Sleep disturbances predict long-term changes in low back pain among Finnish firefighters: 13-year follow-up study

Abstract

PurposeTo investigate the prevalence of low back pain among Finnish firefighters and to examine whether sleep disturbances predict membership of low back pain trajectories.MethodsIn this prospective study, 360 actively working firefighters responded to a questionnaire in 1996, 1999 and 2009. The outcome variables were radiating and local low back pain during the preceding year. Using logistic regression modeling, the likelihood of membership of pain trajectories was predicted by sleep disturbances at baseline.ResultsDuring the 13-year follow-up, the prevalence of radiating low back pain increased from 16 to 29 % (p < 0.0001) and that of local low back pain from 28 to 40 % (p < 0.001). The following trajectories were identified: “pain free,” “recovering,” “new pain,” “fluctuating” and “chronic.” More than one-fifth of the participants belonged to the new pain trajectory as regards both pain types, 6 % of the participants belonged to the chronic radiating and 12 % to the chronic local low back pain trajectory. Those with sleep disturbances at baseline had a 2.4-fold risk (adjusted OR 2.4; 95 % CI 1.2–4.7) of belonging to the new pain or chronic radiating pain cluster compared to pain-free participants.ConclusionsThis is the first prospective study to show that low back symptoms are common and persistent among firefighters and that sleep disturbances strongly predict membership of a radiating pain trajectory. Occupational health and safety personnel, as well as the firefighters themselves, should recognize sleep problems early enough in order to prevent back pain and its development into chronic pain.

A Pilot Study of Audio–Visual Stimulation as a Self-Care Treatment for Insomnia in Adults with Insomnia and Chronic Pain

“…Importantly, findings from a recent systematic review show that sleep impairment not only predicts new onset and the continuation of chronic pain; sleep is a stronger predictor of chronic pain than chronic pain is to sleep impairment (Finan et al, 2013). This hypothesis is further supported by a longitudinal 13-year study in which sleep disturbances at baseline strongly predicted chronic or onset of radiating low back pain over the course of longitudinal follow up (Lusa, Miranda, Luukkonen, & Punakallio, 2014). Finally, results from a recent study show that short-term improvements in sleep predicted long-term improvements in chronic pain, insomnia symptoms, and fatigue (McCurry et al, 2014; Vitiello et al, 2014).…”

Melatonin protects vertebral endplate chondrocytes against apoptosis and calcification via the Sirt1‐autophagy pathway

“…A prospective study in Finland showed that sleep disturbance is a risk factor for LBP development . In addition, a 13‐year follow‐up study reported that sleep disturbance promotes LBP development . These studies imply that a correlation may exist between sleep and IDD.…”

The influence of sleep disorders on the quality of life in patients with chronic low back pain

“…rotation and hyperflexion), pushing and pulling, and exposure to the whole body vibration . An interesting prospective study by Lusa et al on Finnish firefighters reported that that low back symptoms are common and persistent among firefighters and that sleep disturbances strongly predict membership of a radiating pain trajectory. A study by Lunde et al conducted among Norwegian population reported no significant associations between sitting and LBP intensity among construction workers as well as lower levels of LBP intensity during the longer duration of sitting at work among healthcare workers.…”

“…Numerous studies (19,24,(31)(32)(33)(34)(35) have shown that sleep disorders influence the development or exacerbation of back pain and affect the development of depressive symptoms. However, the impact of sleep disorders on the QOL in patients with LBP has not been studied so far.…”