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PubMed2004

The distribution of forces between the upper and lower back during load carriage.

INTRODUCTION/PURPOSE: To determine the effects of backpack mass on the forces exerted by the backpack on the carrier and on the distribution of these forces between the upper back (including shoulders) and lower back (sacrum and iliac crest). METHODS: Eleven male volunteers (mean age 22.7 SEM 1.1 yr) walked on a level treadmill at 1.34 m.s(-1) carrying a backpack loaded to three different masses (13.6, 27.2, and 40.8 kg). The backpack's hip belt was connected to force transducers that measured the forces exerted on the lower back. The total force between the subject and backpack was determined from the backpack's mass and acceleration. Forces on the upper back were calculated as total force minus the forces exerted on the lower back. RESULTS: There was a significant effect of backpack mass on the vertical and anterior/posterior forces exerted on the upper and lower back, and on the total force exerted on the backpack center of mass. Regardless of mass, approximately 30% of the vertical force was borne by the lower back; the upper back and shoulders supported the remaining 70%; this is based on data averaged across the stride. Dimensionless analysis revealed peak forces on the upper and lower back increased proportionately to backpack mass whereas the peak forces exerted on the backpack COM increased disproportionately. CONCLUSIONS: The backpack exerts consistent anterior force on the lower back, which likely contributes to the occurrence of low-back pain associated with load carriage. Approximately 30% of the vertical force generated by the backpack can be transferred to the lower back by using an external frame backpack with a hip belt.

Adult↗

PubMed2006

Study of the prevalence and risk factors for low back pain in truck drivers in the state of São Paulo, Brazil.

OBJECTIVE: To investigate the prevalence of low back pain in truck drivers and check for possible risk factors related to the presence of low back pain. METHODS: A questionnaire was developed including personal factors such as age, practice of physical and sports activities, general health habits, occupation-related issues, and factors associated with low back pain. The body mass index (ratio of body weight to the square of height, kg/m2) was calculated. Of 489 male truck drivers assessed, 410 were enrolled into the study. The statistical analysis was divided into 2 stages: descriptive analysis of data, and binary logistical regression, where the response (dependent) variable (presence of low back pain) was associated with each independent variable to check for correlation with low back pain. RESULTS: Of the 410 truck drivers evaluated, 242 (59%) presented with low back pain, while 168 (41%) did not have low back pain. The only factor correlated with the presence of low back pain was the number of working hours; the other factors had no correlation with low back pain. CONCLUSION: The prevalence of low back pain in truck drivers was 59%. The number of working hours was the only variable associated with occurrence of low back pain, with an average of about 1 hour longer work time for drivers with low back pain compared to those without it and with an odds ratio of 1.07 (P = 0.026).

Adult↗

PubMed2006

Nonsurgical management of acute and chronic low back pain.

A variety of nonsurgical treatment alternatives exists for acute and chronic low back pain. Patients should receive appropriate education about the favorable natural history of low back pain, basic body mechanics, and methods (eg, exercises, activity modification, behavioral modification) that can reduce symptoms. Nonprescription medication is efficacious for mild to moderate pain. Nonsteroidal anti-inflammatory drugs, alone or in combination with muscle relaxants, relieve pain and improve overall symptoms of acute low back pain. Exercise therapy has limited value for acute low back pain, but strong evidence supports exercise therapy in the management of chronic low back pain. Moderately strong evidence supports the use of manipulation in acute back pain. Evidence is weak for the use of epidural corticosteroid injections in patients with acute low back pain, strong for short-term relief of chronic low back pain, and limited for long-term relief of chronic low back pain. The use of facet injections in the management of acute low back pain is not supported by evidence, nor is the effectiveness of orthoses, traction, magnets, or acupuncture. Trigger point injections are not indicated for nonspecific acute or chronic low back pain, and sacroiliac joint injections are not indicated in the routine management of low back pain. Conflicting evidence exists regarding the use of transcutaneous electrical nerve stimulation.

Acute Disease↗

PubMed1999

Water-gymnastics reduced the intensity of back/low back pain in pregnant women.

OBJECTIVE: To investigate if water-gymnastics during pregnancy may reduce the intensity of back/low back pain and the number of days on sick-leave. METHODS: A prospective, randomized study. One hundred and twenty-nine women were randomized to participate in water-gymnastics once a week during the second half of pregnancy and 129 were randomized to a control group. The women in both groups filled in questionnaires in gestational weeks 18, 34 and within the first postpartum week. Every day from week 18 to labor they assessed the intensity of back/low back pain. RESULTS: Back pain intensity increased during pregnancy. No excess risk for the pregnancy associated with water-gymnastics was observed. The women participating in water-gymnastics recorded a lower intensity of back/low back pain. The total number of days on sick-leave because of back/low back pain was 982 in the water-gymnastics group (124 women) compared with 1484 in the control group (120 women). After weeks 32 33, seven women in the water-gymnastics group compared with 17 in the control group were on sickleave because of back/ low back pain (p=0.031). CONCLUSIONS: Intensity of back/low back pain increased with advancing pregnancy. There was no excess risk for urinary or vaginal infections associated with water-gymnastics. Water-gymnastics during the second half of pregnancy significantly reduced the intensity of back/ low back pain. Water-gymnastics decreased the number of women on sick-leave because of back/low back pain. Water-gymnastics during pregnancy can be recommended as a method to relieve back pain and may reduce the need for sick-leave.

Absenteeism↗

PubMedDate not supplied

Nonspecific back pain in children. A search for associated factors in 14-year-old schoolchildren.

BACKGROUND: Nonspecific back pain in children is nearly as common as in adults but is associated with a number of age-specific risk factors including female gender, a family history of low back pain, a high level of physical activity, and prolonged sitting. OBJECTIVE: To investigate potential school-related risk factors for back pain in children, most notably schoolbag weight expressed as a percentage of body weight (relative schoolbag weight), whether the schoolbag is carried by hand or by a shoulder harness, how the child travels to and from school, and sitting positions. PATIENTS AND METHODS: 123 eighth-graders, 58 girls and 65 boys, with a mean age of 14 +/- 0.6 years, completed an anonymous self-questionnaire during a school day involving six hours of classes. Their schoolbag was weighed on the same day. RESULTS: Most respondents traveled to and from school in a vehicle (70%), made one trip in each direction each day (75%), and carried their schoolbag by the shoulder harness (92%). The prevalence of back pain on the study day was 27.6%, whereas the cumulative prevalence for the last 12 months was 82.9% with 16.3% of respondents reporting a single episode of pain, 57.7% recurrent pain, and 8.9% chronic pain. A need for a physician visit for back pain was reported in 18.7% of cases, and 14.6% of respondents had missed school and/or sporting activities because of back pain. Female gender was associated with current back pain (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.2-6.1). A relative schoolbag weight of 20% or more was associated with a history of back pain (OR, 3.1; 95% CI, 1.0-9.2), and this effect was larger in children who traveled to and from school on foot and in those who carried their schoolbag in their hand. Sitting on the edge of the chair while completing the questionnaire was significantly associated with a history of a physician visit for back pain (OR, 3.1; 95% CI, 1.0-9.5). Neither handedness nor the position of the questionnaire on the table were significantly associated with back pain in our study population. CONCLUSIONS: The findings from this cross-sectional study indicate a need for a longitudinal prospective study designed to identify etiologic and prognostic factors of back pain in adolescents, with the goal of devising preventive strategies likely to reduce the risk of low back pain in adulthood.

Adolescent↗

PubMed2000

Prevalence of back symptoms in elders.

OBJECTIVE: The prevalence of back pain has not been well studied in elders in the US. We describe the prevalence of back symptoms in a cohort of elderly subjects residing in the US by age, sex, examination site, and location of pain. METHODS: Data from this study are based on 1037 surviving members of the original Framingham Heart Study cohort aged 68-100 years who participated in the 22nd biennial examination in 1992-93. Subjects were questioned about back pain and timing and location of pain. RESULTS: Prevalence estimates varied, depending on the question used to assess back symptoms and the manner in which the question was asked. For example, back symptoms on most days occurred in 22.3 of 100 elders. Low back symptoms were more prevalent than those in the mid or upper back. Prevalence was higher among women than men, especially for symptoms in the mid or upper back area. Age did not affect the prevalence of back symptoms in this elderly cohort. Back symptoms were also more prevalent among subjects who were examined in their residence than among those who were examined at the examination site. Most subjects who were examined at their residence chose this location for health reasons. CONCLUSION: Back symptoms are highly prevalent in the elderly, although, among elders, they do not increase in prevalence with age. They are more common in women than men. Elders confined mostly to their homes have an especially high prevalence of back symptoms.

Age Factors↗

PubMed2003

Is low back pain in youth associated with weight at birth? A cohort study of 8000 Danish adolescents.

INTRODUCTION: Low back pain has been associated with an increased risk of several diseases and with poor general health. Also low birth weight has been associated with an increased susceptibility to various diseases as well as with poor general health. Thus, low birth weight could be a common factor--indicating a general frailty with an increased risk of both low back pain and overall morbidity. To our knowledge, the association between low back pain and birth weight has not previously been investigated. This study investigates the correlation between birth characteristics and low back pain in adolescence. MATERIAL AND METHODS: Analyses are based on data from The Danish Twin Registry. Information about low back pain is from a postal survey, and information about birth characteristics are from The Danish Medical Birth Register. Analyses include 8278 individuals aged 12-22 years--an age at which they are still largely unaffected by the influence of working life. Possible associations between low back pain, birth weight, birth length, ponderal index, gestational age and Apgar scores are investigated by the use of logistic regression analysis. RESULTS: The odds ratio for the lifetime prevalence of low back pain increases from 1.21 (0.94-1.56) for a birth weight of 2000-2500 g to 1.97 (1.35-2.88) for a birth weight of > 3500 g compared to the smallest weight group (< 2000 g) in males, whereas there is a small statistically insignificant, positive association for females. The same pattern is seen for the one-year prevalence of low back pain. No associations are documented between low back pain and other birth factors. The positive association between low back pain and birth weight is independent of other birth factors and of anthropometric measures in adolescence. CONCLUSION: There is a statistically significant association between high birth weight and the risk of developing low back pain in males but not in females. Our results do not indicate that frailty at birth increases the risk of low back pain in adolescence.

Adolescent↗

PubMed1995

Assessment and exercise in low back pain. With special reference to the management of pain and disability following first time lumbar disc surgery.

Eight articles including 555 low back pain patients have been published. They included the following topics: 1) A ratio interval rating scale (Low Back Pain Rating Scale (RS)) was introduced. The possibility of registering the actual status in low back pain patients including; Back Pain, Sciatica, Functional Disability and Physical Impairment was studied. Methods of evaluating index-scales developed in the field of psychometry were applied in the validation process of RS. RS was found to be both valid and user friendly. 2) Using Low Back Pain Rating Scale the general outcome following first-time lumbar disc surgery was analysed through a survey. The results showed that more than half of the patients still suffered from considerable Back Pain, Sciatica, and Functional Disabilities. Approximately 25% of the patients risked reduced work capabilities, and many receive pensions. 3) By means of a comprehensive statistical analysis of 18 studied preoperative demographic and physical findings, sex, hypoalgesia, smoking and Finneson-index were found to have prognostic value. 4) Attempts at influencing the results obtained from lumbar disc surgery have been tested in 3 randomized trials, including back training and peroperative glucocorticoid administration. 5) Three randomized trials including patients suffering from chronic low back pain (with or without previous lumbar disc surgery) attempted to convey which elements of a training programme provide patients with the greatest effect and the least risk of side-effects. It was concluded that Low Back Pain Rating Scale is a useable assessment instrument in both clinical trials and as a daily quality control instrument of back patients. There is a need of increased patient scrutiny in patient selection prior to lumbar disc surgery. Postoperative rehabilitation should include intensive back training, which has been shown to be of value in behavioural support and restoration of functional deficits. This has resulted in increased work capacities for disc operated patients. The exercise programmes are generally free of side-effects. As regards chronic back pain patients with or without previous lumbar surgery, high dosage exercises with training periods lasting at least 12 to 16 sessions are of crucial importance for success. Exercises should be dynamic and full-range, and carried out following the adage "Don't let the pain be your guide.

Exercise Therapy↗

PubMed1996

Persistent back pain and sciatica in the United States: patient characteristics.

Low back pain is an extremely common, seriously disabling, nonfatal public health problem worldwide. The National Low Back Pain Study was a multicenter study of a large, heterogeneous group of patients who have been referred to either a neurosurgeon or an orthopedic surgeon for the evaluation and treatment of a persistent complaint of low back pain. In this paper, we characterize persistent low back pain patients and their complaints, describe the impact of persistent low back pain on the patients' functional and psychological status, report on the patients' medical characteristics, and identify treatments that are currently prescribed for these patients. Persistent low back pain is most common among people in their mid-to-late thirties and early-to-mid forties. The patients are mostly white, well educated, and generally affluent. The majority are gainfully employed, but some quit working because of pain and those who do tend to be less educated, and more likely to be involved in litigation. The average patient has had low back pain intermittently for 10 years. The pain is usually well localized but its severity varies considerably. Besides pain, most persistent low back pain patients report a variety of motor and sensory deficits. Patients also report significant functional impairment at work, at play, and at home. The typical patient does not, however, display significant psychological distress. Most patients have consulted multiple health care providers, have received a variety of treatments, and have used a variety of medications to alleviate pain; a few have been subjected to more aggressive treatment measures including surgery, intradiscal therapy, and narcotic and psychoactive drugs. None of these treatments has been effective. Physical examinations of these patients do not provide significant clues for making a definitive diagnosis. Nonspecific abnormalities such as muscle spasm, tenderness, and trigger points are quite common, but motor weakness and sensory deficits in the lower extremities, and reflex changes in the knees and ankles, are much less common. The classic combination of reflex changes, motor weakness, and sensory deficits associated with specific protruded discs are extremely rare even though one of three patients had a diagnosis of disc herniation. Diagnostic imaging studies revealed that the majority of persistent low back pain patients have spondylotic abnormalities involving root compression or lumbar instability or both, with root compression as the primary cause of the complaint. Myofascial syndrome and lumbar instability were the next most common diagnoses. After a thorough evaluation by specialists in spinal disorders, three of five persistent low back pain patients were prescribed an additional course of conservative therapy, one of five was prescribed surgery, and the rest were prescribed no treatment. Persistent low back pain patients appear to be a distinct group of low back pain patients who are different from patients who have similar nonpersistent acute symptoms and those who have the chronic pain syndrome characterized by significant behavioral and psychological co-morbidities.

Adult↗

PubMed1991

Technique and clinical results of carotid stump back-pressure to determine selective shunting during carotid endarterectomy.

A method of confirming carotid back pressure accuracy, variability during carotid clamping, and the clinical results with a modified back pressure shunt criterion were evaluated in 665 carotid endarterectomies. Mean arterial pressure, back pressure, and internal jugular vein pressure were measured. Cerebral perfusion pressure (back pressure-jugular vein pressure) and the collateral to hemisphere vascular resistance ratio, (ratio = [arterial pressure-back pressure]/[back pressure-jugular vein pressure]) were calculated. A shunt was used when cerebral perfusion pressure less than 18 mm Hg. Back pressure accuracy was confirmed by test occlusion of the internal carotid artery distal to the plaque. Initial back pressure values were falsely high in 83 (12.5%) carotid endarterectomies. The mean SD (n = 665, mm Hg) were arterial pressure = 84.0 +/- 9.06, back pressure = 41.0 +/- 15.9, jugular vein pressure = 6.2 +/- 3.9, cerebral perfusion pressure = 35.1 +/- 5.7, and resistance ratio = 1.85 +/- 1.44. Perfusion pressure was less than 18 mm Hg in 82 (12.3%), of which 74 (11.1%) were shunted, and 8 (1.2%) had perfusion pressure increased greater than or equal to 18 mm Hg during carotid endarterectomy with phenylephrine. Back pressure was less than 25 mm Hg in 107 (16.1%), less than or equal to 25 in 114 (17.1%), and less than 50 mm Hg in 481 (72.3%). Pressures were continuously monitored during 28 carotid endarterectomies, and all had a positive linear relationship between arterial pressure and back pressure, and minimal variability in the back pressure/arterial pressure and resistance ratios. Only two patients (0.3%) had a new neurologic deficit in the first 12 hours after carotid endarterectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2002

Working memory for complex figures: an fMRI comparison of letter and fractal n-back tasks.

n-back letter and fractal tasks were administered to 11 participants during functional magnetic resonance imaging to test process specificity theories of prefrontal cortex (PFC) function and assess task validity. Tasks were matched on accuracy, but fractal n-back responses were slower and more conservative. Maintenance (1-back minus 0-back) activated inferior parietal and dorsolateral PFC, with additional activation in right ventrolateral PFC during letter n-back and left lingual gyrus during fractal n-back. Maintenance plus manipulation (2-back minus 0-back) activated inferior parietal, Broca's area, insula, and dorsolateral and ventral PFC, with greater right dorsolateral PFC activation for letter n-back. Manipulation only (2-back minus 1-back) produced additional and equivalent dorsolateral PFC and anterior cingulate activation in both tasks. Results support fractal n-back validity and indicate substantial overlap in working memory functions of dorsal and ventral PFC.

Adult↗

PubMed2002

The effect of walking faster on people with acute low back pain.

Little is known about self-selected speed and fast walking in people with acute low back pain. This study aimed to investigate (1) the strategies that people with acute low back pain use to change from self-selected speed to fast walking and (2) the effect of a period of treadmill walking on level of back pain. Eight participants with acute low back pain and eight matched control participants were evaluated during self-selected speed and fast walking on a treadmill. The eight participants with back pain were retested 6 weeks later when pain had resolved. Measurements were taken of (1) three-dimensional angular movements of the pelvis and lumbar spine using a videoanalysis system, (2) the timing and distance parameters of walking, and (3) pain levels as measured by a visual analogue scale. We found that to walk faster, those with acute low back pain increased stride length and the frontal plane movements of pelvic list and lumbar lateral flexion (pelvis) to a greater extent than when symptoms had resolved. We also found that 10 min of treadmill walking at self-selected speed led to a reduction in the level of back pain and that there was a high degree of negative correlation between level of back pain and stride length. An additional 5 min of fast walking did not lead to any further changes in level of back pain. These findings support clinical recommendations that the moderate physical activity of walking may be beneficial in the management of people with acute low back pain. To walk faster, people with acute low back pain may utilise strategies that had been limited at self-selected speed, without any increase in pain.

Adult↗

PubMed2004

Differences in motor recruitment and resulting kinematics between low back pain patients and asymptomatic participants during lifting exertions.

BACKGROUND: Low back disorders are a prevalent problem in society today and may lead to chronic debilitating low back pain. Developing our understanding of temporal muscle and kinematic patterns during manual material handling tasks may provide insight for preventing the cascading series of events leading to chronic low back pain. METHODS: Sixty-two low back pain patients and 61 asymptomatic participants performed a variety of lifting exertions that varied in lift origin horizontal and vertical distance, lift asymmetry, and weight. Electromyographic activity of 10 trunk muscles as well as trunk and pelvic kinematics was recorded during each exertion. Differences in muscle activation and kinematic parameters were compared between low back pain patients and asymptomatic participants as a function of experimental conditions. FINDINGS: Both the left and right erector spinae activated significantly earlier and were on significantly longer in low back pain patients compared to asymptomatic participants. The horizontal and vertical location of the lift influenced the EMG and kinematic differences between the low back pain patients and asymptomatic participants. INTERPRETATION: These finding indicate that low back pain patients would be exposed to increase muscle activity resulting in higher spine loads for a greater length of time compared to asymptomatic participants. The longer exposure time to increased spine load may lead to greater risk of future low back injury and cascading events leading to debilitating low back pain. The longer muscle activation time suggests that low back pain patients have changed their motor program from an open to a closed loop system.

Adult↗

PubMed2003

Back extensor muscle endurance test scores in coal miners in Australia.

STUDY DESIGN: A cross-sectional analytic study was conducted. OBJECTIVES: To collect normative data on back extensor endurance holding times and evaluate the discriminative validity of the Biering-Sorensen test in a group of coal miners in Australia. SUMMARY OF BACKGROUND DATA: Low back pain is a common complaint among those working in the Australian coal mining industry. One test that may be predictive of first-time episodes of low back pain is the Biering-Sorensen test of back extensor endurance strength. While this test has been evaluated in overseas sedentary populations, normative data and the discriminative ability of the test have not been evaluated with coal miners. METHODS: Eighty-eight coal miners completed a questionnaire for known risk factors for low back pain, performed the Biering-Sorensen test, and undertook a test of aerobic fitness. Data analysis was performed to describe the groups and to determine whether any significant difference existed between those with a past history of low back pain and those without. RESULTS: Significantly lower than expected holding times were found in this group of coal miners (mean 113 s). This result was significantly lower than demonstrated in previous studies (mean 138 s, t87 = 6.32, p < 0.001). When holding times for those with a past history of low back pain were compared with times for those with no history of low back pain, the difference was not statistically significant (t86 = 1.56, p = 0.12), nor was there a significant difference in fitness between those with a past history of low back pain and those without (t86 = 0.47, p = 0.64). DISCUSSION/CONCLUSIONS: Coal miners in Australia have lower than normal Biering-Sorensen holding times. This lower back holding time does not differ between coal miners with a past history of low back pain and those without.

Adult↗

PubMed2000

Effect of alendronate on limited-activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures. Fracture Intervention Trial Research Group.

BACKGROUND: Women with new vertebral fractures have an increased risk of back pain and functional limitation because of back pain. Alendronate sodium treatment reduces the risk of new vertebral fracture by 50% in postmenopausal women with osteoporosis. OBJECTIVE: To determine the effect of alendronate therapy on days affected by back pain in postmenopausal women with existing vertebral fractures. DESIGN: Three-year, placebo-controlled, randomized, double-blind study. SETTING: Fifteen university-based research clinics in the United States. PARTICIPANTS: A total of 2027 postmenopausal women aged 55 to 81 years with low femoral neck bone density and a preexisting vertebral fracture. INTERVENTION: Alendronate sodium (5 mg/d for 2 years and 10 mg/d for the third year) or placebo. MAIN OUTCOME MEASURES: Occurrence and severity of back pain, number of days with back pain, and number of days of bed rest or limited activity because of back pain during 3 years of follow-up. RESULTS: Irrespective of treatment assignment, women with new, clinically recognized vertebral fractures during follow-up had an increased risk of days of bed disability and days of limited activity because of back pain after the fracture. Women receiving alendronate reported an average of 3.2 fewer days of bed rest (P = .001) and 11.4 fewer days of limited activity (not including days of bed rest) because of back pain (P = .04) during follow-up than those receiving placebo. In the alendronate group, relative to the placebo group, there was a reduced risk of 1 or more bed-rest days (relative risk, 0.68; 95% confidence interval, 0.53-0.87), of 7 or more bed-rest days (0.44; 0.30-0.64), and of 7 or more limited-activity days (0.87; 0.76-0.99). There were no statistically significant differences between treatment groups in the frequency of days of back pain or increases in back-related disability between baseline and study end. CONCLUSION: In postmenopausal women with preexisting vertebral fracture, alendronate therapy for 3 years reduced the number of days of bed disability and days of limited activity caused by back pain.

Activities of Daily Living↗

PubMed1998

Lumbar supports and education for the prevention of low back pain in industry: a randomized controlled trial.

CONTEXT: Low back pain is a frequent and costly health problem. Prevention of low back pain is important both for the individual patient and from an economic perspective. OBJECTIVE: To assess the efficacy of lumbar supports and education in the prevention of low back pain in industry. DESIGN: A randomized controlled trial with a factorial design. SETTING: The cargo department of an airline company in the Netherlands. PARTICIPANTS: A total of 312 workers were randomized, of whom 282 were available for the 6-month follow-up. INTERVENTIONS: Subjects were randomly assigned to 4 groups: (1) education (lifting instructions) and lumbar support, (2) education, (3) lumbar support, and (4) no intervention. Education consisted of 3 group sessions on lifting techniques with a total duration of 5 hours. Lumbar supports were recommended to be used during working hours for 6 months. MAIN OUTCOME MEASURES: Low back pain incidence and sick leave because of back pain during the 6-month intervention period. RESULTS: Compliance with wearing the lumbar support at least half the time was 43%. In the 282 subjects for whom data were available, no statistically significant differences in back pain incidence (48 [36%] of 134 with lumbar support vs 51 [34%] of 148 without, P=.81) or in sick leave because of low back pain (mean, 0.4 days per month with lumbar support vs 0.4 days without, P=.52) were found among the intervention groups. In a subgroup of subjects with low back pain at baseline, lumbar supports reduced the number of days with low back pain per month (median, 1.2 vs 6.5 days per month; P=.03). CONCLUSIONS: Overall, lumbar supports or education did not lead to a reduction in low back pain incidence or sick leave. The results of the subgroup analysis need to be confirmed by future research. Based on our results, the use of education or lumbar supports cannot be recommended in the prevention of low back pain in industry.

Absenteeism↗

PubMed2001

A 12-year follow-up of subjects initially sicklisted with neck/shoulder or low back diagnoses.

BACKGROUND AND PURPOSE: Neck/shoulder and low back pain are common in the Western world and can cause great personal and economic consequences, but so far there are few long term follow-up studies of the consequences of back pain, especially studies that separate the location of back pain. More knowledge is needed about different patterns of risk factors and prognoses for neck/shoulder and low back pain, respectively, and they should not be treated as similar conditions. The aim of the present study was to investigate possible long-term differences in neck/shoulder and low back symptoms, experienced over a 12-year period, with regard to work status, present health, discomfort and influence on daily activities. METHOD: A retrospective cohort study of individuals sicklisted with neck/shoulder or low back diagnoses 12 years ago was undertaken. Included were all 213 people who, in 1985, lived in the municipality of Linköping, Sweden, were aged 25-34 years and who had taken at least one new period of sickleave lasting > 28 days with a neck/shoulder or low back diagnosis. In 1996, a questionnaire was mailed to the 204 people who were still resident in Sweden (response rate 73%). RESULTS: Those initially absent with neck/shoulder diagnoses rated their present state of discomfort as worse than those sicklisted with low back diagnoses. Only 4% of the neck/shoulder group reported no present discomfort compared with 25% of the low back group. Notably, both groups reported the same duration of low back discomfort during the last year, which may indicate a higher risk for symptoms in more than one location for subjects with neck/shoulder problems. CONCLUSIONS: Individuals with sickness absence of more than 28 days with neck/shoulder or low back diagnoses appear to be at high risk of developing long-standing symptoms significantly more so for those initially having neck/shoulder diagnoses.

Activities of Daily Living↗

PubMed2002

Low back pain in individuals with chronic airflow limitation and their partners--a preliminary prevalence study.

BACKGROUND AND PURPOSE: The prevalence of low back pain in individuals with chronic airflow limitation, and their partners, is unknown. Individuals with chronic airflow limitation, and their respective partners, are likely to have several risk factors that may increase the predisposition for low back pain. The aim of the present study was to provide preliminary data on the prevalence of low back pain in individuals with chronic airflow limitation, and their partners. METHOD: A cross-sectional observational study design was used. Individuals with chronic airflow limitation, and their partners, were approached at South Australian metropolitan Lung Support Group meetings and invited to participate in the study. Three commonly used questionnaires: the Medical Outcomes Survey Short-Form 36 (MOS SF-36); the St George's Respiratory Questionnaire (SGRQ); and the Nordic Low Back Pain Questionnaire (NLBPQ) were used to collect data on general health, respiratory health and low back pain prevalence, respectively. Odds ratios and independent Student's t-tests were used to analyse data by use of Epi Info Version 6.0 software. RESULTS: Sixty subjects participated in the study: 41 individuals with chronic airflow limitation and 19 partners of individuals with chronic airflow limitation. The lifetime, 12-month and seven-day prevalence of low back pain in individuals with chronic airflow limitation was 69%, 58% and 31%, respectively. The prevalence of low back pain in the partners of individuals with chronic airflow limitation was found to be higher, at 74%, 68% and 58%, respectively. Four significant relationships between general and respiratory health, and low back pain were demonstrated for individuals with chronic airflow limitation. CONCLUSIONS: The prevalence of low back pain in individuals with chronic airflow limitation was comparable to the lifetime prevalence for the general and older population, and greater than the 12-month prevalence reported for the older population. The prevalence of low back pain for the partners of individuals with chronic airflow limitation was consistently higher than the lifetime and 12-month prevalence reported for individuals with chronic airflow limitation, the older population and family care workers. These findings suggest a larger prevalence study of low back pain in individuals with chronic airflow limitation, and their partners, is warranted.

Activities of Daily Living↗