Distribution and prevalence of musculoskeletal pain co-occurring with persistent low back pain: a systematic review

Abstract

Background Co-occurring musculoskeletal pain is common among people with persistent low back pain (LBP) and associated with more negative consequences than LBP alone. The distribution and prevalence of musculoskeletal pain co-occurring with persistent LBP has not been systematically described, which hence was the aim of this review. Methods Literature searches were performed in MEDLINE, Embase, CINAHL and Scopus. We considered observational studies from clinical settings or based on cohorts of the general or working populations involving adults 18 years or older with persistent LBP (≥4 wks) and co-occurring musculoskeletal pain for eligibility. Study selection, data extraction and risk of bias assessment were carried out by independent reviewers. Results are presented according to study population, distribution and location(s) of co-occurring pain. Results Nineteen studies out of 5744 unique records met the inclusion criteria. Studies were from high-income countries in Europe, USA and Japan. A total of 34,492 people with persistent LBP were included in our evidence synthesis. Methods for assessing and categorizing co-occurring pain varied considerably between studies, but based on the available data from observational studies, we identified three main categories of co-occurring pain – these were axial pain (18 to 58%), extremity pain (6 to 50%), and multi-site musculoskeletal pain (10 to 89%). Persistent LBP with co-occurring pain was reported more often by females than males, and co-occurring pain was reported more often in patients with more disability. Conclusions People with persistent LBP often report co-occurring neck pain, extremity pain or multi-site pain. Assessment of co-occurring pain alongside persistent LBP vary considerable between studies and there is a need for harmonisation of measurement methods to advance our understanding of how pain in different body regions occur alongside persistent LBP. Systematic review registration PROSPERO CRD42017068807.

Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain

“…Similarly, the probability of benefitting from SMT for NP is reduced for patients presenting LBP complaints (133). Comorbidity is common in patients with chronic NP and LBP (134), with up to 50% of patients presenting symptoms in both regions (135). Patients with overlapping pain may represent a subgroup [i.e., non-localized LBP (136)].…”

Differences In Chronic Pain Prevalence Between Men And Women At Mid-Life: A Systematic Review Protocol

“…Rationale Chronic pain (CP) -pain that lasts for longer than three months (1) -is becoming increasingly common (2)(3)(4), and threatens the physical, social and psychological wellbeing of those who suffer with it (5)(6)(7)(8)(9)(10)(11). While pain is a common experience, there is inequality in CP distribution between men and women, with women being more likely to experience CP at various stages of the life-course (12)(13)(14)(15)(16)(17)(18)(19). There are different hypotheses around the rationale for this inequality: one is sex-linked factors, like hormones and reproductive factors (20)(21)(22), another is it related to discrepancies in the social and cultural experiences between genders (23)(24)(25), leading to forms of gendered stress.…”

“…There are different hypotheses around the rationale for this inequality: one is sex-linked factors, like hormones and reproductive factors (20)(21)(22), another is it related to discrepancies in the social and cultural experiences between genders (23)(24)(25), leading to forms of gendered stress. While systematic reviews have attested to the unequal distribution of CP in childhood and adolescence (26,27) and older age (13,17,18,(28)(29)(30)(31)(32), the evidence is less clear about the prevalence of CP by sex at mid-life -a period with distinct social and physical challenges where growth is balanced with decline (33), related to heightened socioeconomic responsibilities and physiological changes, like the menopause. CP prevalence increases with age (19,34), yet some evidence shows that the burden of pain is increasing for increasingly younger cohorts (35).The mid-life is a potentially sensitive period that may provide an arena for prevention and management interventions to decrease the burden of CP later in life.…”

“…Previous systematic reviews have addressed the prevalence of CP by sex in the adult population spanning from 18 years to older age (16)(17)(18)(19)34). Mans eld et al (2016), for example, identi ed that prevalence of chronic widespread pain was higher in women over 40, while Fayaz et al (2016) reported an increase in prevalence of CP with age in the pooled sample.…”

“…Mans eld et al (2016), for example, identi ed that prevalence of chronic widespread pain was higher in women over 40, while Fayaz et al (2016) reported an increase in prevalence of CP with age in the pooled sample. In summary, current systematic reviews of CP prevalence in adults either fail to differentiate between phases of adulthood (17,18,29,34) or have not strati ed results by sex at mid-life (15,52,53). By comparing CP prevalence at mid-life by sex, this review aims at addressing this gap in the literature.…”