Previous Back Pain Research Articles

Occupational risk factors for the first-onset and subsequent course of low back trouble. A study of serving police officers.

A survey of occupational risks for low back trouble in two police forces discordant for one known physical stressor (wearing body armor weighing approximately 8.5 kg. To determine the hazard for first-onset and subsequent course of low back trouble associated with occupational physical and psychosocial stressors. Various occupational physical stressor have been associated with the prevalence of back pain, but their relationship with first-onset low back trouble is uncertain. Psychosocial factors reportedly are important determinants of chronicity. Anamnestic data on low back trouble were collected from representative random samples of "exposed" and control forces, along with variables describing exposure to occupational physical stressors and sports results. Psychometric tests were administered. Occupational risk factors for first-onset low back trouble were determined from lifetables based on officers with no previous back pain history. Survival time to first onset was affected adversely by wearing body armor and, less so, by vehicular exposure and sports participation. The proportion with persistent (chronic) trouble did not depend on length of exposure since onset, but longer service was associated with recurrent episodes. Chronicity was related to distress and blaming police work. Work loss was associated with blaming work and wearing body armor. Changing to lighter duties after development of low back trouble occurred rarely. Exposure to occupational physical stress seems detrimental; It reduced survival time to first-onset of low back trouble. Recurrence was associated with time since onset, but persistent trouble was not. Sports participation was a risk if occupational hazards were high.

A One-Year Prospective Study on Back Pain Among Novice Golfers

We conducted a 1-year follow-up study on back pain among 196 men taking up golf. A questionnaire on individual characteristics, occupation, sports, and back pain was distributed at the start of the study and was followed by another questionnaire after 12 months. Eleven percent of the original subjects (25 of 211) were lost to followup, but withdrawal from the survey was not associated with health status. In the baseline survey (N = 221), the self-reported lifetime cumulative incidence of back pain was 63%; 28% reported back pain during the month before answering the questionnaire, and 13% reported current back pain. Athletes had an increased odds ratio of 2.1 (95% confidence interval, 1.1 to 4.0) for previous back pain. During the 12 months between the surveys, the incidence of first-time back pain was 8% and the incidence of recurrent back pain was about 45%. Men involved in golf and another sport demonstrated a risk of 1.4 for recurrence of back pain, compared with men playing golf only. Six subjects attributed the recurrent back pain to playing golf. Given the high proportion of athletes in this study (68%), the risk factor of playing golf failed to demonstrate an additional significant effect on the general relationship between sport and back pain.

Previous Back Pain and Risk of Developing Back Pain in a Future Pregnancy

Four hundred twenty-nine pregnant women who had back pain before pregnancy and 375 pregnant women with no previous back pain were followed at regular intervals from the 12th week of pregnancy until delivery; back-pain complaints were recorded. Overall , back pain occurred twice as often in the group with a back-pain history (period prevalence) (P less than 0.001). The point prevalence of back pain in weeks 12, 24, 30, and 36 was three times higher in the group who had had back pain before pregnancy indicating that pain was not only more prevalent but also lasted longer in that group. Women who had been pregnant previously tended to have an increased risk of back pain, and there was a statistically significant correlation between multiparity and longer periods of back pain (P less than 0.001). Young age increased the risk of back pain (P less than 0.001). Pain intensity was higher in the younger women during the first part of their pregnancies but not later on (P less than 0.05).

A longitudinal study of back pain and radiological changes in the lumbar spines of middle aged women. I. Clinical findings.

The natural history of low back pain was evaluated over a nine year period in two groups of middle aged Dutch women selected from the general population. One group had recurrent back pain (n = 236) and the other group had never experienced back pain (n = 241). At the onset of the study recurrent back pain was associated with smoking, previous use of the 'pill', pain in other joints, frequent headaches, and restricted lumbar spine movement. Nine years later 170 (72%) of the group with back pain had continuing pain and 58 (24%) of the group without previous back pain had incident pain. Pain in other joints, especially the hip and knee, was a predictor of continuing and incident pain but age, body mass index, and smoking were not.

Back Pain, Ventilatory Function, Chest Symptoms, and Smoking

Tests of ventilatory function were made and a history of previous back pain was obtained from 909 volunteers (592 men and 317 women). One year later, using postal questionnaires, they were asked about their experience of back pain in the ensuing 12 months and about smoking habits, breathlessness, coughing, and the bringing up of phlegm. From the frequency of their experience of back pain, the population was divided into “nonbacks,” “mild backs,” and “chronic backs.” From their answers to the MRC Questionnaire on respiratory symptoms they were divided first into good, mild, and bad with regard to chest symptoms; and also into smokers, exsmokers, and nonsmokers. Ventilatory function tests were reduced in both smokers and “bad chests” and chest symptoms were significantly worse in smokers. Women with back pain were more likely to be smokers, but men with back pain were not. Chest symptoms were significantly worse in “chronic backs,” whether men or women. The results suggest that previous reports of a relation between smoking and back pain arose incidentally from the associations between (a) chest and back symptoms and (b) chest symptoms and smoking.

Back Pain, Ventilatory Function, Chest Symptoms, and Smoking

Tests of ventilatory function were made and a history of previous back pain was obtained from 909 volunteers (592 men and 317 women). One year later, using postal questionnaires, they were asked about their experience of back pain in the ensuing 12 months and about smoking habits, breathlessness, coughing, and the bringing up of phlegm. From the frequency of their experience of back pain, the population was divided into "nonbacks," "mild backs," and "chronic backs." From their answers to the MRC Questionnaire on respiratory symptoms they were divided first into good, mild, and bad with regard to chest symptoms; and also into smokers, exsmokers, and nonsmokers. Ventilatory function tests were reduced in both smokers and "bad chests" and chest symptoms were significantly worse in smokers. Women with back pain were more likely to be smokers, but men with back pain were not. Chest symptoms were significantly worse in "chronic backs," whether men or women. The results suggest that previous reports of a relation between smoking and back pain arose incidentally from the associations between (a) chest and back symptoms and (b) chest symptoms and smoking.

Low back pain in nurses: the relative importance of medical history, work factors, exercise, and demographics.

Although low back pain (LBP), a major problem for nurses, is presumed to be caused by the physical demands of work, little scientific information supports this view. In this study, registered nurses were surveyed regarding LBP, demographics, medical history, exercise, and work variables. Univariate and multivariate analyses indicated previous LBP or back pain in another location of the spine were strongly associated with LBP during the study year. Aerobic dance exercise was less strongly associated. In contrast, lifting patients was only weakly associated, and other occupational variables not at all. Although results must be interpreted cautiously in light of study limitations, the findings suggest that factors unrelated to work may be more important to LBP than previously thought.

Radiographic measurements of lumbar spinal canal size and their relation to back mobility.

A total of 197 men and women with history of previous back pain were radiographed and clinically examined. Measurements related to the shape and size of the spinal canal were subsequently made from the lumbar radiographs. Interarticular distance and the ratio between interarticular and interpedicular distances were significantly less in women with restriction of lumbar extension, sidebending, and rotation: not in men. Anteroposterior (AP) foraminal distances and pedicular lengths were less in men with restricted extension and sidebending, although not in women. Midsagittal diameters were not significantly less in those with restricted mobility. The radiographic differences between men and women with restricted back mobility arise partly from the sexual differences in interarticular and AP foraminal distance, the former being less in women, the latter in men. This suggests a different pathogenetic factor in the two sexes.

The fear-avoidance model of exaggerated pain perception—II: Preliminary studies of coping strategies for pain

The personal history of pain and personal coping strategies for pain are two of the contributory factors in the Fear-Avoidance Model of exaggerated pain perception proposed by Lethem, Slade, Troup and Bentley (1983, this issue, pp. 401–408). In order to test this aspect of the hypothesis, a questionnaire was designed and has been completed by 165 students (93 female, 72 male) at the University of Liverpool. They were asked about the severity of externally-produced pain (e.g. fracture), of internally-produced pain (e.g. headache) and of back pain; about the strategies they adopted for coping with internallyproduced pain (e.g. did they ignore the pain and carry on—an active strategy—or did they go and rest—a passive strategy); and about the effects of back pain on each of 10 activities or postures (from ‘no effect’ to ‘had to stop completely’) in order to obtain an index of back-pain avoidance. Out of 165, 91 reported previous back pain (Back Pain group) and their average rating for the severity of externally-produced pain was significantly higher than for the No Back Pain group; but there were no differences between these two groups for their coping strategies for internally-produced pain. However, of the Back Pain group with two or more previous attacks, 35 gave a history indicating decreasingly severe attacks and 28, increasingly severe: the coping strategies of the latter group for internally-produced pain were significantly more passive. The ratings for severity of back pain correlated significantly with the indices for back-pain avoidance and with the ratings for severity of internally-produced pain. These findings are in line with the prediction that personal pain history and personal coping strategies are relevant to the Fear-Avoidance Model of exaggerated pain perception and may therefore influence the adoption of an avoidance or a confrontation response by the patient with chronic back pain.