding exercise and outcomes.

The impact of low back pain on work: A study in primary care consulters

Background The cost of low back pain (LBP) to employers is high, with an estimated £9090 million lost in the United Kingdom in 1998. Economic analysis of LBP has focused on work absence among the employed. There is little research characterising individuals who report reduced duties or who are not in employment because of LBP. Aims To compare the health related characteristics of primary care LBP consulters reporting usual employment, reduced duties, sick leave and non-employment as a result of LBP. Methods Prospective cohort study recruiting LBP consulters aged 30–59 years of age from five general practices in North Staffordshire. Results Nine hundred and thirty-five participants completed the baseline phase, 65% were in employment and 35% were not in employment. Of the employed participants over 1 in 10 (11%) were undertaking reduced duties and almost one-fifth were reporting sick leave (22%). Furthermore, 37% of non-employed consulters reported that LBP was the reason for non-employment. Significant differences at baseline in socioeconomic status, self-rated health, anxiety, depression and disability were found between those undertaking their usual job, those on reduced duties and those on sickness absence due to LBP, with those participants further removed from the work force reporting worse health across all measures. Significant differences were also found in self-rated health between those not working due to LBP and those not working for other reasons, with participants not working due to LBP reporting worse self-rated health. At follow-up, work status was found to be relatively stable. Conclusion These findings indicate that the economic impact of LBP may be higher than previously estimated when data on reduced duties is combined with work absence. The additional impact of unemployment due to LBP should also be included in future assessments of the impact of LBP on the workforce.

“Since You’re Asking. . . ”: Free Text Commentaries in an Epidemiological Study of Low Back Pain Consulters in Primary Care

As part of a longitudinal mixed-method study on low back pain (LBP), free-text comments were invited at the end of the 12 month follow-up survey questionnaire. 80% of respondents used this option and provided a wealth of material so that comparisons could be made with survey and interview results. People reported pain in other parts of the body apart from LBP, and illustrated the impact of LBP on physical ability and work, psychological well-being and social activities. Free-text material offers valuable insights that strengthen the findings of the survey, and the study as a whole.

Low Back Pain, Health Status, and Quality of Life in Older Adults: Challenge and Opportunity

The medical literature about low back pain (LBP) is extensive for good reason. LBP is the most common condition in pain medicine and spine specialty practices, but also commonly presents in other specialty practices, such as rheumatology and neurology, as well as in primary care practice. Moreover, unlike many other serious medical problems, the discussion about LBP and its treatment extends beyond medicine to legal and economic forums and even into the political arena. This wider consideration occurs because of LBP's impact on the societal burden of rising health care costs. LBP accounts for more work-related disability than any other health condition, causing it to be the single most costly health problem in the United States and the most costly health burden to businesses. Moreover, LBP is at the center of business-labor disputes over the rights of workers to obtain compensation and medical care once injured on the job versus the rights of businesses to avoid paying compensation to workers who have been injured but then recovered. These disputes spill over into the politics of every state, where workers' compensation programs are administered, and even into economic theory [1,2]. Understandably, its economic salience is the principal reason why most LBP research has focused on working age adults. This research has paid off. Although LBP remains a serious occupational health problem, we have made great strides in learning how to prevent low back injury at work, how to treat acute …

Physiotherapy and low back pain - part iii: outcomes research utilising the biosychosocial model: psychosocial outcomes

A comprehensive understanding of low back pain (LBP)has evolved that necessitates the use of a biopsychosocial model, focusing on illness rather than disease and incorporating the biological, psychological and social aspects that are important to understand and to study LBP in its chronic form. Traditional outcome measures that measure elements within the biological component are limited to assess the spectrum of impacts caused by chronic low back pain (CLBP) and the validity, reliability and sensitivity of some of these measures has been questioned.Few physiologic tests of spine function are clinically meaningful to patients, objective physical findings can be absent, and in CLBP disability and activity intolerance are often disproportional to the original injury. Biological outcomes should be complemented by outcomes of the psychosocial aspects of back pain that measure the considerable functional and emotional impact on the quality of life of patients experiencing low back dysfunction. Outcomes research is an analysis of clinical practice as it actually occurs and can make a valuable contribution to understanding the multidimensional impact of LBP. Psychosocial aspects of the biopsychosocial model for outcomes research are discussed in part III: functional status/disability, psychological impairment, patient satisfaction, health related quality of life

Physiotherapy and low back pain - part 1 outcomes research in the quest for evidence

Low back pain (LBP) is one of the most common and costlyconditions treated by physiotherapists and is acknowledged as a major health problem. Much published research on LBP is of poor design and optimal outcome measures are not selected for LBP patients. Effective and cost-effective interventions for LBP, particularly chronic LBP, need to be identified using appropriate, valid, reliable and responsive measures of outcome. These outcome measures should reflect the biopsychosocial model necessary for evaluating the broad impact of LBP, in particular chronic LBP, on a patient’s life. Outcomes research is a feasible and affordable analysis of clinical practice as it occurs, and provides an opportunity to evaluate the effectiveness of interventions for LBP. This is in contrast to a randomised, controlled trial (RCT) that evaluates efficacy under controlled conditions that often do not reflect clinical practice. Using a battery of outcome measures appropriate for measuring change in the LBP population, outcomes research has the potential to identify effective and cost-effective interventions, promote and influence further research, and contribute to the demand for evidence-based practice.

Working with low back pain: problem-solving orientation and function

A number of ergonomic, workplace and individual psychosocial factors and health behaviors have been associated with the onset, exacerbation and/or maintenance of low back pain (LBP). The functional impact of these factors may be influenced by how a worker approaches problems in general. The present study was conducted to determine whether problem-solving orientation was associated with physical and mental health outcomes in fully employed workers (soldiers) reporting a history of LBP in the past year. The sample consisted of 475 soldiers (446 male, 29 female; mean age 24.5 years) who worked in jobs identified as high risk for LBP-related disability and reported LBP symptoms in the past 12 months. The Social Problem-Solving Inventory and the Standard Form-12 (SF-12) were completed by all subjects. Hierarchical multiple regression analyses were used to predict the SF-12 physical health summary scale from interactions of LBP symptoms with each of five problem-solving subscales. Low scores on positive problem-solving orientation ( F(1,457)=4.49), and high scores on impulsivity/carelessness ( F(1,457)=9.11) were associated with a steeper gradient in functional loss related to LBP. Among those with a longer history of low-grade LBP, an avoidant approach to problem-solving was also associated with a steeper gradient of functional loss (three-way interaction; F(1,458)=4.58). These results suggest that the prolonged impact of LBP on daily function may be reduced by assisting affected workers to conceptualize LBP as a problem that can be overcome and using strategies that promote taking an active role in reducing risks for LBP. Secondary prevention efforts may be improved by addressing these factors.

Assessment of Functional Status, Low Back Disability, and Use of Diagnostic Imaging in Patients with Low Back Pain and Radiating Leg Pain

We analyzed data from outpatients with chronic low back pain (LBP) in the Veterans Health Study ( n = 563) to examine the relationship between localized LBP intensity and radiating leg pain in assessing patient functional status, low back disability, and use of diagnostic imaging. Based on the localized LBP intensity, the study subjects were divided into tertiles (low, moderate, and high intensity). The study subjects were also stratified by the extent of radiating leg pain. Using analysis of variance and multiple regression analysis, we compared the relative importance of localized LBP intensity and radiating leg pain in explaining the variability in the means of the SF-36 scales and low back disability days, and in the proportion of patients who had used diagnostic imaging. The results of the study indicate that measures of localized LBP intensity and radiating leg pain contribute separately to the assessment of patient functional status, low back disability, and use of diagnostic imaging. These results suggest that localized LBP intensity and radiating leg pain may represent two different approaches in assessing back pain severity. Future epidemiological and health services research should consider both measures in assessing the impact of LBP on patient functional status, low back disability, and use of diagnostic imaging.

Psychological factors in disabling low back pain: causes or consequences?

Low back pain (LBP) is a common problem that is costly in both financial and human terms. The impact of LBP on an individual varies greatly. For some, LBP is a minor inconvenience; but for others LBP is associated with significant disability and with psychosocial dysfunction for the individual and for the family. Whether psychosocial factors are causes or consequences has been the subject of debate. This paper is a review of psychosocial factors associated with disabling LBP. It addresses the question of whether these factors are causes or consequences of the disability due to LBP. Based on this review it was concluded that there is little evidence in support of the concept of a pain-prone personality. Once LBP has occurred, the impact of the LBP on the individual and the family is influenced by the health-beliefs and coping strategies of the individual and the family. Distress appears to be secondary to physical restriction rather than pain, but the distress may aggravate the pain and thus the disability. The paper concludes with a discussion of the impact of health practitioners on pain-related disability.

The epidemiology of low back pain in an adolescent population.

We assessed the prevalence of low back pain (LBP) in a cohort of 1242 adolescents (aged 11 through 17) currently participating in a 4-year prospective study of medically treated injuries. Overall, 30.4% of the adolescents reported LBP. The impact of LBP in adolescents was considerable, with one third resulting in restricted activity and 7.3% seeking medical attention. Life-table analysis demonstrated that by age 15, the prevalence of LBP increased to 36%. There were few differences by gender or race. These results suggest that LBP in adolescents is a serious public health problem.