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PubMed2000

One-year prevalence of low back pain in two Swiss regions: estimates from the population participating in the 1992-1993 MONICA project.

STUDY DESIGN: A cross-sectional survey was performed. OBJECTIVE: To estimate the extent of low back pain as a public health problem. SUMMARY OF BACKGROUND DATA: Health surveys converge on very high estimates of low back pain in general populations, but few studies have included severity criteria in their definition and conclusions. Because it is unlikely that interventions will influence the prevalence of minimal and infrequent symptoms, greater attention should be paid to characteristics of low back pain that indicate some impact on the life of survey respondents. METHODS: Two regions participated in the MONICA (MONitoring of trends and determinants in CArdiovascular disease) project in Switzerland. Participants randomly selected from the general population completed a standard self-administered questionnaire on cardiovascular risk factors. A special section on low back pain was added in the third (1992-1993) MONICA survey and completed by 3227 participants. RESULTS: A regional difference found in the 12-month prevalence rate disappeared with the inclusion of severity criteria. Low back pain over more than seven cumulated days was reported among men by 20.2% (age range, 25-34 years) to 28.5% (age range, 65-74 years), respectively, among women by 31.1% to 38.5%. Similar rates of reduction in activity (professional, housekeeping, and leisure time) and medical consultation (conventional and nonconventional) motivated by low back pain characterized the two participating regions. The cumulative duration of pain was related to all the indicators showing the impact of low back pain on everyday life. CONCLUSIONS: Determining the cumulative duration of low back pain over the preceding year is a straightforward task, and a cutoff at 1 week seems appropriate for distinguishing between low- and high-impact low back pain.

Adult↗
PubMed2000

Differences in repositioning error among patients with low back pain compared with control subjects.

STUDY DESIGN: Trunk repositioning error was measured in 20 patients with chronic low back pain and 20 control subjects. OBJECTIVES: To measure trunk repositioning error as a method of measuring proprioception of the low back and to compare trunk repositioning error in patients with low back pain and in control subjects. SUMMARY OF BACKGROUND DATA: Although many current low back pain rehabilitation programs incorporate proprioceptive training, very little research has been performed on proprioception of the low back. METHODS: While standing with the legs and pelvis immobilized, the subject bent the trunk to a predetermined target position and then attempted to replicate the position. Repositioning error was calculated as the absolute difference between the actual target position and the subject-perceived target position. The multiple target positions in the frontal and sagittal planes were tested. Trunk position was measured with a 3Space Tracker, which analyzes the three-dimensional position of the body. RESULTS: Repositioning error in patients with low back pain was significantly higher than that of control subjects in flexion, and significantly lower than that of control subjects in extension. CONCLUSIONS: The increase in repositioning error of patients with low back pain during flexion implies that some aspects of proprioception are lost in patients with low back pain. The decrease in repositioning error in patients with low back pain in extension is not as easily explained, but could possibly be caused by increased activation of mechanoreceptors in facet joints.

Adult↗
PubMed2001

Back pain reporting pattern in a Danish population-based sample of children and adolescents.

STUDY DESIGN: A cross-sectional survey of 806 pupils in Odense, Denmark was performed. This survey included children and adolescents ages 8 to 10 and 14 to 16 years obtained through two-stage cluster sampling from schools stratified according to school type, location, and socioeconomic character of the uptake area. OBJECTIVES: To establish the 1-month prevalence of neck, middle back, and low back pain and the consequences this disorder may have in relation to age and gender. SUMMARY OF BACKGROUND DATA: The differences in definitions of back pain and the variety of age groups included in previous studies make it difficult to draw clear conclusions about the onset of pain for various spinal regions in the young. METHODS: Information on back pain within the preceding month, obtained through a standardized interview of 481 children and 325 adolescents, was categorized according to area of pain, age, and gender. The consequences of back pain also were studied. RESULTS: The 1-month prevalence of back pain was 39%. Thoracic pain is most common in childhood, whereas thoracic pain and lumbar pain are equally common in adolescence. Neck pain and pain in more than one area of the spine are rare in both age groups. No gender differences were found. Of those who had back pain, 38% also reported some type of consequence, usually either visits to a medical physician or diminished physical activities. CONCLUSIONS: For clinical and research purposes, neck pain, middle back pain, and low back pain in childhood should be regarded as three specific entities. In future research the data for different age groups should be reported separately.

Adolescent↗
PubMed2002

The cochrane review of advice to stay active as a single treatment for low back pain and sciatica.

STUDY DESIGN: A systematic review was conducted within the Cochrane Collaboration Back Review Group. OBJECTIVES: To assess the effects of advice to stay active as a single treatment for patients with acute low back pain or sciatica. SUMMARY OF BACKGROUND DATA: Low back pain is a common reason for consulting a health care provider, and advice on daily activities constitutes an important part in the primary care management of low back pain. METHODS: All randomized studies available in systematic searches (electronic databases, contact with authors, reference lists) were included. Two reviewers independently selected trials for inclusion, assessed the validity of the included trials, and extracted data. Investigators were contacted to obtain missing information. RESULTS: Four trials, with a total of 491 patients, were included. In all the trials, advice to stay active was compared with advice for bed rest. Two trials were assessed as having a low risk of bias, and two as having a moderate to high risk of bias. The results were heterogeneous. The results from one high-quality trial of patients with acute, simple low back pain found small differences in functional status (weighted mean difference on a 0 to 100 scale, 6.0; 95% CI, 1.5-10.5) and length of sick leave (weighted mean difference, 3.4 days; 95% CI, 1.6-5.2) in favor of staying active, as compared with advice to stay in bed 2 days. The other high-quality trial compared advice to stay active with advice to rest in bed 14 days for patients with sciatic syndrome, and found no differences between the groups. One of the high-quality trials also compared advice to stay active with advice to engage in exercises for patients with acute, simple low back pain, and found improvement in functional status and reduced sick leave in favor of advice to stay active. CONCLUSION: The best available evidence suggests that advice to stay active alone has little beneficial effect for patients with acute, simple low back pain, and little or no effect for patients with sciatica. There is no evidence that advice to stay active is harmful for either acute low back pain or sciatica. Because there is no considerable difference between advice to stay active and advice for bed rest, and there are potential harmful effects of prolonged bed rest, it is reasonable to advise people with acute low back pain and sciatica to stay active. These conclusions are based on single trials.

Activities of Daily Living↗
PubMed2002

A prospective cohort study of risk factors for disability retirement because of back pain in the general working population.

STUDY DESIGN: A 7-year prospective cohort study of 34,754 employed men and women was conducted. OBJECTIVE: To determine the relative contribution of occupational risk factors, lifestyle factors, comorbidity, and psychological and social factors to the incidence of disability retirement because of back pain in the general working population. SUMMARY OF BACKGROUND DATA: Permanent occupational disability is a serious consequence of a disabling process. Although this condition is a great burden to the individual and extremely costly for society, few population-based studies exist on risk factors for obtaining disability pension because of back pain. METHODS: Patients granted back pain disability pension were ascertained from the national disability register. The exposure variables were taken from a health screening of all the inhabitants in one county: Norway. The participation rate was 72% to 90%. RESULTS: During the follow-up period, 715 individuals (2.1%) were granted a back pain disability pension. In the final combined multivariate model, the strongest predictors for future back pain disability were the occupational risk factor "physically demanding work" (odds ratio [OR], 4.1; 95% confidence interval [CI], 2.7-6.4) and the comorbidity factor "poor general health" (OR, 3.7; 95% CI, 2.4-5.8). "Feeling of being worn out" (OR, 1.7; 95% CI, 1.1-2.4), current smoking (OR, 1.4; 95% CI, 1.2-1.7), and body mass index in the upper percentile (OR, 1.6; 95% CI, 1.2-2) also predicted back pain disability pension. CONCLUSIONS: In a broad public health perspective within a European welfare system, subjects at high risk for future back pain disability pension perceived their work as constantly physically demanding, had health complaints other than back pain, and mostly felt generally tired and worn out. The results indicate that interventions directed toward the painful back alone may be unsuccessful in preventing disability pensions.

Adult↗
PubMed1992

Prevalence of back pain and joint problems in a manufacturing company.

To estimate prevalence of back pain and joint problems in employees of a chemical manufacturing company, a questionnaire was administered during medical surveillance examinations between 1987 and 1989. Among 5903 employees completing the questionnaire 35.4% reported back or joint pain during the past year. Back pain lasting 30 days or more occurred in 5.3% of employees, while joint pain and/or swelling occurred in 19.3% of employees. A physician visit was involved for 10.5% and 11.1% of employees reporting back pain and joint problems respectively. A trend of increasing prevalence with increasing age was significant (P less than .001) for all musculoskeletal outcomes. Unadjusted prevalence of back pain and joint problems was significantly higher among men and among whites. After adjusting for age, race, and occupation using logistic regression, the difference in prevalence for the two sexes was diminished or reversed. Similarly, differences in race were diminished when other variables were controlled. Differences in prevalence by occupation were attenuated after adjustment for age, gender, and race. Back pain tended to be reported more frequently for managers, back pain and joint problems for technicians, and back pain requiring physician visit for craftsmen. Self-reported back pain and joint problems during the previous year vary more by age and occupation and less by gender and race in this employed population.

Adult↗
PubMed2003

Risk factors for sickness absence because of low back pain among scaffolders: a 3-year follow-up study.

STUDY DESIGN: A prospective cohort study was conducted. OBJECTIVE: To find risk factors for short-term ( 14 days) sickness absence because of low back pain among scaffolders. SUMMARY OF BACKGROUND DATA: Although some studies have described the relation between work-related risk factors for musculoskeletal disease and sickness absence, little is known about the role of individual, physical, and psychosocial factors and different end points of low back pain as risk factors for sickness absence among scaffolders. METHODS: Between 1998 and 2001, 222 scaffolders and 66 supervisors (response rate, 86%) completed a questionnaire at baseline. In addition, data on sickness absence were collected from absence records. RESULTS: At baseline, 60% of the study population had experienced an episode of low back pain in the 12 months preceding the investigation, 37% of which were of chronic nature. During the follow-up period, 34% of the population had been on sick leave for at least one episode of low back pain. The risk factors for sickness absence less than 2 weeks were a high physical load from strenuous arm movements and severe low back pain. Workers with severe low back pain were at higher risk for sickness absence longer than 2 weeks. Psychosocial workload and individual characteristics did not predict the occurrence of sickness absence because of low back pain. CONCLUSIONS: Because work-related physical load was a risk factor for sickness absence less than 2 weeks and severe low back pain was a risk factor for sickness absence both shorter than and longer than 2 weeks, a focus on secondary prevention for scaffolders with severe low back pain is advised.

Absenteeism↗
PubMed2003

Importance of the back-café concept to rehabilitation after lumbar spinal fusion: a randomized clinical study with a 2-year follow-up.

STUDY DESIGN: A prospective, randomized, clinical study with a 2-year follow-up. OBJECTIVES: To analyze the effect of three different rehabilitation strategies for lumbar spinal fusion patients. SUMMARY OF BACKGROUND DATA: Fifteen percent to 40% of lumbar spinal fusion patients are not expected to improve significantly over a 2-year period. Optimization of present forms of rehabilitation could possibly further improve the outcome. MATERIALS AND METHODS: Between 1996 and 1999, 90 patients who had undergone lumbar spinal fusion were 3 months after surgery randomized to one of three different rehabilitation groups. Video group participants watched a video of exercises for training and were subsequently and only once provided instruction regarding their use. The back-café group was provided the same program as the video group, but as a supplement met with a back-café with other fusion-operated patients three times over an 8-week period. The training group was provided physical therapy training twice weekly for 8 weeks. Functional outcome was evaluated at 6, 12, and 24 months after surgery by use of the low back pain rating scale and a questionnaire covering daily functions, work status, and a patient's contact with the primary sector. RESULTS: By 2-year follow-up, the back-café and video groups had less pain compared with the training group (P < 0.03). The back-café group was better at performing daily functions such as carrying bags of market items (P < 0.01), getting up from a chair (P < 0.01), and ascending staircases (P < 0.01) compared with the video and training groups. More in the back-café group resumed working after surgery compared with the two other groups (P < 0.04). The video group had significantly more contacts with general practitioners, physical therapists, and so on compared with the back-café and training groups (P < 0.001). CONCLUSION: The patients in the back-café group were significantly better at accomplishing a succession of daily tasks compared with the video and training groups 2 years after lumbar spinal fusion. At the 2-year follow-up the training group had a significant pain problem compared with the video and back-café groups. The video group had significantly more treatment demands outside the hospital system. This study demonstrates the relevance of the inclusion of coping schemes and questions the role of intensive exercises in a rehabilitation program for spinal fusion patients.

Absenteeism↗
PubMed2004

Back-related functional limitations among full-time homemakers: a comparison with women employed full-time outside the home.

STUDY DESIGN: Two-year prospective study with repeated measurements. OBJECTIVES: To describe back-related functional limitations and their evolution among full-time female homemakers and to compare them to that of women employed full-time outside the home. SUMMARY OF BACKGROUND DATA: Back pain is not limited to the formal "working" population. However, there is little information on the consequences of back pain in "nonworking" individuals. METHODS: Subjects were members of a large Health Maintenance Organization who consulted a physician for nonspecific back pain. Telephone interviews were conducted 4 to 6 weeks after the consultation and 1 and 2 years later. Back-related functional limitations were measured with a modified 16-item Roland-Morris scale. Analyses were conducted on 104 full-time homemakers and 288 women employed full-time outside the home. RESULTS: The mean Roland-Morris score among homemakers was 34.4% at baseline and dropped to 22.8% at 2 years. In multiple regression analyses, 2-year back-related functional limitations were significantly associated with symptoms of depression, pain intensity, and the number of days with back pain in the past 6 months measured at baseline, but not with employment status. Functional limitations were not different between homemakers and women employed outside the home, even after adjustment for confounders. CONCLUSIONS: In this study, the functional consequences of back pain had a similar nature and 2-year evolution among full-time homemakers and women employed full-time outside the home. These results did not demonstrate an effect of formal employment on the functional consequences of back pain among women.

Adolescent↗
PubMed2004

Back pain and health policy research: the what, why, how, who, and when.

STUDY DESIGN: A background literature, supported by discussion and outcomes on the subject of Health Policy and Back Pain, from the Fifth International Forum on Low Back Pain Research in Primary Care, in Montreal in May 2002. SUMMARY OF BACKGROUND DATA: A multitude of randomized controlled trials and systematic reviews have been completed in the field of back pain research. There has been limited health policy research in the field of back pain but a greater amount of health policy research in other medical fields. METHODS: The focus of the workshop was on the contribution health policy could make in the area of back pain, the methodologies that are appropriate to research in back pain, and the barriers to back pain health policy research. The workshop was supported by the workshop coordinators' literature review. RESULTS: There was consensus about the lack of improved outcomes from randomized controlled trials and individual treatments and general agreement on the importance supporting current research initiatives with health policy research. That policy-makers were developing policy in this area was agreed, and study methodology to support evidence based policy development was explored. CONCLUSIONS: Health policy research is a relatively underdeveloped area of research in back pain. Back pain as a public health problem may be supported by a broader research approach and a collaborative association with policy-makers in this area.

Back Pain↗
PubMed2005

Implementation of the Dutch low back pain guideline for general practitioners: a cluster randomized controlled trial.

STUDY DESIGN: Cluster randomized controlled trial for a multifaceted implementation strategy. OBJECTIVES: To assess the effectiveness of tailored interventions (multifaceted implementation strategy) to implement the Dutch low back pain guideline for general practitioners with regard to adherence to guideline recommendations. SUMMARY OF BACKGROUND DATA: Guidelines for the management of low back pain in primary care have been developed in various countries, but little is known about the optimal implementation strategy. A multifaceted implementation strategy was developed to overcome identified barriers to the implementation of the Dutch low back pain guideline for general practitioners. METHODS: General practitioners were randomized to an intervention or a control group. The general practitioners in the intervention group (n = 21) received tailored interventions consisting of the Dutch low back pain guideline for general practitioners, a 2-hour educational and clinical practice workshop; two scientific articles on low back pain management; the guideline for occupational physicians; a tool for patient education; and a tool for reaching agreement on low back care with physical, exercise, and manual therapists. The control group (n = 20) received no intervention. The participating general practitioners were asked to recruit consecutive patients with a new episode of low back pain as the main reason for consultation. General practitioners completed registration forms of each individual consultation with regard to the main outcome measures: advice and information, referral to other health-care providers, and prescription of medication. RESULTS: Forty-one of the 67 randomized general practitioners reported on a total of 616 consultations for 531 patients with nonspecific low back pain. The advice and explanation provided by the general practitioners, the prescription of paracetamol or nonsteroidal anti-inflammatory drugs, and prescription of pain medication on atime contingent or a pain contingent basis showed no statistically significant differences between the intervention and control groups. There were also no differences in overall referral rate. However, in follow-up consultations fewer patients were referred to a physical or exercise therapist by the general practitioners in the intervention group than in the control group. CONCLUSIONS: The multifaceted intervention strategy modestly improved implementation (for parts of the recommendations in) the Dutch low back pain guideline by general practitioners and produced small concomitant changes in patient management. The implementation strategy produced fewer referrals to therapists during follow-up consultations.

Adolescent↗
PubMed2006

Risk factors for recurrent episodes of work-related low back disorders in an industrial population.

STUDY DESIGN: An observational longitudinal design. OBJECTIVES: To characterize the rate of and risk factors for recurrent episodes of work-related low back disorder in industrial workers. SUMMARY OF BACKGROUND DATA: Little data exist on risk factors for recurrent episodes of work-related low back disorders in employed persons. METHODS: A total of 352 active hourly union employees who were diagnosed with a recent work-related low back disorder and who had at least one follow-up visit within 12 months enrolled for participation in a rehabilitation intervention study at the workplace. Information on clinical and job factors was obtained at each study visit. Job risk for low back disorder was quantified using the Lumbar Motion Monitor. The main outcome measure, recurrence of work-related low back pain, was derived from a computerized file of administrative records of visits to the plant's medical department. RESULTS: The rate of repeated episodes was 24.4%; an additional episode occurred in 2.3%. Adjusting for age, gender, health status and job exposures, lower levels of physical health, increasing back pain disability, spinal deformity, high stress, and increasing number of different jobs worked at the same plant were risk factors for a recurrent episodes of low back pain. CONCLUSIONS: Early identification of risk factors for a work-related low back disorder may signal the need for early and intense rehabilitation to prevent recurrent episodes. Because these findings were based on jobs with medium risk of low back disorders, other factors may be significant in higher risk jobs.

Adult↗
PubMed2006

Cost-effectiveness of two self-care interventions to reduce disability associated with back pain.

STUDY DESIGN: Two randomized, controlled trials. OBJECTIVE: To evaluate the incremental cost-effectiveness of psychologist-led and lay-led interventions in reducing disability in 2 cohorts of primary care patients with back pain. SUMMARY OF BACKGROUND DATA: Although activating self-care interventions have been advanced as effective tools to reduce back pain-related activity limitations, few studies have evaluated the added costs of these programs relative to their added benefits. METHODS: We estimated the incremental benefits and incremental costs associated with 2 self-care interventions for primary care patients with back pain. Effectiveness was measured as the number of low-impact back pain days (i.e., days when patients were satisfied with their level of back pain) over a 1-year follow-up. Costs of back-pain related services were estimated from health plan cost data. Incremental cost-effectiveness ratios were calculated for each intervention to determine the costs associated with an additional low-impact back pain day. RESULTS: Patients assigned to the lay and psychologist interventions had a mean of 14.3 (95% confidence interval [CI] -2.7 to 30.9) and 26.2 (95% CI 9.1-44.4) additional low-impact back pain days, respectively, compared with patients receiving usual care. The incremental per-person costs of the lay-led and psychologist-led interventions were dollar 139 (95% CI - dollar 62.13 to dollar 321.76) and dollar 161 (95% CI dollar 51.18 to dollar 275.93), respectively. The mean cost of an additional low-impact back pain day was dollar 9.70 for the lay-led intervention and dollar 6.13 for the psychologist-led intervention. CONCLUSIONS: Both the lay and psychologist interventions were associated with modest improvements in outcomes but with somewhat higher costs compared to usual care.

Adult↗
PubMed2002

The prevalence of recalled low back pain during and after pregnancy: a South Australian population survey.

OBJECTIVE: To determine the prevalence of low back pain during pregnancy (LBPP) in an Australian population. DESIGN: A representative population-based survey of women aged 15 years and older. SETTING AND SAMPLE: Four thousand four hundred randomly selected South Australian households were visited by trained surveyors who interviewed 1531 women (69.7% response rate) using pre-tested questions. METHODS: The South Australian Health Omnibus survey was utilised. MAIN OUTCOME MEASURES: Demographic data were collected along with details of previous pregnancies, and degree of back pain during pregnancy treatment regimens, and persistence of back pain. RESULTS: Thirty-five and a half per cent of women recall having at least moderately severe back pain during pregnancy. Women who reported such back pain were younger, were more likely to report ill health and be unemployed. Increasing parity was not associated with current back pain. The most commonly used treatments were bed rest, pain killing medication, physiotherapy, and chiropractic treatment. Half of those with symptoms were untreated. Sixty-eight per cent of women who experienced moderate or worse low back pain during pregnancy continued to experience recurring low back pain with a self reported reduction in their health. CONCLUSIONS: Chronic low back pain is commonly associated with an onset in pregnancy subjectively contributing to long-term morbidity The high prevalence may be an underestimate in view of the potential for recall bias in older women.

Adolescent↗
PubMed2004

New low back pain in nurses: work activities, work stress and sedentary lifestyle.

BACKGROUND: Low back pain is common among nurses. Previous studies have shown that the risk of low back pain increases rapidly with greater amounts of physical work and psychological stress, but is inversely related to leisure activities. However, these previous studies were predominantly retrospective in design and not many took account of three factors simultaneously. AIMS: This 12-month prospective study examined the relationships between work activities, work stress, sedentary lifestyle and new low back pain. METHODS: A total of 144 nurses from six Hong Kong district hospitals completed a face-to-face baseline interview, which was followed-up by a telephone interview. The main study measures were demographic characteristics, work activities, work stress, physical leisure activities and the nature of new low back pain during the 12-month follow-up period. Level of work stress, quality of relationships at work, level of enjoyment experienced at work, and work satisfaction were self-reported. RESULTS: Fifty-six (38.9%) nurses reported experiencing new low back pain. Sedentary leisure time activity was not associated with new low back pain. Being comparatively new on a ward (adjusted relative risk 2.90), working in bending postures (adjusted relative risk 2.76) and poor work relationships with colleagues (adjusted relative risk 2.52) were independent predictors of new low back pain. CONCLUSION: The findings of this study suggest that low back pain is a common problem in the population of nurses in Hong Kong. Being comparatively new on a ward, bending frequently during work and having poor work relationships with colleagues are independent predictors of new low back pain. Training for high-risk work activities and ergonomic assessment of awkward work postures are essential. Moreover, relaxation and team-building workshops for nurses, especially those who are less experienced in the type of work on their current ward, are recommended.

Adult↗
PubMed1997

Does the menstrual cycle and use of oral contraceptives influence the risk of low back pain? A prospective study among female soccer players.

Female sex hormones have been suggested to affect the risk of low back pain. One reason is the fact that back pain is a very common symptom during pregnancy. It also seems to be a more common problem among female than male athletes, e.g. in soccer. Although there are few scientific data supporting a relationship between female sex hormones, use of oral contraceptives and low back pain, many doctors and physiotherapists advise women with low back pain to avoid oral contraceptives. The aim of this study was to evaluate whether low back pain fluctuated during the menstrual cycle and differed between women using and not using oral contraceptives. A questionnaire was sent to 12 female soccer teams; 261 players answered and 50 players (28 with back pain and 22 controls) fulfilled the prospective study. At baseline the players underwent a thorough clinical examination and then filled in a diary concerning menstrual data, back pain, training and matches during one season. A total of 296 menstrual cycles was analysed. No difference in prevalence or severity of back pain was seen between the different phases of the menstrual cycle or between users and non-users of oral contraceptives. Our data do not support the hypothesis that low back pain is influenced by hormonal fluctuations during the menstrual cycle or by use of oral contraceptives.

Adolescent↗
PubMed1992

Low back pain and disability in 14-year-old schoolchildren.

In this cross-sectional prevalence study in 1503 14-year-old Finnish schoolchildren (n = 1503) low back pain was found to be the third most common form of pain interfering with schoolwork or leisure time during the past 12 months. The lifetime cumulative incidence of low back pain was 30% and that of sciatica 1.8%. Of the 417 pupils who had experienced low back pain at some time, 39% had suffered during the past month; 65% recovered in one month from the last pain episode, while 35.2% of those reporting disabling low back pain during the past year were aware of recurrent or continual pain. Thus, 7.8% (n = 107) of the whole population could be classified as "low back pain chronics": 86% of the low back pain chronics had trouble with at least one of the daily activities listed, most commonly with sitting at school. Excluding pain in the extremities or sciatica, girls reported various pains more commonly than boys. Moreover, girls reporting recurrent low back pain had more trouble with their daily activities due to pain than boys (p < 0.001), even though the recovery from the last pain episode took the same time in boys and girls. The pupils who had had sciatica at some time, in addition to recurrent low back pain, had more trouble with the 10 daily activities than others with recurrent low back pain (p = 0.014).

Activities of Daily Living↗
PubMed1997

Prospective cohort study of predictors of incident low back pain in nurses.

OBJECTIVE: To assess the impact of handling patients and indicators of individual susceptibility on risk of low back pain in nurses. DESIGN: Prospective cohort study with follow up by repeated self administered every three months over two years. SETTING: NHS university hospital trust. SUBJECTS: 961 female nurses who had been free from low back pain for at least one month at the time of completing a baseline questionnaire. MAIN OUTCOME MEASURES: Incidence of new low back pain during follow up and of pain leading to absence from work. RESULTS: Of 838 women who provided data suitable for analysis, 322 (38%) developed low back pain during follow up (mean 18.6 months), including 93 (11%) whose pain led to absence from work. The strongest predictor of new low back pain was earlier history of the symptom, and risk was particularly high if previous pain had lasted for over a month in total and had occurred within the 12 months before entry to the study (incidence during follow up 66%). Frequent low mood at baseline was strongly associated with subsequent absence from work for back pain (odds ratio 3.4; 95% confidence interval 1.4 to 8.2). After adjustment for earlier history of back pain and other potential confounders, risk was higher in nurses who reported frequent manual transfer of patients between bed and chair, manual repositioning of patients on the bed, and lifting patients in or out of the bath with a hoist. CONCLUSIONS: Of the indicators of individual susceptibility that were examined, only history of back trouble was sufficiently predictive to justify selective exclusion of some applicants for nursing posts. The main route to prevention of back disorders among nurses is likely to lie in improved ergonomics.

Absenteeism↗