No abstract

Objectives Occupational physical loading has been reported to be associated with intervertebral disc degeneration. However, previous literature reports inconsistent results for different vertebral levels. The aim of our study was to investigate the association between lumbar disc degeneration (LDD) at different vertebral levels and the self‐reported physical loading of occupation. Methods The study population consisted of 1,022 postmenopausal women and was based on the prospective Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort. The severity of LDD was graded from T2‐weighted MRI images using the five‐grade Pfirrmann classification. Five intervertebral levels (L1–L2 to L5–S1) were studied (total 5110 discs). The self‐rated occupational physical loading contained four groups: sedentary, light, moderate, and heavy. Results The heavy occupational physical loading group had higher odds for severe LDD at the L5–S1 vertebral level (OR 1.86, 95% CI: 1.19–2.92, p = .006) in comparison with the sedentary work group. A clear trend of increasing disc degeneration with heavier occupational loading was also observed at the L5–S1 level. Age, smoking, and higher body mass index (BMI) were associated with more severe LDD. Leisure‐time physical activity at the age of 11–17 years was associated with less severe LDD. Controlling for confounding factors did not alter the results. Conclusions There appears to be an association between occupational physical loading and severe disc degeneration at the lower lumbar spine in postmenopausal women. Individuals in occupations with heavy physical loading may have an increased risk for work‐related disability due to more severe disc degeneration.

Effects of inpatient and outpatient treatment on physical measurements in chronic low back pain patients (n = 476) were analyzed at 1.5- and 2.5-year follow-ups as well as 3 months after a refresher programme which was carried out 1.5 years after the first treatment. Physical measurements consisted of hip and lumbar spinal mobility, and trunk muscle strength. At the 1.5-year follow-up the two treatment groups did not differ from the control group, but at the 2.5-year follow-up inpatients showed better improvements in physical functions from the pretreatment level. The refresher treatment was found to improve physical functions more effectively than the first treatment program, especially in the outpatients. Self-care with heavy exercising was related with the improvement of physical functions, but back exercises and light exercising were not. Statistically significant but modest correlations were found between improved physical functions and subjective progress during the long-term follow-ups

The purpose of the study was to examine how neurological deficits of the leg, i.e. sensory deficit, deficient reflexes and muscular weakness, correlate with reaction times of upper limbs in a group with chronic low-back pain. Thirty-two patients were studied. Three sets of measurements of simple reaction time and choice reaction time of upper limbs were conducted at one-week intervals. Neurological deficits of the leg were recorded by a physician and the subjects answered a questionnaire about the severity of their low-back symptoms (Oswestry's index). We also defined a neurological index which reflected the total sum of the three types of leg deficits experienced by each of the subjects. Sensory deficit of the leg and the neurological index correlated strongly with slower reaction times of upper limbs, while the other two neurological deficits did not reach a level of significance. Sensory deficits of the leg seem to be an indicator of much greater motor disability than has been thought so far. The motor disability not only appears distally from the lumbar radicular damage caused for example by an intervertebral herniation, it also seems to relate to psychomotor reaction more generally, even on upper limbs.

Inpatient and outpatient treatments were compared with a control intervention in 288 men and 168 women, aged 35-54, who were at work, but suffered from chronic or recurrent low back pain. Physical measurements and back pain assessments were carried out before the intervention and at a 3-month follow-up. Physical fitness improved most in the inpatients, but the outpatients did not differ from the controls. Correlations between back pain and physical measurements indicated that increase of lumbar and hip mobility was more important than increase of trunk strength for subjective progress in these patients. Increased trunk extension strength correlated significantly with subjective progress in women, who also had higher correlations between improved physical fitness and progress than men.