The Correlation between Neck Pain and Disability, Forward Head Posture, and Hyperkyphosis with Opium Smoking: A Cross-Sectional Study from Iran

Abstract

Opium smoking has been a common practice in Iran for many years, with people often smoking for long hours. During the COVID-19 pandemic, there was an increase in opium smoking due to false beliefs about its protective effects against COVID-19 infection. In this study, we aimed to examine the association between the non-ergonomic positions associated with traditional opium smoking in Iran and the development of neck pain and disability, forward head posture (FHP), and hyperkyphosis (HK). In this cross-sectional, correlational study, a total of 120 individuals who smoked opium were selected based on the inclusion criteria. They were interviewed about their addiction profile using the Lite version of the Addiction Severity Index and the Leeds Dependence Questionnaire. The presence of neck pain and disability was also evaluated using the Visual Analog Scale and the Neck Disability Index. The participants were examined for FHP via side-view photography and for HK using a flexible ruler. Data were analyzed using correlation coefficient tests and stepwise linear regression analysis. Based on the results, homelessness, the lifetime duration of opium smoking (in months), the duration of daily opium smoking (in minutes), and the severity of drug dependence had significant relationships with the severity of neck pain, neck disability, FHP, and HK. Homelessness was the strongest predictor of neck pain and disability (R2 = 0.367, p < 0.001), FHP (R2 = 0.457, p < 0.001), and HK (R2 = 0.476, p < 0.001), followed by the lifetime duration of opium smoking and the duration of daily opium smoking, respectively, in which R2 increased to 0.505 (p = 0.011), 0.546 (p = 0.022), and 0.570 (p = 0.004) with the addition of two other variables. Overall, an increase in the duration of sitting in non-ergonomic positions could lead to neck pain and disability, FHP, and HK due to the non-neutral posture of opium smokers.

Is Opium Smoking A Cause of Sway Back Posture and Spinal Musculoskeletal Disorders? What is the Relation?

“…The high prevalence of hyperkyphosis in people with sway back posture has been shown in previous studies (60,61). A higher prevalence of hyperkyphosis has also been shown in people who smoke opium (19,20), and in this study, they also had a more sway back posture. Also, forward head posture is more prevalent in people with sway back posture, which is in line with Posture's findings in opium smokers (9).…”

“…The prevalence of this abnormality is high in some athletes and it is also related to some musculoskeletal disorders and diseases (15)(16)(17)(18). Many drug users are not normal in terms of physical condition (posture) and at first glance, kyphotic or sway back posture is evident in them (19,20). In the sway back posture, the pelvis is moved forward and the hip is pulled inside.…”