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At least 919 records · Page 51Linked to original sources
PubMed2005

Gender differences in the cause of low back pain in British soldiers.

OBJECTIVES: To explore gender differences in the cause of low back pain in a population of military personnel who are expected to undertake high levels of sport, exercise and physical military training. METHODS: A prospective study of trained British soldiers, with symptomatic low back pain, referred to the Colchester Garrison Sports Injury and Rehabilitation Centre over a four year period. RESULTS: The study demonstrates that 928 (17.8%) of the 5214 referrals were for new cases of low back pain. The incidence of low back pain in female soldiers is higher than their male counterparts with an odds ratio of 3.17 (95% CI 2.31 - 4.35) There was a highly significant cross gender difference in low back pain caused by activities in the followining categories: military physical traininong (OR 2.65, 95% CI 1.70 - 4.02), work or occupation (OR 2.49, 95% CI 1.56 - 3.87) and off-duty pursuits (OR 2.91, 95% CI 1.72 - 4.72). There was no cross gender difference in low back pain caused by sport, road traffic accidents or activities pre-dating military service. CONCLUSIONS: Female soldiers are significantly more likely to suffer low back pain as a result of physical military training, their occupation, or off-duty activities. Sporting activities do not cause low back pain in women to a greater extent than men By demonstrating the scale of the problem and by determining of the cause of injury, it should now be possible to propose methods of effective intervention to reduce injury, implement those interventions and audit effectiveness.

Adult↗
PubMed2006

The role of physical workload and pain related fear in the development of low back pain in young workers: evidence from the BelCoBack Study; results after one year of follow up.

AIMS: To study the influence of work related physical and psychosocial factors and individual characteristics on the occurrence of low back pain among young and pain free workers. METHODS: The Belgian Cohort Back Study was designed as a prospective cohort study. The study population of this paper consisted of 716 young healthcare or distribution workers without low back pain lasting seven or more consecutive days during the year before inclusion. The median age was 26 years with an interquartile range between 24 and 29 years. At baseline, these workers filled in a questionnaire with physical exposures, work related psychosocial factors and individual characteristics. One year later, the occurrence of low back pain lasting seven or more consecutive days and some of its characteristics were registered by means of a questionnaire. To assess the respective role of predictors at baseline on the occurrence of low back pain in the following year, Cox regression with a constant risk period for all subjects was applied. RESULTS: After one year of follow up, 12.6% (95% CI 10.1 to 15.0) of the 716 workers had developed low back pain lasting seven or more consecutive days. An increased risk was observed for working with the trunk in a bent and twisted position for more than two hours a day (RR 2.2, 95% CI 1.2 to 4.1), inability to change posture regularly (RR 2.1, 95% CI 1.3 to 3.5), back complaints in the year before inclusion (RR 1.7, 95% CI 1.1 to 2.8), and high scores of pain related fear (RR 1.8, 95% CI 1.0 to 3.1). Work related psychosocial factors and physical factors during leisure time were not predictive. CONCLUSION: This study highlighted the importance of physical work factors and revealed the importance of high scores of pain related fear in the development of low back pain among young workers.

Adult↗
PubMed1999

Analysis by sex of low back pain among workers from small companies in the Paris area: severity and occupational consequences.

OBJECTIVES: To describe workers with low back symptoms, to identify risk factors and to assess the occupational consequences separately in men and women. METHODS: A descriptive study was conducted between 1 October 1996 and 31 December 1996 in a sample of workers selected at random from all types of small companies in the Paris area. A group of 202 occupational physicians interviewed 7129 workers with a standardised questionnaire including the Nordic questionnaire. Data analysis was performed by sex in the two groups: with low back pain and without low back pain over the previous 12 months. The group with low back pain was then divided into four subgroups: mild cases (without referred pain), moderate cases (with referred pain above the knee), serious cases (with referred pain below the knee), and low back pain with occupational consequences. RESULTS: 7010 questionnaires were able to be evaluated. The sample consisted of 54.8% of men (3842) and 45.2% of women (3168), with a mean age of 37.8 and 37.0 years, respectively (p < 0.05). The following risk factors occurred significantly more often in men: high weight, height, body mass index (BMI), smoking, number of children, increased driving time and work time, material handling tasks, uncomfortable working positions. Most women were clerks (53%). Non-conditional logistic regression applied to the whole sample identified female sex as a risk factor (odds ratio (OR) = 1.85, 95% confidence interval (95% CI) 1.58 to 2.13). The following risk factors were common to both sexes: lifting weights > 10 kg, in women (OR 1.69, 95% CI 1.27 to 2.25) and in men (OR 1.27, 95% CI 1.06 to 1.53), uncomfortable working positions (OR 2.04, 95% CI 1.58 to 2.17 and OR 1.85, 95% CI 1.69 to 2.43), and absence of means to achieve good quality work (OR 1.39, 95% CI 1.19 to 1.63 and OR 1.38, 95% CI 1.15 to 1.65), respectively. Driving was a risk factor only in men and its importance increased with driving time (driving > 4 hours a day (OR 1.61, 95% CI 1.24 to 2.09)). Severe low back pain was linked to female sex (10.2% of women v 6.6% of men), high BMI, aging, and uncomfortable working positions. Low back pain with occupational consequences (n = 258) was not linked to sex, but only to aging and severity. CONCLUSIONS: The incidence and severity of low back pain were higher in women, although they seemed to be less exposed to known occupational risk factors. However, our results indicate a preponderance of these risk factors among female workers. Particular attention must therefore be paid to lifting of weights and uncomfortable working positions in female jobs (clerk, trading, health care staff).

Adult↗
PubMedDate not supplied

Back pain in intercollegiate rowers.

BACKGROUND: Back pain is prevalent among intercollegiate rowers. PURPOSE: We conducted a large-scale study to determine the rate of and the potential etiologic factors for clearly defined back pain that developed during intercollegiate rowing. STUDY DESIGN: Survey. METHODS: Surveys from 1632 former intercollegiate rowing athletes were analyzed. These surveys concerned training methods and back pain before and during intercollegiate rowing. Back pain was defined as pain that lasted at least 1 week. RESULTS: Five hundred twenty-six subjects reported that back pain developed during intercollegiate rowing. Factors significantly associated with the development of back pain included age at the time of the survey; history of rowing before age 16; use of a hatchet oar blade; training with free weights, weight machines, and an ergometer; midline ergometer cable position; and ergometer training sessions longer than 30 minutes. Back pain while in college also was associated with higher mean college weight and height. CONCLUSIONS: Intercollegiate rowers in the last 10 years covered by this study were larger, started rowing at an earlier age, trained more intensely, and developed more back pain during college than their predecessors.

Adult↗
PubMedDate not supplied

Relationship between radiographic abnormalities of lumbar spine and incidence of low back pain in high school and college football players: a prospective study.

BACKGROUND: Low back pain is a common presenting symptom among players of American football. In Japan, however, skeletal disorders in football players, including low back problems, have been rarely studied, and management to prevent skeletal disorders has not been established. STUDY DESIGN: An epidemiological study with prospective observation. METHODS: The authors analyzed the relationship between lumbar spine abnormalities viewed through radiographs taken during the preparticipation physical examination, and the incidence of low back pain during a 1-year period in 171 high school and 742 college football players. Abnormalities assessed were spondylolysis, disc space narrowing, spinal instability, Schmorl's node, balloon disc, and spina bifida occulta. RESULTS: High school players with spondylolysis had a higher incidence of low back pain (79.8%) than those with no abnormal radiographic results (37.1%). College players with spondylolysis, disc space narrowing, and spinal instability had a higher incidence of low back pain (80.5%, 59.8%, and 53.5%, respectively) than those with no abnormal radiographs (32.1%), and college players with spondylolysis had a higher incidence of low back pain than those with disc space narrowing and spinal instability. CONCLUSIONS: The results of the present study suggest that an abnormality such as spondylolysis is the most significant risk factor for low back pain in high school and college football players, and that disc space narrowing and spinal instability are also significant risk factors for low back pain in athletes with greater athletic activity such as college football players.

Adolescent↗
PubMed2006

Nordic walking and chronic low back pain: design of a randomized clinical trial.

BACKGROUND: Low Back Pain is a major public health problem all over the western world. Active approaches including exercise in the treatment of low back pain results in better outcomes for patients, but it is not known exactly which types of back exercises are most beneficial or whether general physical activity provide similar benefits. Nordic Walking is a popular and fast growing type of exercise in Northern Europe. Initial studies have demonstrated that persons performing Nordic Walking are able to exercise longer and harder compared to normal walking thereby increasing their cardiovascular metabolism. Until now no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to low back pain. The primary aim of this study is to investigate whether supervised Nordic Walking can reduce pain and improve function in a population of chronic low back pain patients when compared to unsupervised Nordic Walking and advice to stay active. In addition we investigate whether there is an increase in the cardiovascular metabolism in persons performing supervised Nordic Walking compared to persons who are advised to stay active. Finally, we investigate whether there is a difference in compliance between persons receiving supervised Nordic Walking and persons doing unsupervised Nordic Walking. METHODS: One hundred and fifty patients with low back pain for at least eight weeks and referred to a specialized secondary sector outpatient back pain clinic are included in the study. After completion of the standard back centre treatment patients are randomized into one of three groups: A) Nordic Walking twice a week for eight weeks under supervision of a specially trained instructor; B) Unsupervised Nordic Walking for eight weeks after one training session with an instructor; C) A one hour motivational talk including advice to stay active. Outcome measures are pain, function, overall health, cardiovascular ability and activity level. RESULTS: No results available at this point. DISCUSSION: This study will investigate the effect of Nordic Walking on pain and function in a population of people with chronic LBP.

Chronic Disease↗
PubMed2005

Chronic low back pain in traumatic lower limb amputees.

OBJECTIVE: To ascertain the prevalence of back pain amongst traumatic lower limb amputees attending a regional rehabilitation centre and to determine the possible causes of back pain. DESIGN: All traumatic lower limb amputees given a semi-structured questionnaire to complete and a comparative subgroup of amputees with back pain and without back pain underwent physical examination, gait analysis, magnetic resonance scanning (MRI) and gait/standing stability analysis. SETTING: A subregional amputee rehabilitation centre. RESULTS: Transfemoral amputees were more likely to suffer from back pain (81 %) than transtibial amputees (62%) (p<0.05) and of those suffering from severe back pain, 89% and 81% also suffered from severe pain in the phantom limb and severe stump pain respectively. In two comparative subgroups of amputees there was no significant difference between back pain and pain-free groups except those with pain were more likely to have a body mass index (BMI) ratio above 50% of the recommended ratio. No difference in degeneration or disc disease between the groups on MR scans was found. Impact ground reaction forces during walking, irrespective of limb, were significantly greater (p < 0.05) in the pain-free group than in the pain group, as was walking speed. Gait asymmetry measures were similar in both groups. Centre of pressure displacement measures during standing were greater in the pain group than in the pain-free group. CONCLUSIONS: Low back pain in amputees is a significant problem equal to that of pain in the phantom limb and a biomechanical (myofascial) rather than a degenerative aetiology is suggested.

Adolescent↗
PubMed1998

Designing a Back Management Service: the Exeter experience and first year results.

BACKGROUND: The recent British Clinical Standards Advisory Group report on back pain highlighted the importance of primary care in the active management of acute back pain and, at the same time, recommended the establishment of rehabilitation services for those with subacute and chronic back pain. OBJECTIVE: To describe a new Back Management Service (BMS) in Exeter and to review the first year's results. METHODS: Analysis of observational data collected from the clinic and therapy database. ASSESSMENTS: Clinic outcome assessed by diagnostic and referral patterns as well as by general practitioner questionnaire. The Back Management Programme was assessed by Short Form 36 (SF36), Hospital Anxiety and Depression score (HAD) and Oswestry Disability Index (ODI). RESULTS: In the first year 297 patients were seen in the clinic; clinic triage resulted in confirmation of primary care diagnosis in 235 (79%) of patients, with diagnosis revised in 62 (21 %). One hundred and eighty-nine (63.6%) patients were referred for therapy. Of these, 54 were referred for one-to-one therapy and 135 were referred for multidisciplinary review with 29 patients subsequently recruited into the Back Management Programme for rehabilitation. Two out of three outcome measures were significantly improved at the end of the 36-hour, four-week course. CONCLUSIONS: A Back Management Service can provide useful diagnostic reassessment of patients with chronic low back pain, and can focus therapeutic effort for the effective management of their pain.

Adult↗
PubMed1995

Work-related factors of low back pain among nursing aides in nursing homes for the elderly.

This survey was performed in December 1991 on 555 nursing aides (NAs) in 32 Special Nursing Homes for the Elderly (SNHs) in Kochi Prefecture, Japan. The purpose of the survey was to establish the relationship between low back pain among NAs in SNHs, and the degree of dependency in the activities of daily living (ADL) of the patients under their care. In order to investigate the work-related factors of low back pain, a questionnaire was sent to the NAs, requesting information on the NAs' low back pain condition. Another questionnaire was sent to the 32 SNHs, concerning the status of patients in the respective SNHs. Of the 463 NAs questionnaires which were returned, 443 female NAs' responses were analyzed. The following findings were observed. The prevalence of low back pain among the NAs was high (the one month prevalence was 77.0%), and of the afflicted NAs, 98 (24.5%) were visiting a health care provider. The NAs with low back pain experienced difficulty in completing their care-giving tasks, and complained about their working conditions and working environment more often than the NAs without low back pain. In addition, this study showed that, at SNHs where the proportions of dependence in patients' ADL were high, the prevalence of low back pain among their NAs was high. This fact was also confirmed by multiple logistic regression. We, therefore, suggest in this study that patients' care needs are associated with low back pain among NAs.

Activities of Daily Living↗
PubMed2005

[The debate on lower back pain and its relationship to work: a retrospective study of workers on sick leave].

Lower back pain has a high prevalence among the Mexican working population, with extensive social and economic repercussions. Official figures show that lower back pain accounts for 10.0 to 15.0% of sick leave excuses. However, this fails to identify any relationship between lower back pain and job conditions, since such leave is only granted if it can be shown that the condition was not work-related. The present study shows that such a relationship does in fact exist. A retrospective study examined all cases (n = 210) in which workers were granted sick leave for lower back pain in an IMSS (Mexican Government Health Insurance) hospital in Mexico City during a seven-year period. The results show the association and interactions between debilitating lower back pain and several work-related variables: job position, time-on-the-job, and physical effort and weight-carrying associated with the position. Causes of lower back pain and the difficulty in obtaining accurate, precise back pain diagnosis are discussed. A number of clinical, epidemiological, and legal strategies for the study and prevention of back pain are suggested.

Case-Control Studies↗
PubMed2005

Devastating injuries in healthcare workers: description of the crisis and legislative solution to the epidemic of back injury from patient lifting.

The purpose of this report is to describe a crisis in healthcare, disabling back injuries in US healthcare workers. In addition, outlined is the proven solution of safe, mechanized, patient lifting, which has been shown to prevent these injuries. A "Safe Patient Handling--No Manual Lift" policy must be immediately instituted throughout this country. Such a policy is essential to halt hazardous manual patient lifting, which promotes needless disability and loss of healthcare workers, pain and risk of severe injury to patients, and tremendous waste of financial resources to employers and workers' compensation insurance carriers. Healthcare workers consistently rank among top occupations with disabling back injuries, primarily from manually lifting patients. Back injury may be the single largest contributor to the nursing shortage. Reported injuries to certified nursing assistants are three to four times that of registered nurses. A national healthcare policy for "Safe Patient Handling--No Manual Lift" is urgently needed to address this crisis. Body mechanics training is ineffective in prevention of back injury with patient lifting. Mandated use of mechanical patient lift equipment has proven to prevent most back injury to nursing personnel and reduce pain and injury to patients associated with manual lifting. With the national epidemic of morbid obesity in our country, innovative devices are available for use in emergency medical systems and hospitals for patient lifting and transfer without injury to hospital personnel. The US healthcare industry has not voluntarily taken measures necessary to reduce patient handling injury by use of mechanical lift devices. US healthcare workers who suffer disabling work-related back injuries are limited to the fixed, and often inadequate, relief which they may obtain from workers' compensation. Under workers' compensation law, healthcare workers injured lifting patients may not sue their employer for not providing mechanical lift equipment. Discarding healthcare workers disabled by preventable back injuries is an abuse which legislators must remedy. In addition, Medicare reimbursement policies must also be updated to allow the disabled community to purchase electrically operated overhead ceiling lifts. The US lags far behind countries with legislated manual handling regulations and "No Lifting" nursing policies. England and Australia have had "No Lifting" nursing policies in place since 1996 and 1998, respectively. The National Occupational Research Agenda (NORA) recognized a model in 2003 for reduction of back injuries to nursing staff in US healthcare facilities. Also in 2003, the American Nurses Association called for elimination of manual patient handling because it is unsafe and causes musculoskeletal injuries to nurses. The first state legislation for safe patient handling passed both houses in California but was vetoed by the Governor in September 2004. California and other states are preparing to (re)introduce legislation in January 2005. A national, industry-specific policy is essential to quell the outflow of nursing personnel to disability from manual patient lifting.

Adult↗
PubMedDate not supplied

Electromyographic activity imbalances between contralateral back muscles: An assessment of measurement properties.

Electromyographic (EMG) contralateral imbalances of back muscles are often interpreted as an aberrant back muscle pattern related to back pain. This study assessed different measurement properties (influence of the control of asymmetric efforts and of the force level, reliability, and sensitivity to low back status) of EMG imbalance parameters. Healthy controls (n = 34) and chronic low back pain subjects (n = 55) stood in a dynamometer measuring the principal (extension) and coupled (lateral bending, axial rotation) L5/S1 moments during isometric trunk extension efforts. The results showed that back pain subjects did not produce higher coupled moments than controls. Providing feedback of the axial rotation moment to correct asymmetric efforts during the task did not reduce EMG contralateral imbalances, except for some extreme cases. Normalized EMG imbalance parameters remain relatively constant between 40% and 80% of the maximal voluntary contraction. The reliability of EMG imbalance parameters was moderate, at best. Finally, neither low back status nor pain location had an effect on EMG contralateral imbalances. We conclude that the clinical relevance of EMG contralateral imbalances of back muscles remains to be established.

Adult↗
PubMedDate not supplied

Physical and functional measures related to low back pain in individuals with lower-limb amputation: an exploratory pilot study.

For this study, we compared the physical impairments and functional deficits of individuals with lower-limb amputation (LLA) for those with and without low back pain (LBP). Nineteen participants with LLA were placed into two groups based on visual analog scores of LBP. We assessed functional limitations, iliopsoas length, hamstring length, abdominal strength, back extensor strength, and back extensor endurance. Data analysis included correlations and t-tests. We found significant correlations between pain score and functional limitations, iliopsoas length, and back extensor endurance. We also detected significant differences in functional limitations, iliopsoas length, back extensor strength, and back extensor endurance between those with and without LBP. We saw significant differences in back extensor strength and back extensor endurance between those with transtibial and transfemoral amputations. Differences exist in physical measures of individuals with LLA with and without LBP. Clinicians should consider these impairments in individuals with amputation who experience LBP. Because of the participants' characteristics, these findings may be applicable to veterans with LLA.

Adult↗
PubMed1991

Low back pain in young athletes. A practical approach.

Lumbar spine pain accounts for 5 to 8% of athletic injuries. Although back pain is not the most common injury, it is one of the most challenging for the sports physician to diagnose and treat. Factors predisposing the young athlete to back injury include the growth spurt, abrupt increases in training intensity or frequency, improper technique, unsuitable sports equipment, and leg-length inequality. Poor strength of the back extensor and abdominal musculature, and inflexibility of the lumbar spine, hamstrings and hip flexor muscles may contribute to chronic low back pain. Excessive lifting and twisting may produce sprains and strains, the most common cause of low back pain in adolescents. Blows to the spine may create contusions or fractures. Fractures in adolescents from severe trauma include compression fracture, comminuted fracture, fracture of the growth plate at the vertebral end plate, lumbar transverse process fracture, and a fracture of the spinous process. Athletes who participate in sports involving repeated and forceful hyperextension of the spine may suffer from lumbar facet syndrome, spondylolysis, or spondylolisthesis. The large sacroiliac joint is also prone to irritation. The signs and symptoms of disc herniation in adolescents may be more subtle than in adults. Disorders simulating athletic injury include tumours and inflammatory connective tissue disease. Often, however, a specific diagnosis cannot be made in the young athlete with a low back injury due to the lack of pain localisation and the anatomic complexity of the lumbar spine. A thorough history and physical examination are usually more productive in determining a diagnosis and guiding treatment than imaging techniques. Diagnostic tests may be considered, though, for the adolescent athlete whose back pain is severe, was caused by acute trauma, or fails to improve with conservative therapy after several weeks. Radiographs, bone scanning, computed tomography, and magnetic resonance imaging may help identify, or exclude serious pathology. Fortunately, the majority of cases of low back pain in adolescents respond to conservative therapy. Immediate treatment of an acute injury, such as a sprain or strain, includes cryotherapy, electrogalvanic stimulation, anti-inflammatory medications and gentle exercises. Prolonged bed rest should be avoided since atrophy may occur rapidly. Strong analgesics are also usually contraindicated, except for sleep, since they mask pain and may allow overvigorous activity. Early strengthening exercises include the Williams flexion exercises and/or McKenzie extension exercises. Both exercise motions may often be prescribed. Athletes with an acute disc herniation, however, should only perform extension exercises initially. Athletes with spondylolysis, spondylolisthesis and facet joint irritation should initially be limited to flexion exercises.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed2006

[Masticatory muscle activity during exertion of the back].

PURPOSE: The lower jaw is considered to be fixed during body exercise. However, its mechanism remains to be elucidated. The present study investigated masticatory muscle activity during of the back. METHODS: The subjects were 9 healthy dentulous patients. The maximum back strength of the patients was measured with a back-dynamometer. Muscle activities of the temporal, masseter and digastric muscles during exertion of the back and mastication of peanuts were measured. Muscle activities of the temporal and masseter muscle during maximum voluntary clenching and that of the digastric muscles during exertion of resistance against forced mouth opening were also measured, and maximum voluntary muscle activities were obtained. The relative percentage of each masticatory muscle against maximum voluntary activity was calculated from the data obtained, and muscle activities during exertion of the back, mastication of peanuts and maximum muscle activity were compared. RESULTS: Muscle activities of the temporal, masseter and digastric muscles during exertion of back muscles against maximum voluntary muscle activity were 32.1%, 26.4% and 97.4% respectively. Muscle activities of these muscles during mastication of peanuts against maximum voluntary muscle activity were 40.7%, 36.0% and 17.3% respectively. CONCLUSIONS: Muscle activities during exertion of the back were 30% in the temporal and masseter muscle, and approximately 100% in the digastric muscles. The result suggests that the digastric muscles play a key role in fixing the mandible in all masticatory muscles including jaw-opening and closing muscles. People exert back strength not only in sports but also in daily life. This study demonstrates the stronger involvement of the digastric muscles in fixation of the mandible during exercise than during strong clenching. The results are of interest in terms of mandibular position, occlusal contact and the load on the temporomandibular joint (TMJ) since there is no wide mouth opening.

Adult↗
PubMed1999

Clinical usefulness of a cluster of sacroiliac joint tests in patients with and without low back pain.

STUDY DESIGN: Observation to examine the clinical usefulness of a cluster of sacroiliac joint tests. OBJECTIVES: To find the sensitivity, specificity, and positive and negative predictive values (4 commonly used epidemiologic measures) for a cluster of sacroiliac joint tests in a group of subjects with and without low back pain. BACKGROUND: Sacroiliac joint testing is commonly used by orthopaedic physical therapists in the evaluation of patients with low back pain. METHODS AND MEASURES: Two hundred nineteen patients who either were being treated for low back pain or were being treated for some other condition not related to the low back participated in the study. The diagnosis of low back pain was obtained from the physician's prescription, which included low back strain, low back pain, or sacroiliac joint dysfunction, and the patient's pain drawing. RESULTS: The results were a finding of 0.82 for sensitivity, 0.88 for specificity, 0.86 for positive predictive value of a test, and 0.84 for negative predictive value of the cluster of tests. CONCLUSIONS: The results of this study show that using a cluster of sacroiliac joint tests can be useful in identifying sacroiliac joint dysfunction in patients with low back pain.

Adolescent↗
PubMed2003

Straightforward consultation or complicated condition? General practitioners' perceptions of low back pain.

BACKGROUND: Low back pain is a common condition in general practice and represents a significant part of a general practitioner's workload. However, despite guidelines, back pain still presents considerable challenges to clinicians. OBJECTIVE: To explore the perceptions and declared behaviour of UK general practitioners in relation to patients with low back pain. METHOD: A qualitative design was used, involving semi-structured interviews with 17 GPs in the North of England. Interviews were transcribed verbatim and analysed using qualitative thematic analysis. RESULTS: Two major themes emerged from the data relating to approaches to and perceptions of low back pain. A dichotomy emerged, where GPs describe their approach to what they know to be a straightforward consultation where most patients recover, and the frustration they experience when patients do not. Although GPs are using a simple bio-mechanistic approach to low back pain, they also operate a method of categorising patients, which involves identifying real and pseudo patients. When confronted with 'challenging' cases, that is those who do not recover, most GPs feel isolated and poorly prepared. CONCLUSION: GPs adopt a bio-mechanistic approach to LBP which appears to work well for the majority of patients, as the natural history of low back pain dictates that most patients will recover. However, this approach to low back pain fails at the margins and this is evident by the significant minority of persistent sufferers and the GP's reaction to them. Expanding patient-centredness to explore psychological and social dimensions in relation to low back pain presents an ongoing challenge in general practice.

Adult↗
PubMed2006

A correlation between low back pain and associated factors: a study involving 772 patients who had undergone general physical examination.

Many factors are associated with the development of low back pain. Among them, exercise, obesity, smoking, age, educational level and stress are the most common. This study examined the association of these factors with low back pain. An additional aim was to determine a procedure for preventing low back pain. This study analyzed the responses to a questionnaire sent to 772 individuals who had undergone a medical examination at this hospital in 2003 and excluded the individuals who had shown symptoms or their test results indicated a particular disease. Assuming that there were no variables, individuals who exercised regularly 3-4 times per week would have a lower chance of having low back pain than those who did not exercise regularly. The analysis revealed that individuals with a college degree or higher education have a lower chance of experiencing low back pain than those with only a high school education or even college drop-outs. When the other variables were constant, age, extent of obesity (body mass index), smoking and level of stress were not found to affect the development of low back pain. The level of education was associated with the development of low back pain. However, regular exercise 3-4 times per week or more would be most effective in reducing the incidence and duration of low back pain.

Adolescent↗