Seasonal Allergy Induced Back Pain: A Report of Two Cases

Abstract

A computerized literature search using PubMed (www.nlm.nih. gov) documented other physicians' observations of the co-occurrence of back pain and allergy. As early as the 1920's, Dr. AH Rowe demonstrated that chronic muscular pain often had a food allergy connection [1,2]. More than fifty years ago, Dr. WN Sisk, an industrial medicine physician with the Upjohn Company in Michigan, wrote that many allergy patients "suffer from spastic myalgia" manifesting as sudden, intense pain or "generalized aches and pains" in cases where there was no apparent injury to account for the symptoms. A nurse he employed experienced neck pain and headache whenever she ate chicken [3].Theron Randolph, described the co-occurrence of allergy and muscle spasms in a patient whose family harbored an apple allergy. In a 1976 publication, Randolph pleaded for physicians to consider the connection between allergy and myalgia. "The most important point in making a tentative working diagnosis of allergic myalgia is to think of it. The fact remains that this possibility is rarely ever considered and is even more rarely approached by means of diagnostico-therapeutic measures capable of identifying and avoiding the most common environmental incitants and perpetuants of this conditionnamely, specific foods addictants, environmental chemical exposures and house dust" [4].Dr. AH Rinkel and colleagues listed symptoms of allergy as "low back pain, muscle tightness and muscles pulling" with discomfort in nuchal and hamstring muscles with the sharp pain often resembling that of sciatica [5]. Allergist Joseph Miller wrote, "Physicians interested in food allergy are very familiar with the ability of foods to cause muscle spasms and joint pain in various parts of the body. We frequently see food-allergic patients suffering from muscle and joint pains of the chest, back, abdomen, arms, legs or the back of the neck" [6].Epidemiologists Hurwitz and Morgenstern interviewed a large population between 20 and 39 years of age and found that patients with a history of allergy were 50% more likely to report suffering from back pain and depression [7]. More recently, a 2009 study in the Journal of Pain concluded that women with incontinence or allergy were at a greater risk for developing back pain than women without those conditions. They suggested that back pain in allergic individuals was a result of changes in the trunk muscles and the muscles of respiration (diaphragm and transverses abdominis) resulting in "compromised postural control". They also noted that sneezing and coughing are associated with trunk muscle co-contraction and "increased spinal loading" adding to the "development of pain" [8]. CasesThe Medical Director of the Center for Occupational and Environmental Medicine (COEM), in N. Charleston, SC, told of his observations that some patients routinely arrive at his practice for allergy treatment with coincidental back pain. This clinic has an integrative approach to allergy treatment using provocationneutralization immunotherapy as well as traditiona...

Analysis of risk factors of recurring non-specific low back pain with particular emphasis on “new” predictive factors

“…apart from that, histamine, in high concentrations, may irritate nociceptors, inter alia, in the area of the annulus fibrosus of an intervertebral disc [18]. the existence of a relationship between allergy and the occurrence of low back pain incidents has been confirmed by a study carried out in australia in which over 8,000 women took part [21].…”

“…Some authors claim that depression and anxiety disorders are the best-studied risk factors for nSLBP, and patients who complain of these types of pain score significantly higher in tests for drug disorders, depression and emotional lability [4,14]. up until now, there have been isolated English-language reports suggesting nSLBP association with hyperlipidemia, cardiovascular disease, type 2 diabetes, asthma, allergy or urinary incontinence [15][16][17][18][19][20][21][22].…”