Risk Factors For Low Back Pain Research Articles

Potential causal association between leisure sedentary behaviors, physical activity and musculoskeletal health: A Mendelian randomization study.

Increasing evidence shows that leisure sedentary behaviors (LSB) and physical activity (PA) are associated with various musculoskeletal disorders. However, the causality between LSB/PA and musculoskeletal health remained unknown. In this study, we aimed to evaluate the causal relationships between LSB/PA and lower back pain (LBP), intervertebral disc disorder (IVDD), rheumatoid arthritis (RA), and bone mineral density (BMD) by using a two-sample Mendelian randomization method. The exposure data were obtained from large-scale genome-wide association studies (GWAS), including the PA dataset (self-reported PA, n = 377,234; accelerometer-assessed PA, n = 91,084) and LSB dataset (n = 422,218). The outcome data were derived from the FinnGen LBP dataset (n = 248,528), FinnGen IVDD dataset (n = 256,896), BMD GWAS dataset (n = 56,284), and RA GWAS dataset (n = 58,284). The causal relationships were estimated with inverse variance weighted (IVW), MR-Egger, and weighted median methods. Sensitivity analyses were performed with Cochran's Q test, MR-Egger intercept test, and leave-one-out analysis to estimate the robustness of our findings. Genetically predicted leisure television watching increased the risk of LBP (OR = 1.68, 95% CI 1.41 to 2.01; P = 8.23×10-9) and IVDD (OR = 1.62, 95% CI 1.37 to 1.91; P = 2.13 × 10-8). In addition, this study revealed a potential causal relationship between computer use and a reduced risk of IVDD (OR = 0.60, 95% CI 0.42 to 0.86; P = 0.005) and RA (OR = 0.28, 95% CI 0.13 to 0.60; P = 0.001). Our results suggest that leisure television watching is a risk factor for LBP and IVDD, whereas leisure computer use may act as a protective factor against IVDD and RA. These findings emphasized the importance of distinguishing between different sedentary behaviors in musculoskeletal disease studies.

Do MRI-derived muscle moment-arms in patients with chronic low back pain differ from healthy individuals? A comparative study.

The present study aimed to estimate the trunk muscles moment-arms in low back pain (LBP) patients and compare this data to those of healthy individuals. This research further explored whether the difference of the moment-arms between these two is a contributing factor to LBP. Fifty patients with CLBP (group A) and 25 healthy controls (group B) were enrolled. All participants were subjected to magnetic resonance imaging of lumbar spine. Muscle moment-arms were estimated on a T2W axial section parallel to the disc. There was statistically significant differences (p < 0.05) in the sagittal plane moment-arms at L1-L2 for right erector spinae (ES), bilateral psoas and rectus abdominis (RA), right quadratus lumborum (QL), and left obliques; bilateral ES, QL, RA, and right psoas at L2-L3; bilateral QL, RA, and obliques at L3-L4; bilateral RA and obliques at L4-L5; and bilateral psoas, RA, and obliques at L5-S1. There was no statistically significant difference (p < 0.05) in the coronal plane moment-arms except for left ES and QL at L1-L2; left QL and right RA at L3-L4; right RA and obliques at L4-L5; and bilateral ES and right RA at L5-S1. There was a significant difference in muscle moment-arms of the lumbar spine's prime stabilizer (psoas) and primary locomotors (rectus abdominis and obliques) between LBP patients and healthy individuals. This difference in the moment-arms leads to altered compressive forces at intervertebral discs and may be one of the risk factors for LBP.

The relevance of identifying the biomechanical and functional effects of abdominar obesity on activities of daily living in individuals with low back pain

The Global Burden of Disease Studies 2019 defines low back pain (LBP) as pain in the area of the posterior aspect of the body from the lower margin of the twelfth rib to the lower gluteal folds with or without pain referred into one or both lower limbs that lasts for at least one day. Disability due to LBP increased by more than 50% since 1990 and this disability holds the first place in years of healthy life lost due to disability (YLD) which is reflected by medical, insurance and pension statistics of the countries of the civilized world (GBD 2019 Diseases and Injuries Collaborators, 2019).&#x0D; It has been established that a high body mass index is one of the main risk factors for LBP (Shiri et al., 2010). A number of studies demonstrating a significant association between LBP development and abdominal obesity. Based on the findings of these studies, it is concluded that abdominal obesity is an independent risk factor for LBP (Uçar et al., 2021). However, there are only a few studies on the musculoskeletal characteristics developed as a result of this association. Existing knowledge on the identification and explanation of biomechanical role of abdominal obesity in the development of LBP, description and evaluation of the movement patterns of people with LBP and abdominal obesity and comparing their characteristics to the movement patterns of healthy adults needs to be supplemented by new data.&#x0D; A study is proposed that investigates postural control and (neuro-) biomechanical movement patterns during various daily basic and complex movements in adults with abdominal obesity and LBP will qualitatively extend existing recommendations for LBP therapy.&#x0D; The investigation of central obesity-related postural alterations and compensatory mechanisms/strategies during activities of daily living compared to individuals without central obesity and exploring possible associations between those biomechanical alterations and body composition are relevant. In the concept of a “personalized medicine” approach, these individualized recommendations are needed to be added to comprehensive current patient-oriented strategies of obesity management for people with LBP. Such data and additional recommendations are also needed for the development of current methods of obesity management in order to properly and effectively organize physical exercise for people with LBP.&#x0D; References&#x0D; GBD 2019 Diseases and Injuries Collaborators. (2019). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study. Global Health Metrics. The Lancet, 396(10258), 1204-. 1222. https://doi.org/10.1016/S0140-6736(20)30925-9&#x0D; Shiri, R., Karppinen, J., Leino-Arjas, P., Solovieva, S., &amp; Viikari-Juntura, E. (2010). The association between obesity and low back pain: A meta-analysis. American Journal of Epidemiology, 171(2), 135-154. https://doi.org/10.1093/aje/kwp356&#x0D; Uçar, İ., Karartı, C., Cüce, İ., Veziroğlu, E., Özüdoğru, A., Koçak, F. A., &amp; Dadalı, Y. (2021). The relationship between muscle size, obesity, body fat ratio, pain and disability in individuals with and without nonspecific low back pain. Clinical Anatomy, 34(8), 1201-1207. https://doi.org/10.1002/ca.23776

Predictors of residual low back pain in patients with osteoporotic vertebral fractures following percutaneous kyphoplasty.

Patients with osteoporotic vertebral fractures (OVFs) often suffer from residual low back pain (LBP) after percutaneous kyphoplasty (PKP). The purpose of this study was to identify risk factors for postoperative residual LBP and to develop a nomogram to predict the occurrence of residual LBP. We retrospectively reviewed 236 patients who underwent PKP for OVFs and had a minimum follow-up of 12 months. The mean age was 72.1 ± 6.3, 74.3% were female and 25.7% were male. Patients with LBP VAS scores ≥ 3.5 at the 12th month postoperatively were considered to have residual LBP. Risk factors for residual LBP were identified by univariate and multifactorial logistic regression analysis. Then, a predictive nomogram was constructed and validated using the bootstrap method. The discrimination, calibration, and clinical utility of the nomogram were assessed using a receiver operating characteristic curve (ROC), a calibration curve, and a decision curve analysis (DCA). univariate and multifactorial logistic regression analysis identified depression (P = 0.02), intravertebral vacuum cleft (P = 0.01), no anti-osteoporosis treatment (P < 0.001), cement volume <3 ml (P = 0.02), and cement distrubution (P = 0.01) as independent risk factors for residual LBP. The area under the ROC was 0.83 (0.74-0.93) and further validated by bootstrap method was 0.83 (0.73-0.92). The calibration curve illustrated the consistency between the predicted probability and the observed results. DCA showed that nomogram exhibits clinical utility and net benefit when the threshold probability is between 6% and 73%. Our study found that depression, intravertebral vacuum cleft, no anti-osteoporosis treatment, cement volume <3 ml and cement distribution represent independent risk factors for residual LBP. The nomogram containing the above five predictors can accurately predict the risk of residual LBP after surgery.

MINIMIZING THE RISK FACTORS FOR LOW BACK PAIN IN THE CREATIVE INDUSTRY WORKERS

Low back pain (LBP) felt in the anatomical area of ??a person's body is affected by a load or pressure outside the tolerance limit, with various variations in the length of time the pain complaint process occurs. This pain is felt in the lumbar or lumbo-sacral area. Workers in the batik industry may be at risk of LBP caused by work activities, such as bending, repetitive or monotonous movements, using work equipment and a non-ergonomic work environment. This study aims to minimize the risk factors for LBP in batik creative industry workers. The population of this study were all batik artisans in the written batik industry in Wukirsari Village, Imogiri District, Bantul Regency, Yogyakarta Special Region, totaling 1,021 people. The sample of this study was obtained by random sampling, to determine the sample using a lottery number and the name of the batik maker, totaling 60 batik people. The inclusion criteria for the sample of this study included female gender, writing batik work, working sitting using a chair. The sample consisted of a treatment group and a control group, each consisting of 30 batik makers, hereinafter referred to as respondents. The research instruments include: meter, microthoice, scales, chair, batik hurdle, and NBM questionnaire. Ergonomic work chair design for batik size: height of seat holder = 30 cm; length of seat holder = 40 cm; seat width = 37 cm; high back of chair = 43 cm; seat back width = 37 cm. Modification of batik gawangan is to redesign batik gawangan, material from bamboo diameter of about 3 cm, with size: height = 88 cm, width = 158 cm, 4-legged pieces, equipped with 3 watt LED lights. The results of the NBM in the treatment group decreased skeletal muscle complaints into criteria: low 96.7% and moderate 3.3%. The control group had skeletal muscle disorders criteria: low 23.3%, moderate 46.7%, high 20% and very high 10%. While the results of the t-test from the NBM data each of the 30 respondents between the treatment group and the control group, the value of p = 0.000 means that there are significant differences between respondents who use chairs and ergonomic modification modifications with respondents who use dingklik and gawangan which is old. The conclusion is that the use of chairs and modifications of the ergonomic batik wrestling can minimize the risk factors for LBP in the workers of the written batik creative industry

Examining the Peer-Reviewed Published Literature Regarding Low Back Pain in Rowing: A Scoping Review.

Low back pain (LBP) is highly prevalent in the rowing population. The body of existing research variously investigates risk factors, prevention, and treatment methods. The purpose of this scoping review was to explore the breadth and depth of the LBP literature in rowing and to identify areas for future research. Scoping review. PubMed, Ebsco and ScienceDirect were searched from inception to November 1, 2020. Only published, peer-reviewed, primary, and secondary data pertaining to LBP in rowing were included for this study. Arksey and O'Malley's framework for guided data synthesis was used. Reporting quality of a subsection of the data was assessed using the STROBE tool. Following the removal of duplicates and abstract screening, a set of 78 studies were included and divided into the following categories: epidemiology, biomechanics, biopsychosocial, and miscellaneous. The incidence and prevalence of LBP in rowers were well mapped. The biomechanical literature covered a wide range of investigations with limited cohesion. Significant risk factors for LBP in rowers included back pain history and prolonged ergometer use. A lack of consistent definitions within the studies caused fragmentation of the literature. There was good evidence for prolonged ergometer use and history of LBP to constitute risk factors and this may assist future LBP preventative action. Methodological issues such as small sample size and barriers to injury reporting increased heterogeneity and decreased data quality. Further exploration is required to determine the mechanism of LBP in rowers through research with larger samples.

Prevalence of self-reported low back pain and it is effect on health-related quality of life in Bisha, Saudi Arabia

Background: This study aimed to determine the prevalence of self-reported low back pain (LBP) and its effect on health-related quality of life (HRQoL) in Bisha, Saudi Arabia. Methods: A descriptive cross-sectional study was conducted in Bisha, a city in the southern region of Saudi Arabia, in 2021. Data were collected using a validated Arabic-language self-administrated questionnaire that provided insights into sociodemographic characteristics, LBP prevalence, LBP risk factors, and HRQoL via the tool EuroQoL-5D. Data were statistically analyzed using Statistical Package for the Social Sciences version 23. Results: A total of 184 participants were enrolled in the study. Ninety participants (48.9%) reported LBP during the week before the study and 68 (36.9%) reported LBP during the year before the study. The relation between the prevalence of LBP and sociodemographic characteristics was statistically significant (p-value &amp;le; 0.05). Higher prevalence of LBP was observed among participants younger than 30, male participants, university- educated participants, and employed participants. Regarding the HRQoL domain, there were associations between LBP prevalence and problems with mobility (27.2%), self-care (9.8%), usual activity (26.2%), pain/discomfort (57.6%), and anxiety/depression (30.4%). Measurement of the health status of participants resulted in an average score of 81.7 ± 15.7. This was significantly associated with LBP prevalence (p = 0.001). Conclusion: LBP is prevalent in Bisha. This might be attributed to various environmental and social factors. LBP is a burden to our society that demands interventions to improve HRQoL.

Low Back Pain, Disability and Quality of Life in Nursing Personnel: A Cross-Sectional Study

Background and Purpose:Low back pain (LBP) is a global health problem and one of the leading causes of disability. Also, LBP is a major occupational problem among nursing staff. The study aims to determine LBP, disability, quality of life (QoL), and the relationship between LBP and job-related risk factors and dimensions of QoL in nurses. Materials and Methods: In this cross-sectional study with a descriptive-analytic approach, eligible nurses working in teaching hospitals affiliated with Mazandaran University of Medical Sciences were included in the study by census method. Data were collected based on the demographic questionnaire, Visual Analog Scale (VAS), Quebec Back Pain Disability Scale (QBPDS), and Short-Form 36 (SF-36) health survey questionnaire. Data were analyzed (descriptive, logistic regression, spearman correlation) using SPSS software, version 23. Results: This study included 402 nurses with a mean age of 36.47±7.1 years and employment mean of 11.83±6.4 years of an employment. The prevalence of LBP was 86.3% and the mean of pain intensity and disability were 4.8±2.7 and 30.4±17.4, respectively. The mean QoL components, such as physical and mental were 58.03±19.6 and 57.42±18.3, respectively. The factors that were significantly associated with LBP were body mass index (BMI) (P&lt;0.0001), frequent bending (P=0.004), and workplace communication (P=0.008). LBP affected dimensions of QoL, especially physical function (P=0.008), role physical (P=0.02), general health (P&lt;0.0001), and social function (P=0.03). Conclusion: This study showed the high prevalence of LBP among nurses and the role of individual and workplace factors in the occurrence of LBP. Such cognition facilitates the design of an educational program and undertakes the targeted preventive actions.

Psychological Stress as a Risk Factor for Low Back Pain: a Review Article

Low back pain (LBP) is one of the most common complaints of pain in the settings of primary care. It affects the posterior region of the trunk that surrounds the first to fifth lumbar spine posteriorly. One of the most common mechanisms of LBP is excess muscle use in the posterior lumbar region that can promote the activation of nociceptors and cause pain. There are many risk factors that may lead to LBP which are classified into three types: individual, psychosocial, and occupational. One of the psychosocial risk factors of LBP is psychological stress. Based on the review over previous articles, psychological stress plays a role in the occurrence of LBP through excess cortisol and pain perception. There are also studies that stated a strong correlation between psychological stress and LBP.

What factors are associated with recovery from low back pain (LBP) in elite athletes? A Concept Mapping study of clinicians, coaches and elite athletes

Introduction: Despite being in peak physical fitness, 90% of Olympic athletes experiencing LBP in their career. Established risk factors for athlete LBP relate to training exposure variables, longer sporting career, and older age. It is well recognised in community patients with LBP that factors beyond physical load and age influence recovery. However, there is little evidence of what factors are associated with recovery from LBP in elite athlete populations. This concept mapping study aimed to identify factors that experienced clinicians, athletes, and coaches within elite sport associate with recovery from LBP in athletes.

Risk Factor of Low Back Pain in the Informal Sector Tailor in Solor Kupang City 2019

Tailor is a risky job that impact to low back pain. Low back pain (LBP) can cause a tailor to experience a decrease in the ability to perform daily activities and occupational health problems. One of the low back pain risk factors is individual factors include body mass index (BMI), exercise habits, and working period. This research was observational analytical research with a cross-sectional design conducted at Informal Sector tailor in Solor, Kupang City by filling questioner, body mass index measurement, and direct interview. The sampling technique used was total sampling with 48 samples that fulfilled inclusion and exclusion criteria. The data were analyzed by using the univariate, bivariate with chi-square, and multivariate with logistic regression as well. The bivariate analysis results showed that the results were significant on the variable of body mass index (p=0.012, OR=5.667) and work period (p=0.026). While there was no significant correlation between the variables of exercise habits with the incidence of low back pain (p=0.407).The multivariate analysis results found that the variable of the work period was the variable that had the biggest effect on the incidence of low back pain (OR=0.361). There are correlations between body mass index and work period with low back pain incidence at Informal Sector tailor in Solor, Kupang City in 2019.

Prevalence and risk factors analysis for low back pain among occupational groups in key industries of China

BackgroundWith the acceleration of industrialization and population aging, low back pain (LBP) has become the leading cause of life loss years caused by disability. Thus, it places a huge economic burden on society and is a global public health problem that needs urgent solution. This study aimed to conduct an epidemiological investigation and research on a large sample of workers in key industries in different regions of China, determine the incidence and distribution characteristics of LBP, explore the epidemic law, and provide a reference basis for alleviating global public health problems caused by LBP.MethodsWe adopted a modified epidemiological cross-sectional survey method and a stratified cluster sampling method. All on-duty workers who fulfill the inclusion criteria are taken as the research participants from the representative enterprises in key industries across seven regions: north, east, central, south, southwest, northwest, and northeast China. The Chinese version of the musculoskeletal disease questionnaire, modified by a standardized Nordic questionnaire, was used to collect information, and 57,501 valid questionnaires were received. Descriptive statistics were used, and multivariate logistic regression analysis (p < 0.05) was performed to explore the association between musculoskeletal disorders and potential risk factors.ResultsLBP annual incidence among workers in China’s key industries is 16.4%. There was a significant difference in LBP incidence among occupational groups across different industries (p < 0.05). The multivariate regression model showed the following as risk factors for LBP: frequent repetitive movements with the trunk, working in the same positions at a high pace, trunk position, frequently turning around with your trunk, often working overtime, lifting heavy loads (i.e., more than 20 kg), education level, staff shortage, working age (years), cigarette smoking, use of vibration tools at work, body mass index, lifting heavy loads (i.e., more than 5 kg), and age (years). Physical exercise, often standing at work, and absolute resting time were protective factors.ConclusionLBP incidence among key industries and workers in China is high. Thus, it is urgent to take relevant measures according to the individual, occupational, and psychosocial factors of LBP to reduce the adverse impact of LBP on workers’ health.

The Validity and Inter-Rater Reliability of a Video-Based Posture-Matching Tool to Estimate Cumulative Loads on the Lower Back.

Background: Low back pain (LBP) is known as one of the most common work-related musculoskeletal disorders. Spinal cumulative loads (CLs) during manual material handling (MMH) tasks are the main risk factors for LBP. However, there is no valid and reliable quantitative lifting analysis tool available for quantifying CLs among Iranian workers performing MMH tasks.Objective: This study aimed to investigate the validity and inter-rater reliability of a posture-matching load assessment tool (PLAT) for estimating the L5-S1 static cumulative compression (CC) and shear (CS) loads based on predictive regression equations.Material and Methods: This experimental study was conducted among six participants performing four lifting tasks, each comprised of five trials during which their posture was recorded via a motion capture (Vicon) and simultaneously a three-camera system located at three different angles (0°, 45°, and 90°) to the sagittal plane.Results: There were no significant differences between the two CLs estimated by PLAT from the three-camera system and the gold-standard Vicon. In addition, ten raters estimated CLs of the tasks using PLAT in three sessions. The calculated intra-class correlation coefficients for the estimated CLs within each task revealed excellent inter-rater reliability (> 0.75), except for CS in the first and third tasks, which were good (0.6 to 0.75). Conclusion: The proposed posture-matching approach provides a valid and reliable ergonomic assessment tool suitable for assessing spinal CLs during various lifting activities.

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 and exposure to factors associated with low back pain (LBP) among commercial motorcycle riders in south eastern Nigeria

Introduction: LBP is the most common cause of activity restriction and work absence in much parts of the world, putting a heavy financial burden on people. This study aims at determining the prevalence and exposure to risk factors associated with low back pain (LBP) among commercial bike riders within Nnewi-North Local Government Area of Anambra state. Methodology: This was a cross-sectional study that involved commercial motorcycle riders that ply within the four major villages of Nnewi town in Nnewi-North local government area of Anambra state. An interviewer based semi-structured questionnaire was administered to the respondents at their muster points. Results: One hundred and fifty-four riders were recruited and all were male. The prevalence of LBP was 25%. LBP was highest among riders between ages of 26-36years. There was significant association linking age and marital status to low back pain (LBP) with p-values of 0.001 and 0.013 respectively. Conclusion: Our findings suggest that low back pain is very common among this population and has led to both mild, moderate and severe functional disabilities to the riders. This study also demonstrated the exposure of the riders to some risk factors of LBP. Adequate public awareness, education and use of ergonomics would help in the reduction of this problem.

A Study from a Highly Populated Country : Risk Factors Associated with Lower Back Pain in Middle-Aged Adults.

Low back pain (LBP) is a global health problem that affects the productivity of the patients. Several factors such as individual, occupational, and psychosocial factors increase the risk of LBP. However, only a few studies investigated those factors, especially in middle adulthood in Indonesia. Indonesia is a country with a young population that has been rapidly developing in recent years. This study was conducted to find out the factors associated with LBP in middle adulthood. This study is a cross-sectional observational analytic study using a convenience sampling method with a total sample of 3005 respondents. Data were collected using a questionnaire which was then analyzed using the chi-square test, Kolmogorovsmirnov, Spearman's Rank, and logistic regression test. From the result of this study, it was found that the 12-month prevalence of LBP in middle-aged adults was 44,29%. Female (odds ratio [OR], 1.3; 95% confidence interval [Cl], 1.098-1.545; p=0.002), lack of physical exercises (OR, 0.87; 95% Cl, 0.794-0.959; p=0.005), high body mass index (OR, 1.09; 95% Cl, 1.009-1.187; p=0.002), stress level (OR, 1.26; 95% Cl, 1.088-1.458; p=0.002), and years of work experience (OR, 1.1; 95% Cl, 1.001-1.225; p=0.047) were determined as risk factors that significantly associated with LBP. LBP is quite common among middle-aged adults in Indonesia. Female gender, higher body mass index, lack of physical activity, stress level, and years of work experience were all potential risk factors for LBP in middle-aged adults. Middle-aged adults in Indonesia should be aware of LBP and avoid disabilities by identifying risk factors that may worsen LBP in the future.

Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study.

Background: Low back pain (LBP) is one of the leading causes of disability worldwide. Different studies showed the high prevalence of LBP among medical students. However, no study has been conducted on Bangladeshi medical students to estimate the prevalence of LBP. This study determined the prevalence, characteristics, and associated risk factors of LBP among medical students in Bangladesh. Methods: A cross-sectional study was conducted from October to December 2020 among randomly selected 270 medical students and medical interns in Faridpur Medical College, Bangladesh, using an online questionnaire. In data analysis, chi-square test and binary logistic regression were performed, and a p-value of < 0.05 was regarded as statistically significant. Results: A total of 207 participants responded fully to the survey, and were included in the analysis. The mean age of the participants was 22.4 ± 1.9 years. The point, 6-month, and 12-month prevalence of LBP was 25.6%, 46.9%, and 63.3%, respectively. In most participants, LBP was localized (53.2%), recurrent (64.9%), non-specific (70.8%), affected for a short period (55%), and relieved without receiving any treatment (60.4%). Participants who had a significantly higher 12-month prevalence of LBP included females (72.2% vs 52.2%), with BMI >25 kg/m 2 (73.2% vs 56.7%), those who performed physical activity at low to moderate frequency (72.4% vs 29.5%), those who spent > 6 hours/day by sitting (71.3% vs 45.3%), and those who did not have enough rest time (92.7% vs 56%). Ergonomic features of chairs, such as having back support, adjustable back support, and adjustable sitting surface, significantly (p < 0.05) influenced the outcomes. Conclusion: The prevalence of LBP among medical students in Bangladesh was high, and most of the risk factors associated with the high prevalence of LBP were modifiable. Hence, LBP can be prevented by implementing preventive strategies and providing ergonomic training and physical activity facilities.

The impact of lumbosacral alignment on lumbar mobility, functional disability and psychological wellbeing in office workers with chronic low back pain

Background/aims The lumbosacral curvature of the spine has a special role in its mobility during weight-bearing activities. Office work is a sedentary role, which requires sitting for long durations, having a negative effect on spinal posture. Therefore, low back pain risk factors in office workers are different from other populations. The aim of this study was to examine the effect of lumbosacral joint angle on the lumbar mobility, functional disability, pain intensity and overall health in office workers with chronic low back pain. Methods A total of 116 male office workers with chronic low back pain (aged between 30–59 years) participated in this cross-sectional study. The lumbosacral radiography was used to divide the participants into two groups, according to the value of their lumbosacral joint angle: group A (lumbosacral joint angle &lt;20°, n=61) and group B (lumbosacral joint angle group &gt;20°, n=55). The lumbar mobility, functional disability, pain intensity and overall health issues of participants were measured. Results The functional disability and pain intensity of individuals in group A were significantly higher than group B (P&lt;0.05). There was a significant decrease in the lumbar flexion and extension range of motion and activities of daily living of those in group A compared to group B (P&lt;0.05). There was a significant increase in emotional health problems and impaired social activity of individuals in group A compared to group B (P&lt;0.05). There were fair positive correlations between lumbosacral joint angle values and functional disability, pain intensity and social activity in office workers in group B (r=0.292, 0.036, 0.333 respectively). Conclusions A decreased lumbosacral joint angle increases functional disability and pain intensity, decreasing lumbar mobility and level of functionality. Furthermore, it reduces emotional health and social activity in participants with low back pain. Therefore, measuring the lumbosacral joint angle of patients with chronic low back pain during treatment may be useful to decrease their pain intensity and improve their functional disability and quality of life.

Low-back pain in adolescents with an osteopathic component

Low-back pain (LBP) is a common symptom presenting in adolescents. Most back pain in adolescents is benign and musculoskeletal in nature, due to trauma or congenital anomalies. Other less common causes include infection, inflammatory conditions or neoplasm. A comprehensive history and physical focusing on posture, muscle tenderness, range of motion, muscle strength and neurological function is essential in understanding the cause of low-back pain. Identification of risk factors for low-back pain will help the clinician in managing their patient. Treatment includes rest, avoiding activities that cause pain, physical therapy, osteopathic manipulative treatment, limited use of non-steroidal anti-inflammatory drugs and family and patient education. Assessing for warning signs or red flags of serious causes of LBP is a fundamental part of the clinical assessment. Pain that awakens from sleep, pain lasting longer than 4 weeks, sudden onset pain, systemic findings such as fever or weight loss and abnormal neurological findings should warrant immediate evaluation as these may suggest serious infectious conditions, malignancy or fracture. This article presents a comprehensive review of the epidemiology, relevant anatomy, biomechanics, causes and major risk factors for adolescent low-back pain. A diagnostic algorithm utilizing a step-by-step approach is also introduced to aid the clinician in management of the patient. Finally, the article presents guidelines for management of the adolescent with low-back pain including conservative, pharmacologic, as well as the osteopathic approach to treatment. Evidence-based recommendations on osteopathic approach to treatment has been reviewed from meta-analysis data and randomized controlled trials.

Cortical function and sensorimotor plasticity are prognostic factors associated with future low back pain after an acute episode: the Understanding persistent Pain Where it ResiDes prospective cohort study.

Predicting the development of chronic low back pain (LBP) at the time of an acute episode remains challenging. The Understanding persistent Pain Where it ResiDes study aimed to identify neurobiological and psychological risk factors for chronic LBP. Individuals with acute LBP (N = 120) participated in a prospective cohort study with 6-month follow-up. Candidate predictors were selected from the neurobiological (eg, sensorimotor cortical excitability assessed by sensory and motor-evoked potentials and brain-derived neurotrophic factor genotype), psychological (eg, depression and anxiety), symptom-related (eg, LBP history), and demographic domains. Analyses involved multivariable linear regression models with pain intensity or disability degree as continuous variables. Secondary analyses involved a multivariable logistic model with the presence of LBP at 6 months (thresholding pain intensity and disability degree) as a dichotomous variable. Lower sensory cortex and corticomotor excitability, higher baseline pain intensity, higher depression, stress, and pain catastrophizing were the strongest predictors ( R2 = 0.47) of pain intensity at 6 months. Older age and higher pain catastrophizing were the strongest predictors ( R2 = 0.30) of disability at 6 months. When the LBP outcome was dichotomised, sensory cortex and corticomotor excitability, brain-derived neurotrophic factor genotype, depression and anxiety, LBP history and baseline pain intensity, discriminated between those who did and did not report LBP at 6 months (C-statistic 0.91). This study identifies novel risk factors for the development of future LBP. Neurobiological risk factors, when added to a multivariable linear regression model, explained a further 15% of the variance in the 6-month pain intensity.