Risk Of Low Back Pain Research Articles

Association between nighttime sleep duration and quality with low back pain in middle-aged and older Chinese adults

BackgroundThis study aims to investigate the association between sleep duration, sleep quality, and the risk of low back pain (LBP) among middle-aged and elderly individuals in China. MethodsUtilizing data from the China Health and Retirement Longitudinal Study spanning 2011 to 2020, we categorized sleep duration into long, medium, and short categories, and sleep quality into good, fair, and poor levels. LBP status was determined based on self-reported information by participants. Multivariable logistic regression analysis was employed to assess the relationship between sleep duration, sleep quality, with the risk of LBP. ResultsA total of 6750 individuals were included in the longitudinal study. After 9 years of follow-up, the prevalence of LBP was 25.69 %. In the fully adjusted model, compared to individuals with medium sleep duration, those with short sleep duration had a 28 % increased risk of developing LBP (OR = 1.28, 95%CI: 1.12, 1.46). Additionally, when compared to individuals with good sleep quality, those with fair and poor sleep quality had a 35 % (OR = 1.35, 95%CI: 1.19, 1.54) and 33 % (OR = 1.33, 95%CI: 1.12, 1.58) increased risk of LBP, respectively. Joint analysis of both factors revealed that individuals with poor sleep quality and short sleep duration had the highest risk of LBP. ConclusionAmong middle-aged and elderly individuals in China, short sleep duration and poor sleep quality were associated with an increased risk of LBP. Future studies should further explore the mechanisms underlying this association and validate the findings through randomized controlled trials.

Overweight and obesity as risk factors for chronic low back pain: a new follow-up in the HUNT Study

BackgroundNumerous studies have examined associations between overweight and obesity and risk of low back pain (LBP), but the exact magnitude of these associations is not yet clear. The purpose of this work was to assess such sex-specific associations in a community-based setting in Norway, taking into account potential relationships with other risk factors.MethodsA cohort study was conducted combining data from two waves of the Trøndelag Health Study, HUNT3 (2006–2008) and HUNT4 (2017–2019). Separate analyses were performed of risk of chronic LBP in HUNT4 among 14,775 individuals without chronic LBP in HUNT3, and of recurrence or persistence in HUNT4 among 5034 individuals with chronic LBP in HUNT3. Relative risks were estimated in generalised linear models for overweight and obesity compared to normal weight. Body size classification was based on values of BMI computed from measurements of height and weight. Chronic LBP was defined as LBP persisting at least 3 months during last year.ResultsAfter adjustment for age, smoking, physical activity in leisure time and work activity, analysis of risk among women produced relative risks 1.11 (95% CI 1.00–1.23) for overweight, 1.36 (95% CI 1.20–1.54) for obesity class I and 1.68 (95% CI 1.42–2.00) for obesity classes II-III. Relative risks among men were 1.10 (95% CI 0.94–1.28) for overweight, 1.36 (95% CI 1.13–1.63) for obesity class I and 1.02 (95% CI 0.70–1.50) for obesity classes II-III, the last estimate being based on relatively few individuals. Analyses of recurrence or persistence indicated similar relationships but with smaller magnitude of relative risks and no drop in risk among obesity classes II-III in men. The change in BMI from HUNT3 to HUNT4 hardly differed between individuals with and without chronic LBP in HUNT3.ConclusionsRisk of chronic LBP increases with higher values of BMI in both sexes, although it is uncertain whether this applies to very obese men. Very obese women carry a particularly large risk. Probabilities of recurrence or persistence of chronic LBP among those already afflicted also increase with higher values of BMI. Adjustment for other factors does not influence relationships with overweight and obesity to any major extent.

The Impact of Physical Activity on Adolescent Low Back Pain: A Systematic Review.

Background: The relationship between physical activity and low back pain (LBP) in adolescents is complex, with conflicting evidence on whether activity is protective or a risk factor. The COVID-19 pandemic has introduced new challenges, increasing sedentary behaviors among adolescents. This systematic review updates the evidence on the association between physical activity and LBP in this population, focusing on the impact of the pandemic. Methods: A systematic search of PubMed, Cochrane Library, Web of Science, Medline, and SCOPUS identified observational studies published between January 2011 and December 2023. This review focused on adolescents aged 10 to 19 years, examining the effects of various physical activity levels and types on LBP incidence. Quality assessment was conducted using the ROBINS-I tool. Results: Twelve studies were included, with a total of 78,850 adolescents. The findings suggest a U-shaped relationship between physical activity and LBP, where low and high activity levels increase LBP risk, while moderate activity appears protective. The pandemic exacerbated LBP prevalence, likely due to increased sedentary behavior. Gender differences were noted, with females more likely to report LBP, particularly related to sports participation. Conclusions: Moderate physical activity may protect against LBP in adolescents, whereas both inactivity and excessive activity heighten risk. The pandemic's impact highlights the need for balanced physical activity to prevent LBP. Further research should explore the long-term effects of these changes.

Causal associations between frailty and low back pain: a bidirectional two-sample mendelian randomization study

BackgroundPrevious observational studies have revealed a potentially robust bidirectional relationship between frailty and low back pain (LBP). However, the precise causal relationship remains unclear.MethodsTo examine the potential causal association between frailty and LBP, we conducted bidirectional two-sample Mendelian randomization analysis (MR) study. Genetic data on frailty index (FI) and LBP were acquired from publicly available genome-wide association studies (GWAS). Various MR methodologies were utilized, such as inverse variance weighting (IVW), weighted median, and MR-Egger, to evaluate causality. Additionally, sensitivity analyses were conducted to evaluate the robustness of the findings.ResultsGenetically predicted higher FI (IVW, odds ratio [OR] = 1.66, 95% CI 1.17–2.36, p = 4.92E-03) was associated with a higher risk of LBP. As for the reverse direction, genetic liability to LBP showed consistent associations with a higher FI (IVW, OR = 1.13, 95% CI 1.07–1.19, p = 2.67E-05). The outcomes from various MR techniques and sensitivity analyses indicate the robustness of our findings.ConclusionOur research findings provide additional evidence bolstering the bidirectional causal relationship between frailty and LBP.

The vicious cycle of frailty and pain: a two-sided causal relationship revealed.

The decline in physiological functions in the older people is frequently accompanied with pain and frailty, yet the causal connection between frailty and pain remains uncertain. In this study, we utilized a two-sample Mendelian randomization (MR) approach to investigate the potential causal association between frailty and pain. Two-sample bidirectional MR was conducted using summary data from genome-wide association studies to examine the potential causal relationship between frailty (defined by the frailty index and frailty phenotype) and pain. Summary genome wide association statistics were extracted from populations of European ancestry. We also investigated the causal relationship between frailty and site-specific pain, including joint pain, limb pain, thoracic spine pain and low back pain. Causal effects were estimated using the inverse variance weighting method. Sensitivity analyses were performed to validate the robustness of the results. Genetic predisposition to frailty was associated with an increased risk of pain (frailty phenotype odds ratio [OR]: 1.73; P = 3.54 × 10-6, frailty index OR: 1.36; P = 2.43 × 10-4). Meanwhile, individuals with a genetic inclination toward pain had a higher risk of developing frailty. Regarding site-specific pain, genetic prediction of the frailty phenotype increased the occurrence risk of joint pain, limb pain and low back pain. Reverse MR analysis further showed that limb pain and low back pain were associated with an increased risk of frailty occurrence. This study presented evidence supporting a bidirectional causal relationship between frailty and pain. We highlighted the significance of addressing pain to prevent frailty and recommend the inclusion of pain assessment in the evaluation system for frailty.

Estimating the impact of metabolic syndrome on low back pain and the joint effects of metabolic syndrome and depressive symptoms on low back pain: insights from the China Health and Retirement Longitudinal Study

BackgroundAlthough metabolic syndrome (MetS) and depressive symptoms (DS) are predictors of low back pain (LBP), their combined effects and relative contributions to LBP have not been well studied. Using the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), this study conducted cross-sectional and longitudinal analyses to investigate the impact of MetS on LBP, and the joint effects of MetS and DS on LBP.MethodsThis study included a cross-sectional analysis of 8957 participants aged at least 45 years from the CHARLS 2011 dataset and a longitudinal follow-up of 3468 participants without LBP from the CHARLS 2011, tracked over 9.25 years (from June 2011 to September 2020) with 4 times LBP assessment in CHARLS 2013, 2015, 2018, and 2020. To explore the association between MetS on LBP and the joint effects of MetS and DS on LBP, multivariable-adjusted multinomial logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Multivariable-adjusted COX proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95% CIs. All statistical analyses were conducted using STATA (version SE16).ResultsIn the cross-sectional analysis, MetS was associated with a lower risk of LBP (adjusted OR = 0.85, 95% CI = 0.74–0.97), while there was no significance for this association in the longitudinal analysis. In the joint association of MetS and DS with LBP, participants with NoMetS + DS (adjusted OR = 2.31, 95% CI = 1.94–2.75), and MetS + DS (adjusted OR = 2.16, 95% CI = 1.81–2.59) were risk factors for LBP events, while those with MetS + NoDS (adjusted OR = 0.75, 95% CI = 0.62–0.90) was a protective factor for LBP events than those with NoMetS + NoDS. During the 9.25 years of follow-up, 1708 cases (49.25%) experienced incident LBP events. In the longitudinal analysis, a significantly negative association was not found in MetS + NoDS for LBP events. Three sensitivity analyses identified the robustness of the associations. Moreover, the nature of cross-sectional associations differed by age (45–64 and 65 + years).ConclusionsOur study found that MetS was linked to a lower incidence of LBP, but this effect does not persist over time. Importantly, the combination of MetS and DS significantly increased LBP risk, a joint effect not extensively studied before. These findings underscore the novel contribution of our research, advocating for the joint assessment of MetS and DS to enhance LBP risk stratification and inform prevention strategies.

THE RELATIONSHIP BETWEEN SMOKING AND LOW BACK PAIN - UP TO DATE 2024

The relationship between smoking and lower back pain is a condition whose exact cause is complex and not yet fully understood. Lower back pain can originate from various components of the spine, such as facet joints, ligaments, and intervertebral discs, and typically arises between the ages of 30 and 50. The literature review reveals that risk factors such as age, gender, genetics, and lifestyle are associated with the development of lower back pain, with smoking being a notable factor. Studies show a correlation between smoking and lower back pain, although the evidence is inconsistent. Some research indicates that smoking is associated with a higher risk of lower back pain, especially in young people and those with physically demanding jobs. The meta-analysis suggests that current and former smokers have a higher prevalence of lower back pain compared to non-smokers, and smoking cessation may reduce these effects. Proposed mechanisms include the impact of smoking on the health of intervertebral discs, blood circulation, and increased inflammation. The study concludes that further research is needed to clarify these associations and improve clinical and preventive practices.

P115. Cannabis use disorder is associated with an increased risk of persistent low-back pain in patients following posterior lumbar decompression and fusion surgery: a propensity score-matched analysis

P115. Cannabis use disorder is associated with an increased risk of persistent low-back pain in patients following posterior lumbar decompression and fusion surgery: a propensity score-matched analysis

Utilizing machine learning to analyze trunk movement patterns in women with postpartum low back pain

This paper presents an analysis of trunk movement in women with postnatal low back pain using machine learning techniques. The study aims to identify the most important features related to low back pain and to develop accurate models for predicting low back pain. Machine learning approaches showed promise for analyzing biomechanical factors related to postnatal low back pain (LBP). This study applied regression and classification algorithms to the trunk movement proposed dataset from 100 postpartum women, 50 with LBP and 50 without. The Optimized optuna Regressor achieved the best regression performance with a mean squared error (MSE) of 0.000273, mean absolute error (MAE) of 0.0039, and R2 score of 0.9968. In classification, the Basic CNN and Random Forest Classifier both attained near-perfect accuracy of 1.0, the area under the receiver operating characteristic curve (AUC) of 1.0, precision of 1.0, recall of 1.0, and F1-score of 1.0, outperforming other models. Key predictive features included pain (correlation of -0.732 with flexion range of motion), range of motion measures (flexion and extension correlation of 0.662), and average movements (correlation of 0.957 with flexion). Feature selection consistently identified pain, flexion, extension, lateral flexion, and average movement as influential across methods. While limited to this initial dataset and constrained by generalizability, machine learning offered quantitative insight. Models accurately regressed (MSE < 0.01, R2 > 0.95) and classified (accuracy > 0.94) trunk biomechanics distinguishing LBP. Incorporating additional demographic, clinical, and patient-reported factors may enhance individualized risk prediction and treatment personalization. This preliminary application of advanced analytics supported machine learning's potential utility for both LBP risk determination and outcome improvement. This study provides valuable insights into the use of machine learning techniques for analyzing trunk movement in women with postnatal low back pain and can potentially inform the development of more effective treatments.Trial registration: The trial was designed as an observational and cross-section study. The study was approved by the Ethical Committee in Deraya University, Faculty of Pharmacy, (No: 10/2023). According to the ethical standards of the Declaration of Helsinki. This study complies with the principles of human research. Each patient signed a written consent form after being given a thorough description of the trial. The study was conducted at the outpatient clinic from February 2023 till June 30, 2023.

Work-Related Fear-Avoidance Beliefs and Risk of Low-Back Pain: Prospective Cohort Study Among Healthcare Workers.

Low-back pain (LBP) is a prevalent condition among healthcare workers, negatively affecting well-being and work ability. Research has identified fear-avoidance beliefs, i.e., the belief that physical activities worsen or prolong pain, as a key psychological factor in LBP. Given the physical demands of healthcare work, understanding the link between fear-avoidance and LBP is crucial for effective prevention and management strategies. This study investigated the prospective association between fear-avoidance beliefs and risk of increased LBP intensity and duration in hospital workers. Fear-avoidance beliefs and LBP were assessed in 1933 healthcare workers from 389 departments at 19 hospitals at baseline and 1-year follow-up. Associations between baseline work-related fear-avoidance beliefs (FABW) and LBP intensity and duration at follow-up were analyzed using cumulative logistic regression, adjusting for various factors including age, sex, baseline LBP, education, seniority, patient transfers, psychosocial work environment, and lifestyle. Moderate and high FABW was associated with higher odds of increased pain intensity (OR: 1.37 [95% CI 1.09-1.73] and 1.85 [95% CI 1.18-2.88], respectively) and prolonged pain duration (OR: 1.37 [95% CI 1.05-1.78] and 2.27 [95% CI 1.50-3.44], respectively). A sensitivity analysis including only female nurses showed similar results, with the high FABW group having significantly higher odds of increased pain intensity (OR 2.95, 95% CI 1.84-4.72) and duration (OR 2.64, 95% CI 1.55-4.49). Fear-avoidance beliefs increase the risk of LBP intensity and duration among healthcare workers, emphasizing the need for interventions dealing with psychological aspects of LBP.

Association Between Dominant-Shoulder Internal-Rotation Restriction and Low-Back Pain in Elite Male High School Soft Tennis Players.

The incidence of low-back pain (LBP)is high among elite male high school soft tennis players. A previous report showed that hip internal-rotation (IR) restriction in the non-dominant leg could increase the risk of LBP. Moreover, IR in the dominant shoulder is important for serve and stroke movements, suggesting that IR restriction in the dominant shoulder can contribute to LBP. The simultaneous incidence of non-dominant-hip IR restriction may help in developing a good LBP-related factor model; therefore, this study aimed to investigate the association between dominant-shoulder IR restriction and LBP in elite male high school soft tennis players. This is a single-center cross-sectional study. This study included 176 male high school soft tennis players from 14 elite teams. The main measures were IR and external-rotation range of motion (ROM) in the dominant and non-dominant shoulders and hip, assessed using a goniometer with a bubble attached. Multiple logistic regression analyses were performed with the presence of LBP as a categorical variable (LBP, 1; non-LBP (NLBP), 0). Multiple logistic regression models were created as follows: Model 1 included dominant-shoulder IR restriction (loss of glenohumeral IR (GIRLoss)), Model 2 included non-dominant-hip IR ROM, and Model 3 included both GIRLoss and non-dominant-hip IR ROM as the main explanatory variables to test the association between dominant-shoulder IR restriction and LBP, compare its suitability as an associated factor with non-dominant-hip IR restriction, and determine if either or both should be considered in an LBP association model based on model fit. The significance of each multiple logistic regression model was examined using the model χ2 test, and a model with P<0.05 was judged as a significant model. Model fit was examined using the Hosmer-Lemeshow test, and P≥0.05 was judged as a good model fit. The Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare the goodness-of-fit among multiple logistic regression models. Results: The LBP and non-LBP groups comprised 59 and 117 players, respectively. GIRLoss in the dominant shoulder was a significant independent factor (odds ratio: 1.06, 95% CI: 1.02-1.09; P<0.01) in Model 3, which included hip IR restriction in the non-dominant leg (odds ratio: 0.90, 95% CI: 0.86-0.94; P<0.01).In all models, the explanatory variables fitted were significantly associated with LBP, indicating that the models were significant and fitted well: the AICs (and BICs) for Models 1, 2, and 3 were 198.4 (207.6), 178.6 (187.9), and 168.8 (181.1), respectively, indicating that Model 3 was the best fit. In elite male high school soft tennis players, IR restriction in the dominant shoulder was associated with LBP. IR restriction in the dominant shoulder and non-dominant hip as a significant factor for LBP may contribute to developing an optimal multiple logistic regression model for LBP.

Firefighter Hose Rolling Method: Low Back Pain Risks Analysis with Full-Factorial Approach

Firefighters frequently face the risk of Low back pain (LBP) due to the strenuous nature of their duties, especially during hose rolling tasks. Prioritizing their safety and health is vital. This study aimed to evaluate and compare various hose rolling techniques to lower the LBP risk in firefighters. A full-factorial approach was employed to exhaustively examine every possible combination of three key factors: the hose rolling method (conventional, mechanical, motorized), hose condition (dry, wet, dirty), and hose length (10, 20, 30 meters). Across 27 different trials, an Industrial Lumbar Motion Monitor (iLMM) was used to assess the LBP risk, which is lift rate, average twisting velocity, maximum moment, maximum sagittal flexion, and maximum lateral velocity. The study's results indicated that conventional method had the highest LBP risk at 58.22%, with mechanical rolling at 34.33%. In contrast, the motorized hose rolling method showed a significantly lower risk, averaging at 17.44%. This denotes a 40.78% reduction in LBP risk compared to conventional hose rolling method, positioning the motorized roller as the most effective and safest option among those tested. This method's efficacy underscores its potential as a viable solution for improving firefighter safety. These findings offer important insights into occupational health and safety in firefighting. The data suggests that adopting motorized hose rolling tools could significantly alleviate the physical burdens and associated health hazards firefighters face. This advancement is a critical step towards enhancing their overall safety and well-being in the field.

Low Back Pain Risk Among Athlete: A Scientometric Study

Low back pain (LBP) emerges as a prevalent concern within the athletic community, characterized by a noteworthy proclivity for recurrence. The repeated occurrence of LBP substantially impedes athletes and adversely affects their performance. As such, it becomes imperative to discern the underlying factors contributing to injuries in the lumbar region. The scientometric analysis will provide a clear pathway for researchers to understand the current state and evolution of the theme research area of low back pain risk among athletes. No scientometric study on this theme has been undertaken until today. Therefore, this research objective was to collect data from the database to identify the present trend of low back pain risk, development patterns, and current research. Software that has been utilized for commonness, co-occurrence, clustering, co-citation and analysis of burst was CiteSpace. A scientometric review of studies on athletes' low back pain risk from 2000 to 2023 finds considerable additional studies in the amount of literature, the citation frequency, and the hotspots available. The most influential author is Douglas W. Jackson, the most influential article is Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Thoraco-lumbar spine is the most common cluster, whereas the most popular keyword is spondylolisthesis. In conclusion, low back pain is becoming one of the future study topics. Furthermore, many stakeholders must be aware of current trends and advances in the athlete's low back pain risk.

Role of the Flexion Relaxation Phenomenon in the Analysis of Low Back Pain Risk in the Powerlifter: A Proof-of-Principle Study.

Unlike the most common training approaches for bodybuilding, powerlifting programs are generally based on maximum and submaximal loads, putting enormous stresses on the lumbar spine. The flexion relaxation phenomenon evaluation is a clinical tool used for low back pain (LBP) assessment. This study aimed to evaluate the role of the flexion relaxation phenomenon in the analysis of LBP in the powerlifters. Healthy professional powerlifters participated in the study. In fact, we divided the participants into a LBP-low-risk group and a LBP-high-risk group, based on a prior history of LBP. Outcome measures included flexion relaxation ratio (FRR) and trough surface electromyography collected during trunk maximum voluntary flexion; furthermore, during a bench press lifting, we measured the height of the arched back(ARCH), using a camera and the Kinovea video editing software, to consider a potential correlation with the risk of LBP. We included a group of 18 male (aged 24-39y) powerlifters of 93kg category. We measured a nonsignificant mean difference of ARCH between low-risk LBP group and high-risk LBP subjects. Curiously, maximum voluntary flexions were both above the threshold of 3.2μV; therefore, with an absence of appropriate myoelectric silence, on the contrary, the FRR ratios were higher than 9.5, considering the presence of the phenomenon, exclusively for the low-risk group. The lumbar arched back measurement data did not report any association with the LBP risk, regarding the maximum voluntary flexion value, and even more than the FRR there is a relationship with the presence or the absence of LBP risk. FRR could be considered as a useful parameter for studying the risk of LBP in powerlifting. The FRR index not only refers to the possible myoelectric silence of the lumbar muscles in trunk maximum forward flexion but also takes into account the energy value delivered by the lumbar muscles during the flexion. Furthermore, we can indicate that the size of the powerlifter ARCH may not be a determining factor in the occurrence of LBP.

Influence of Work Posture and Work Duration on the Incidence of Low Back Pain Among Batik Artisans: a Cross-sectional Study

Background: Batik artisans, particularly those involved in the "nyanting" process, are susceptible to lower back pain due to non-ergonomic working postures. These craftsmen sit for long durations as they meticulously apply wax to fabric. They utilize dingklik, which compels them to sit in a slightly hunched position. The repeated adoption of such postures can heighten the risk of lower back pain. This research aims to investigate the relationship between work posture, years of service, and the incidence of low back pain among "nyanting" batik artisans in Pulorejo Village Methods: This observational analytical research employed a cross-sectional approach with 42 "nyanting" batik artisans chosen through a total sampling technique. Conducted in Pulorejo Village in January 2024, the research assessed work posture using the Rapid Entire Body Assessment (REBA) instrument, while the occurrence of low back pain was evaluated through history taking and physical examination. Statistical analysis was performed using IBM SPSS version 25.0 software. Results: A significant positive correlation was found between years of service and the occurrence of low back pain (LBP) (p=0.002; r=0.471). The risk of LBP increases with the length of service. Additionally, there was a significant positive correlation between working posture, as indicated by the REBA score, and the occurrence of LBP (p=0.010; r=0.395). A higher REBA score corresponds to a greater risk of LBP. Conclusions: the Years of service and the working posture were associated to the incidence of low back pain (LBP) among "nyanting" batik artisans in Pulorejo Village.

Comparative analysis of machine learning models for efficient low back pain prediction using demographic and lifestyle factors.

Low back pain (LBP) is one of the most frequently occurring musculoskeletal disorders, and factors such as lifestyle as well as individual characteristics are associated with LBP. The purpose of this study was to develop and compare efficient low back pain prediction models using easily obtainable demographic and lifestyle factors. Data from adult men and women aged 50 years or older collected from the Korean National Health and Nutrition Examination Survey (KNHANES) were used. The dataset included 22 predictor variables, including demographic, physical activity, occupational, and lifestyle factors. Four machine learning algorithms, including XGBoost, LGBM, CatBoost, and RandomForest, were used to develop predictive models. All models achieved an accuracy greater than 0.8, with the LGBM model outperforming the others with an accuracy of 0.830. The CatBoost model had the highest sensitivity (0.804), while the LGBM model showed the highest specificity (0.884) and F1-Score (0.821). Feature importance analysis revealed that EQ-5D was the most critical variable across all models. In this study, an efficient LBP prediction model was developed using easily accessible variables. Using this model, it may be helpful to identify the risk of LBP in advance or establish prevention strategies in subjects who have difficulty accessing medical facilities.

Novel Ensemble Learning Algorithm for Early Detection of Lower Back Pain Using Spinal Anomalies

Lower back pain (LBP) is a musculoskeletal condition that affects millions of people worldwide and significantly limits their mobility and daily activities. Appropriate ergonomics and exercise are crucial preventive measures that play a vital role in managing and reducing the risk of LBP. Individuals with LBP often exhibit spinal anomalies, which can serve as valuable indicators for early diagnosis. We propose an advanced machine learning methodology for LBP detection that incorporates data balancing and bootstrapping techniques. Leveraging the features associated with spinal anomalies, our method offers a promising approach for the early detection of LBP. Our study utilizes a standard dataset comprising 310 patient records, including spinal anomaly features. We propose an ensemble method called the random forest gradient boosting XGBoost Ensemble (RGXE), which integrates the combined power of the random forest, gradient boosting, and XGBoost methods for LBP detection. Experimental results demonstrate that the proposed ensemble method, RGXE Voting, outperforms state-of-the-art methods, achieving a high accuracy of 0.99. We fine-tuned each method and validated its performance using k-fold cross-validation in addition to determining the computational complexity of the methods. This innovative research holds significant potential to revolutionize the early detection of LBP, thereby improving the quality of life.

Relationship of disc degeneration after pubertal growth spurt to future low back pain: a longitudinal cohort study.

In this longitudinal cohort study, we investigated the relationship of disc degeneration (DD) after pubertal growth spurt to future low back pain (LBP). A group of healthy volunteers underwent a semi-structured interview about LBP without trauma and a 1.5T lumbar MRI at ages 18 and 34. A Pfirrmann Summary Score (PSS) was calculated by adding up the Pfirrmann grades of the three lowest lumbar discs of each subject (range 3-15). The relationship of PSS at age 18 to LBP at age 34 was analyzed. Forty-one participants had full data at both time points. Mean PSS at age 18 was 6.8 (SD 1.1) and 5.6 (SD 1.2) for participants with or without LBP at age 34, respectively (p = 0.009). The OR (95% CI) of PSS at age 18 for LBP at age 34 was 5.46 (1.22 to 24.47) when adjusted for sex, BMI, smoking and physical activity. All participants but one with PSS greater than 6 at age 18 reported LBP at age 34. This is the first study to suggest that DD may be associated with future LBP and the critical time frame seems to be the pubertal growth spurt. Every 1-point increase in Pfirrmann grade at age 18 increased the risk of LBP 5.5-fold at age 34 when adjusted for sex, BMI, smoking and physical activity at age 34. All participants but one with at least one disc with Pfirrmann grade 3 or higher at age 18 reported LBP at age 34.

Human and Porcine Lumbar Endplate Injury Risk in Repeated Flexion-Compression.

Low back pain (LBP) affects 50-80% of adults at some pointin their lifetime, yet the etiology of injury is not well understood. Those exposed to repeated flexion-compression are at a higher risk for LBP, such as helicopter pilots and motor vehicle operators. Animal injury models offer insight into in vivo injury mechanisms, but interspecies scaling is needed to relate animal results to human. Human (n = 16) and porcine (n = 20) lumbar functional spinal units (FSUs) were loaded in repeated flexion-compression (1Hz) to determine endplate fracture risk over long loading exposures. Flexion oscillated from 0 to 6° and peak applied compressivestress ranged from 0.65 to 2.38MPa for human and 0.64 to 4.68MPa for porcine specimens. Five human and twelve porcine injuries were observed. The confidence intervals for human and porcine 50% injury risk curves in terms of stress and cycles overlapped, indicating similar failure behavior for this loading configuration. However, porcine specimens were more tolerant to the applied loading compared to human, demonstrated by a longer time-to-failure for the same applied stress. Optimization revealed that time-to-failure in human specimens was approximately 25% that of porcine specimens at a given applied stress within 0.65-2.38MPa. This study determined human and porcine lumbar endplate fracture risks in long-duration repeated flexion-compression that can be directly used for future equipment and vehicle design, injury prediction models, and safety standards. The interspecies scale factor produced in this study can be used for previous and future porcine lumbar injury studies to scale results to relevant human injury.

A causal examination of the correlation between hormonal and reproductive factors and low back pain.

The relationship between hormonal fluctuations in the reproductive system and the occurrence of low back pain (LBP) has been widely observed. However, the causal impact of specific variables that may be indicative of hormonal and reproductive factors, such as age at menopause (ANM), age at menarche (AAM), length of menstrual cycle (LMC), age at first birth (AFB), age at last live birth (ALB) and age first had sexual intercourse (AFS) on low back pain remains unclear. This study employed Bidirectional Mendelian randomization (MR) using publicly available summary statistics from Genome Wide Association Studies (GWAS) and FinnGen Consortium to investigate the causal links between hormonal and reproductive factors on LBP. Various MR methodologies, including inverse-variance weighted (IVW), MR-Egger regression, and weighted median, were utilized. Sensitivity analysis was conducted to ensure the robustness and validity of the findings. Subsequently, Multivariate Mendelian randomization (MVMR) was employed to assess the direct causal impact of reproductive and hormone factors on the risk of LBP. After implementing the Bonferroni correction and conducting rigorous quality control, the results from MR indicated a noteworthy association between a decreased risk of LBP and AAM (OR=0.784, 95% CI: 0.689-0.891; p=3.53E-04), AFB (OR=0.558, 95% CI: 0.436-0.715; p=8.97E-06), ALB (OR=0.396, 95% CI: 0.226-0.692; p=0.002), and AFS (OR=0.602, 95% CI: 0.518-0.700; p=3.47E-10). Moreover, in the reverse MR analysis, we observed no significant causal effects of LBP on ANM, AAM, LMC and AFS. MVMR analysis demonstrated the continued significance of the causal effect of AFB on LBP after adjusting for BMI. Our study explored the causal relationship between ANM, AAM, LMC, AFB, AFS, ALB and the prevalence of LBP. We found that early menarche, early age at first birth, early age at last live birth and early age first had sexual intercourse may decrease the risk of LBP. These insights enhance our understanding of LBP risk factors, offering valuable guidance for screening, prevention, and treatment strategies for at-risk women.