The global burden of low back pain: estimates from the Global Burden of Disease 2010 study

Hoy, Damian; March, Lyn; Brooks, Peter; Blyth, Fiona; Woolf, Anthony D.; Bain, Christopher; Williams, Gail M.; Smith, Emma; Vos, Theo; Barendregt, Jan J.; Murray, Chris; Burstein, Roy; Buchbinder, Rachelle

doi:10.1136/annrheumdis-2013-204428

Cited by 2,422 publications

(1,691 citation statements)

References 29 publications

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“…The associated direct and indirect annual total costs for back pain are estimated to 1-2% of GDP [3,4]. Degeneration of intervertebral discs (IVDs) is strongly associated with LBP and suggested to be the most common cause of LBP [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

MRI histogram analysis enables objective and continuous classification of intervertebral disc degeneration

et al. 2017

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Purpose Magnetic resonance imaging (MRI) is the best diagnostic imaging method for low back pain. However, the technique is currently not utilized in its full capacity, often failing to depict painful intervertebral discs (IVDs), potentially due to the rough degeneration classification system used clinically today. MR image histograms, which reflect the IVD heterogeneity, may offer sensitive imaging biomarkers for IVD degeneration classification. This study investigates the feasibility of using histogram analysis as means of objective and continuous grading of IVD degeneration. Methods Forty-nine IVDs in ten low back pain patients (six males, 25-69 years) were examined with MRI (T2-weighted images and T2-maps). Each IVD was semi-automatically segmented on three mid-sagittal slices. Histogram features of the IVD were extracted from the defined regions of interest and correlated to Pfirrmann grade. Results Both T2-weighted images and T2-maps displayed similar histogram features. Histograms of well-hydrated IVDs displayed two separate peaks, representing annulus fibrosus and nucleus pulposus. Degenerated IVDs displayed decreased peak separation, where the separation was shown to correlate strongly with Pfirrmann grade (P \ 0.05). In addition, some degenerated IVDs within the same Pfirrmann grade displayed diametrically different histogram appearances. Conclusions Histogram features correlated well with IVD degeneration, suggesting that IVD histogram analysis is a suitable tool for objective and continuous IVD degeneration classification. As histogram analysis revealed IVD heterogeneity, it may be a clinical tool for characterization of regional IVD degeneration effects. To elucidate the usefulness of histogram analysis in patient management, IVD histogram features between asymptomatic and symptomatic individuals needs to be compared.

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Section: Introductionmentioning

confidence: 99%

MRI histogram analysis enables objective and continuous classification of intervertebral disc degeneration

et al. 2017

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“…With its lifetime prevalence between 58 and 84 %, low back pain poses substantial burden on global health care [2][3][4]. A large proportion (85 %) of low back pain is non-specific and has an unknown aetiology [5].…”

Section: Introductionmentioning

confidence: 99%

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

et al. 2016

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Purpose To identify prognostic factors for curve progression in de novo degenerative lumbar scoliosis (DNDLS) by performing a systematic review of the literature. Methods Studies were selected for inclusion following a systematic search in the bibliographic databases PubMed and EMBASE prior to September 2015 and hand searches of the reference lists of retrieved articles. Two authors independently assessed methodological quality. Data were extracted and presented according to a best evidence synthesis. Results The literature search generated a total of 2696 references. After removing duplicates and articles that did not meet inclusion criteria, 12 studies were included. Due to the lack of statistical analyses, pooling of data was not possible. Strong evidence indicates that increasing intervertebral disk degeneration, lateral vertebral translation C6 mm, and an intercrest line through L5 (rather than L4) are associated with DNDLS curve progression. Moderate evidence suggests that apical vertebral rotation Grade II or III is associated with curve progression. For the majority of other prognostic factors, we found limited, conflicting, or inconclusive evidence. Osteoporosis, a coronal Cobb angle \30°, lumbar lordosis, lateral osteophytes difference of C5 mm, and degenerative spondylolisthesis have not been shown to be risk factors. Clinical risk factors for progression were not identified. Conclusions This review shows strong evidence that increased intervertebral disk degeneration, an intercrest line through L5, and apical lateral vertebral translation C6 mm are associated with DNDLS curve progression. Moderate evidence was found for apical vertebral rotation (Grade II/III) as a risk factor for curve progression. These results, however, may not be directly applicable to the individual patient.

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“…It is estimated that, in 2010, 21% of the global population experienced tension-type headache, 15% suffered from migraines, 9% experienced lower back pain and 5% experienced neck pain. 1 CNCP is responsible for considerable social, economic and healthcare burden, [2][3][4] and is predicted to increase with an aging population. 5 As such, there is a public health imperative to better understand the use of evidence-based treatments by people with CNCP.…”

Section: Introductionmentioning

confidence: 99%

Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

Nielsen¹,

Campbell²,

Peacock

et al. 2016

Aust. Health Review

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Objective. The aims of the present study were to describe the use, and barriers to the use, of non-medication pain therapies and to identify the demographic and clinical correlates of different non-opioid pain treatments.Methods. The study was performed on a cohort (n = 1514) of people prescribed pharmaceutical opioids for chronic noncancer pain (CNCP). Participants reported lifetime and past month use of healthcare services, mental and physical health, pain characteristics, current oral morphine equivalent daily doses and financial and access barriers to healthcare services.Results. Participants reported the use of non-opioid pain treatments, both before and after commencing opioid therapy. Services accessed most in the past month were complementary and alternative medicines (CAMs; 41%), physiotherapy (16%) and medical and/or pain specialists (15%). Higher opioid dose was associated with increased financial and access barriers to non-opioid treatment. Multivariate analyses indicated being younger, female and having private health insurance were the factors most commonly associated with accessing non-opioid treatments.Conclusions. Patients on long-term opioid therapy report using multiple types of pain treatments. High rates of CAM use are concerning given limited evidence of efficacy for some therapies and the low-income status of most people with CNCP. Financial and insurance barriers highlight the importance of considering how different types of treatments are paid for and subsidised.What is known about the topic? Given concerns regarding long-term efficacy, adverse side-effects and risk of misuse and dependence, prescribing guidelines recommend caution in prescribing pharmaceutical opioids in cases of CNCP, typically advising a multidisciplinary approach to treatment. There is a range of evidence supporting different (non-drug) treatment approaches for CNCP to reduce pain severity and increase functioning. However, little is known about the non-opioid treatments used among those with CNCP and the demographic and clinical characteristics that may be associated with the use HEALTH SERVICE RESEARCH of different types of treatments. Understanding the use of non-drug therapy among people with CNCP is crucial given the potential to improve pain control for these patients. What does this paper add? The present study found that a wide range of non-opioid treatments was accessed by the study sample, both before and after commencing opioids, indicating that in this sample opioids were not the sole strategy used for pain management. The most common treatment (other than opioids) was CAM, reported by two-fifths of the sample. Having private health insurance was associated with increased use of non-opioid treatments for pain, highlighting the importance of considering how treatments are paid for and potential financial barriers to effective treatments. What are the implications for practitioners? Patients' beliefs and financial barriers may affect the uptake of different treatments. Many patients may be using com...

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The global burden of low back pain: estimates from the Global Burden of Disease 2010 study

Cited by 2,422 publications

References 29 publications

MRI histogram analysis enables objective and continuous classification of intervertebral disc degeneration

MRI histogram analysis enables objective and continuous classification of intervertebral disc degeneration

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

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