Potential of Magnetic Resonance Imaging Findings to Refine Case Definition for Mechanical Low Back Pain in Epidemiological Studies

Endean, Alison; Palmer, Keith T; Coggon, David

doi:10.1097/brs.0b013e3181cd9adb

Cited by 169 publications

(134 citation statements)

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“…2,4,8,12,13,17,29,31,35 Authors of cross-sectional studies have noted that there is an association between degeneration of the lumbar discs and specific LBP, 4,8 although a systematic review with a meta-analysis of degeneration of lumbar discs related to LBP argued that degeneration of lumbar discs identified by MRI cannot be a cause of LBP at the inAssociation between low-back pain and lumbar spine bone density: a population-based cross-sectional study Object. The authors undertook this study to investigate the relationships between low-back pain (LBP) and spinal bone density.…”

Section: 18mentioning

confidence: 99%

Association between low-back pain and lumbar spine bone density: a population-based cross-sectional study

Lee

Nam²,

Yoon

et al. 2013

SPI

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Object The authors undertook this study to investigate the relationships between low-back pain (LBP) and spinal bone density. Low-back pain is a major health issue and contributes to increases in medical and economic costs. Epidemiological studies have identified individual, sociodemographic, psychosocial, and occupational risk factors for LBP. However, there have been limited studies addressing the relationships between LBP and spinal bone density. Methods Data were obtained from the population-based Fourth Korea National Health and Nutrition Examination Survey (K-NHANES IV, 2009). From 10,533 K-NHANES participants, the authors identified 7144 (3099 men and 4045 women) 21 years of age or older who underwent dual-energy x-ray absorptiometry and anthropometric measurements for inclusion in this study. Low-back pain patients were defined as those who had been diagnosed with LBP by a medical doctor. Chi-square tests, t-tests, and multivariable logistic regression analyses were used to examine the relationships between LBP and spinal bone density. Results The total prevalence of LBP in the patient sample was 17.1%. More females (21.0%) reported LBP than males (12.1%). A number of sociodemographic and medical factors—sex, age, place of residence, occupation, education, hypertension, diabetes mellitus, and depression—were all associated with LBP, while LBP was not associated with income or exercise levels. Regression analyses indicated that higher lumbar spine T-scores (OR 1.11, 95% CI 1.02–1.20) were associated with LBP. Conclusions Higher bone density in the lumbar spine is associated with LBP, independent of confounding factors such as sociodemographic status, education, and medical-psychiatric disorders. Cause and effect relationship between higher bone density and LBP, such as degenerative changes in spine, requires further investigation.

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Section: 18mentioning

confidence: 99%

Association between low-back pain and lumbar spine bone density: a population-based cross-sectional study

Lee

Nam²,

Yoon

et al. 2013

SPI

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“…The latter, in particular, was recently ranked the sixth leading contributor to overall disease burden and the leading cause of disability in both developed and developing countries (Murray et al, 2012). Few cases are due to specific causes with a clearly demonstrable underlying pathology, but a common denominator, although not necessarily the primary cause, is often the intervertebral disc (Cheung et al, 2009;Endean et al, 2011).…”

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confidence: 99%

Non-invasive biomechanical characterization of intervertebral discs by shear wave ultrasound elastography: a feasibility study

et al. 2014

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Objectives: Although magnetic resonance is widely spread to qualitatively assess disc morphology, a simple method to reliably determine intervertebral disc status is still lacking. Shear wave elastography is a recent technique that allows quantitative evaluation of soft-tissues mechanical properties; the aim of this study was to preliminary assess the feasibility and reliability of cervical intervertebral disc mechanical characterization by elastography and to provide first reference values for asymptomatic subjects.Methods: Elastographic measurements were performed to determine shear wave speed (SWS) in C6-C7 or C7-T1 disc of forty-seven subjects; repeatability and inter-operator reproducibility were assessed.Results: Global average shear wave speed (SWS) was 3.0 ± 0.4 m/s; measurement repeatability and inter-user reproducibility were 7 and 10 %, respectively. SWS was correlated with both subject's age (p = 1.3e-5) and body mass index (p = 0.008).Conclusions: Shear wave elastography in intervertebral disc proved reliable and allowed stratification of subjects according to age and BMI. Applications could be relevant, for instance, in early detection of disc degeneration or in follow-up after trauma; these results open the way to larger cohort studies to define the place of this technique in routine intervertebral disc assessment.

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“…herniation of an intervertebral disc in people with back pain), it appears often not to be the explanation for the symptom [1]. Furthermore, there have been major temporal changes in the prevalence of musculoskeletal illness and disability that cannot be explained by altered physical exposures.…”

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Psychological and psychosocial determinants of musculoskeletal pain and associated disability

Vargas-Prada

Coggon

2015

Best Practice & Research Clinical Rheumatology

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Although much attention has been given to the physical determinants of common musculoskeletal complaints such as back and arm pain, research points to a stronger influence of psychological factors. Multiple studies have implicated poor mental health and somatisation (a tendency to worry about common somatic symptoms) in the incidence and chronicity of musculoskeletal pain and associated disability. Also important are adverse beliefs about the prognosis of such disorders, and about the role of physical activity in their development and persistence. Differences in societal beliefs may have contributed to major variation in the prevalence of disabling musculoskeletal pain that has been observed between countries and in the same countries over time. Psychosocial aspects of work have also been linked with musculoskeletal pain, although relative risks have generally been smaller. There is a need to take account of psychological factors in the clinical management of patients with back, neck and arm pain. KeywordsMusculoskeletal pain; mental health; somatisation; health beliefs; psychosocial factors Historically, attempts to prevent incapacity for work from musculoskeletal disorders have focused mainly on the physical demands of employment. It has been assumed that symptoms and disability arise from injury to tissues, and can be prevented by better ergonomic design of occupational tasks to reduce mechanical loading. This biophysical paradigm may be appropriate for some types of musculoskeletal disease -for example, osteoarthritis of the hip caused by heavy lifting (see Chapter X) and degenerative meniscal Europe PMC Funders Group Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts tears in the knee caused by prolonged kneeling and squatting Chapter X). However, it has become increasingly apparent that the model has only limited applicability to common painful disorders of the back, neck and upper limb, which are the main musculoskeletal causes of disability for work.Most disabling pain of the back and upper limb is non-specific in nature with no clear evidence of underlying injury to tissues, and even where pathology can be demonstrated (e.g. herniation of an intervertebral disc in people with back pain), it appears often not to be the explanation for the symptom [1]. Furthermore, there have been major temporal changes in the prevalence of musculoskeletal illness and disability that cannot be explained by altered physical exposures. For example, social security statistics indicate that in Britain, long-term incapacity for work because of back pain increased more than eightfold between 1950 and the early 1990s [2], at a time when the physical demands of work were declining because of greater mechanisation and a shift in employment from manufacturing to service industries. And in Australia, there was a major epidemic of arm pain during the 1980s among office workers, which was not paralleled in other countries that were using similar technology [3].These observations indicate that factors ...

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Potential of Magnetic Resonance Imaging Findings to Refine Case Definition for Mechanical Low Back Pain in Epidemiological Studies

Cited by 169 publications

References 54 publications

Association between low-back pain and lumbar spine bone density: a population-based cross-sectional study

Association between low-back pain and lumbar spine bone density: a population-based cross-sectional study

Non-invasive biomechanical characterization of intervertebral discs by shear wave ultrasound elastography: a feasibility study

Psychological and psychosocial determinants of musculoskeletal pain and associated disability

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