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Smalley H, Edwards K. Chronic back pain prevalence at small area level in England - the design and validation of a 2-stage static spatial microsimulation model. Spat Spatiotemporal Epidemiol 2024; 48:100633. [PMID: 38355256 DOI: 10.1016/j.sste.2023.100633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 02/16/2024]
Abstract
Spatially disaggregated estimates provide valuable insights into the nature of a disease. They highlight inequalities, aid public health planning and identify avenues for further research. Spatial microsimulation is advantageous in that it can be used to create large microdata sets with intact microlevel relationships between variables, which allows analysis of relationships between variables locally. This methodological paper outlines the design and validation of a 2-stage static spatial microsimulation model for chronic back pain prevalence across England, suitable for policy modelling. Data used was obtained from the Health Survey for England and the 2011 Census. Microsimulation was performed using SimObesity, a previously validated static deterministic program, and the synthetic chronic back pain microdataset was internally validated. The paper also highlights modelling considerations for researchers embarking on similar work, as well as future directions for research in this area of microsimulation.
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Affiliation(s)
- Harrison Smalley
- School of Medicine, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom.
| | - Kimberley Edwards
- School of Medicine, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
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Nah S, Park SS, Choi S, Jang HD, Moon JE, Han S. Associations of walking and resistance training with chronic low back pain in older adults: A cross-sectional analysis of Korean National Health and Nutrition Examination Survey data. Medicine (Baltimore) 2022; 101:e29078. [PMID: 35356936 PMCID: PMC10684243 DOI: 10.1097/md.0000000000029078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/21/2022] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Physical activities, such as resistance training and walking, are known to be effective against chronic low back pain (CLBP). However, few studies have examined the associations of walking and resistance training with CLBP in the general older population. Therefore, this study analyzed these relationships in the older Korean population (aged ≥65 years), with the goal of determining which exercise is better for CLBP.This cross-sectional study analyzed Korean National Health and Nutrition Examination Survey data for the period 2012 to 2015. The Korean National Health and Nutrition Examination Survey, which provides representative data for the Korean population, uses a clustered, multistage, random sampling method with stratification based on geographic area, age, and sex. Three multiple logistic regression models were generated in this study to determine the associations of walking and resistance training with CLBP.A total of 5233 participants were enrolled, 3641 (69.6%) of whom were free from CLBP; the remaining 1592 (30.4%) had CLBP. 78.4% and 64.8% of the non-CLBP and CLBP group patients, respectively, walked at least once a week. Also, 23.5% and 11.6% of the participants in the non-CLBP and CLBP groups, respectively, engaged in resistance training at least once a week. In the multiple logistic regression analysis, which was adjusted for all potential confounders, walking was significantly associated with a lower risk of CLBP (1-2d/wk: odds ratio [OR] = 0.65, P = .002; 3-4d/wk: OR = 0.69, P = .004; ≥5 d/wk: OR = 0.57, P < .001). However, resistance training showed no association with the risk of CLBP.In this cross-sectional study, walking was associated with a lower risk of CLBP. In particular, walking >5days per week had the maximum benefit in a lower risk of CLBP. Therefore, clinicians can consider recommending walking to patients with CLBP for optimal pain improvement.
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Affiliation(s)
| | | | | | | | | | - Sangsoo Han
- Correspondence: Sangsoo Han, Department of Emergency Medicine,Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Bucheon 14584,Republic of Korea (e-mail: ).
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Raines BT, Stannard JT, Stricklin OE, Stoker AM, Choma TJ, Cook JL. Effects of Caffeine on Intervertebral Disc Cell Viability in a Whole Organ Culture Model. Global Spine J 2022; 12:61-69. [PMID: 32935580 PMCID: PMC8965308 DOI: 10.1177/2192568220948031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
STUDY DESIGN Controlled laboratory study. OBJECTIVE To investigate the impact of exposure to physiologically relevant caffeine concentrations on intervertebral disc (IVD) cell viability and extracellular matrix composition (ECM) in a whole organ culture model as potential contributing mechanisms in development and progression of IVD disorders in humans. Primary outcome measures were IVD viable cell density (VCD) and ECM composition. METHODS A total of 190 IVD whole organ explants from tails of 16 skeletally mature rats-consisting of cranial body half, endplate, IVD, endplate, and caudal body half-were harvested. IVD explants were randomly assigned to 1 of 2 groups: uninjured (n = 90) or injured (20G needle disc puncture/aspiration method, n = 100). Explants from each group were randomly assigned to 1 of 3 treatment groups: low caffeine (LCAF: 5 mg/L), moderate caffeine (MCAF: 10 mg/L), and high caffeine (HCAF: 15 mg/L) concentrations. RESULTS Cell viability was significantly higher in the low-caffeine group compared with the high-caffeine group at day 7 (P = .037) and in the low-caffeine group compared with the medium- and high-caffeine groups at day 21 (P ≤ .004). Analysis of ECM showed that all uninjured and control groups had significantly higher (P < .05) glycosaminoglycan concentrations compared with all injured groups. Furthermore, we observed a temporal, downward trend in proteoglycan to collagen ratio for the caffeine groups. CONCLUSIONS Caffeine intake may be a risk factor for IVD degeneration, especially in conjunction with disc injury. Mechanisms for caffeine associated disc degeneration may involve cell and ECM, and further studies should elucidate mechanistic pathways and potential benefits for caffeine restriction.
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Affiliation(s)
- Benjamin T. Raines
- University of Missouri, Columbia, MO, USA,University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | | | | | - James L. Cook
- University of Missouri, Columbia, MO, USA,James L Cook, Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Avenue, Columbia, MO 65212, USA.
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The prevalence of chronic pain in young adults: a systematic review and meta-analysis. Pain 2021; 163:e972-e984. [PMID: 34817439 DOI: 10.1097/j.pain.0000000000002541] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/15/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Prior systematic reviews have summarized the prevalence and impact of chronic pain in "average" pediatric (i.e., school-age) and adult (i.e., middle-age) age groups. To our knowledge, this is the first study to describe the prevalence of chronic pain in the subgroup of individuals that fall in between established boundaries of "childhood" and "adulthood" - known as young adulthood. The goal of this research was to meta-analyze prevalence data on pain in young adults based on available data published between 2008 and 2020. Searches were identified with MEDLINE, Embase, and PsycINFO. We included general population and university-based studies presenting prevalence estimates of chronic pain (pain lasting ≥3 months) in young adults. We identified 43 articles providing prevalence estimates across a combined population of 97,437 young adult respondents (age range: 15-34), with studies undertaken in 22 countries. Available data allowed for stratification of prevalence according to pain condition. The overall pooled random-effect prevalence rate of chronic pain in young adults was 11.6%, suggesting that 1 in every 9 young adults experience chronic pain worldwide. Prevalence rates varied considerably according to pain condition. Estimates did not vary according to sex, geographic location, and several study methodological characteristics (i.e., population type, sampling area, sampling year, investigation period, assessment method). Overall, young adult chronic pain is common and should be recognized as a major public health concern. Considering the difficulties young adults face accessing adult healthcare, greater attention is needed to develop transition programs and evidence-based treatments tailored to the unique needs of this age group.
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The prevalence and risk factors of chronic low back pain among adults in KwaZulu-Natal, South Africa: an observational cross-sectional hospital-based study. BMC Musculoskelet Disord 2021; 22:955. [PMID: 34781916 PMCID: PMC8591969 DOI: 10.1186/s12891-021-04790-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/07/2021] [Indexed: 12/19/2022] Open
Abstract
Background Globally, chronic low back pain (CLBP) is the leading cause of disability associated with economic costs. However, it has received little attention in low-and-middle-income countries. This study estimated the prevalence and risk factors of CLBP among adults presenting at selected hospitals in KwaZulu-Natal. Methodology This cross-sectional study was conducted among adults aged ≥18 years who attended the selected hospitals in KwaZulu-Natal during the study period. A self-administered questionnaire was used to collect data on socio-demographic, work-related factors, and information about CLBP. The SPSS version 24.0 (IBM SPSS Inc) was used for data analysis. Descriptive statistics were used for demographic characteristics of participants. CLBP risk factors were assessed using multivariate logistic regression analysis. A p-value of ≤0.05 was deemed statistically significant. Results A total of 678 adults participated in this study. The overall prevalence of CLBP was 18.1% (95% CI: 15.3 – 21.3) with females having a higher prevalence than males, 19.8% (95% CI: 16.0 – 24.1) and 15.85% (95% CI: 11.8 – 20.6), respectively. Using multivariate regression analysis, the following risk factors were identified: overweight (aOR: 3.7, 95% CI: 1.1 – 12.3, p = 0.032), no formal education (aOR: 6.1, 95% CI: 2.1 – 18.1, p = 0.001), lack of regular physical exercises (aOR: 2.2, 95% CI: 1.0 – 4.8, p = 0.044), smoking 1 to 10 (aOR: 4.5, 95% CI: 2.0 – 10.2, p < 0.001) and more than 11 cigarettes per day (aOR: 25.3, 95% CI: 10.4 – 61.2, p < 0.001), occasional and frequent consumption of alcohol, aOR: 2.5, 95% CI: 1.1 – 5.9, p < 0.001 and aOR: 11.3, 95% CI: 4.9 – 25.8, p < 0.001, respectively, a sedentary lifestyle (aOR: 31.8, 95% CI: 11.2 – 90.2, p < 0.001), manual work (aOR: 26.2, 95% CI: 10.1 – 68.4, p < 0.001) and a stooped sitting posture (aOR: 6.0, 95% CI: 2.0 – 17.6, p = 0.001). Conclusion This study concluded that the prevalence of CLBP in KwaZulu-Natal is higher than in other regions, and that it is predicted by a lack of formal education, overweight, lack of regular physical exercises, smoking, alcohol consumption, sedentary lifestyle, manual work, and a stooped posture. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04790-9.
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Sany SA, Tanjim T, Hossain MI. Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study. F1000Res 2021; 10:698. [PMID: 35999897 PMCID: PMC9360907 DOI: 10.12688/f1000research.55151.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 09/07/2023] Open
Abstract
Background: Low back pain (LBP) is one of the leading causes of disability worldwide. Different studies showed the high prevalence of LBP among medical students. However, no study has been conducted on Bangladeshi medical students to estimate the prevalence of LBP. This study evaluated the prevalence, characteristics, and associated risk factors of LBP among medical students in Bangladesh. Methods: A cross-sectional study was conducted from October to December 2020 among randomly selected 270 medical students and medical interns in Faridpur Medical College, Bangladesh, using an online questionnaire. In data analysis, chi-square test and binary logistic regression were performed, and a p-value of < 0.05 was regarded as statistically significant. Results: A total of 207 participants responded fully to the survey, and were included in the analysis. The mean age of the participants was 22.36 ± 1.915 years. The point, 6-month, and 12-month prevalence of LBP was 25.6%, 46.9%, and 63.3%, respectively. In most participants, LBP was localized (53.2%), recurrent (64.9%), undiagnosed (70.8%), affected for a short period (55%), and relieved without receiving any treatment (60.4%). Participants who had a significantly higher 12-month prevalence of LBP included females (72.2% vs 52.2%), with BMI >25 kg/m 2 (73.2% vs 56.7%), those who performed physical activity at low to moderate frequency (72.4% vs 29.5%), those who spent > 6 hours/day by sitting (71.3% vs 45.3%), and those who did not have enough rest time (92.7% vs 56%). Ergonomic features of chairs, such as having back support, adjustable back support, and adjustable sitting surface, significantly (p < 0.05) influenced the outcomes. Conclusion: The prevalence of LBP among medical students in Bangladesh was high, and most of the risk factors associated with the high prevalence of LBP were modifiable. Hence, LBP can be prevented by implementing preventive strategies and providing ergonomic training and physical activity facilities.
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Affiliation(s)
- Shabbir Ahmed Sany
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
| | - Taukir Tanjim
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
- Project Research Physician, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ikbal Hossain
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
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Sany SA, Tanjim T, Hossain MI. Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study. F1000Res 2021; 10:698. [PMID: 35999897 PMCID: PMC9360907 DOI: 10.12688/f1000research.55151.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Low back pain (LBP) is one of the leading causes of disability worldwide. Different studies showed the high prevalence of LBP among medical students. However, no study has been conducted on Bangladeshi medical students to estimate the prevalence of LBP. This study determined the prevalence, characteristics, and associated risk factors of LBP among medical students in Bangladesh. Methods: A cross-sectional study was conducted from October to December 2020 among randomly selected 270 medical students and medical interns in Faridpur Medical College, Bangladesh, using an online questionnaire. In data analysis, chi-square test and binary logistic regression were performed, and a p-value of < 0.05 was regarded as statistically significant. Results: A total of 207 participants responded fully to the survey, and were included in the analysis. The mean age of the participants was 22.4 ± 1.9 years. The point, 6-month, and 12-month prevalence of LBP was 25.6%, 46.9%, and 63.3%, respectively. In most participants, LBP was localized (53.2%), recurrent (64.9%), non-specific (70.8%), affected for a short period (55%), and relieved without receiving any treatment (60.4%). Participants who had a significantly higher 12-month prevalence of LBP included females (72.2% vs 52.2%), with BMI >25 kg/m 2 (73.2% vs 56.7%), those who performed physical activity at low to moderate frequency (72.4% vs 29.5%), those who spent > 6 hours/day by sitting (71.3% vs 45.3%), and those who did not have enough rest time (92.7% vs 56%). Ergonomic features of chairs, such as having back support, adjustable back support, and adjustable sitting surface, significantly (p < 0.05) influenced the outcomes. Conclusion: The prevalence of LBP among medical students in Bangladesh was high, and most of the risk factors associated with the high prevalence of LBP were modifiable. Hence, LBP can be prevented by implementing preventive strategies and providing ergonomic training and physical activity facilities.
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Affiliation(s)
- Shabbir Ahmed Sany
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
| | - Taukir Tanjim
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
- Project Research Physician, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ikbal Hossain
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
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Sany SA, Tanjim T, Hossain MI. Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study. F1000Res 2021; 10:698. [PMID: 35999897 PMCID: PMC9360907 DOI: 10.12688/f1000research.55151.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 11/03/2023] Open
Abstract
Background: Low back pain (LBP) is one of the leading causes of disability worldwide. Different studies showed the high prevalence of LBP among medical students. However, no study has been conducted on Bangladeshi medical students to estimate the prevalence of LBP. This study determined the prevalence, characteristics, and associated risk factors of LBP among medical students in Bangladesh. Methods: A cross-sectional study was conducted from October to December 2020 among randomly selected 270 medical students and medical interns in Faridpur Medical College, Bangladesh, using an online questionnaire. In data analysis, chi-square test and binary logistic regression were performed, and a p-value of < 0.05 was regarded as statistically significant. Results: A total of 207 participants responded fully to the survey, and were included in the analysis. The mean age of the participants was 22.4 ± 1.9 years. The point, 6-month, and 12-month prevalence of LBP was 25.6%, 46.9%, and 63.3%, respectively. In most participants, LBP was localized (53.2%), recurrent (64.9%), non-specific (70.8%), affected for a short period (55%), and relieved without receiving any treatment (60.4%). Participants who had a significantly higher 12-month prevalence of LBP included females (72.2% vs 52.2%), with BMI >25 kg/m 2 (73.2% vs 56.7%), those who performed physical activity at low to moderate frequency (72.4% vs 29.5%), those who spent > 6 hours/day by sitting (71.3% vs 45.3%), and those who did not have enough rest time (92.7% vs 56%). Ergonomic features of chairs, such as having back support, adjustable back support, and adjustable sitting surface, significantly (p < 0.05) influenced the outcomes. Conclusion: The prevalence of LBP among medical students in Bangladesh was high, and most of the risk factors associated with the high prevalence of LBP were modifiable. Hence, LBP can be prevented by implementing preventive strategies and providing ergonomic training and physical activity facilities.
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Affiliation(s)
- Shabbir Ahmed Sany
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
| | - Taukir Tanjim
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
- Project Research Physician, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ikbal Hossain
- Department of Community Medicine, Faridpur Medical College, Faridpur, Dhaka, Bangladesh
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Santa Barbara MT, Cortazzo M, Emerick T, Furnier J, Duff J, Shapiro S, Zigler CK, Badway A, Sowa G. Descriptive Analysis of an Interdisciplinary Musculoskeletal Program. PM R 2019; 12:639-646. [PMID: 31747134 DOI: 10.1002/pmrj.12288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 11/04/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Interdisciplinary musculoskeletal programs address comorbidities confounding musculoskeletal conditions and serve as an alternative to the single provider model. OBJECTIVE Descriptive analysis of an interdisciplinary musculoskeletal program. DESIGN Retrospective descriptive analysis of patients enrolled in an interdisciplinary musculoskeletal program. Retrospective subanalysis: cohort of patients enrolled in interdisciplinary program with low back pain compared to historical cohort of patients in a single provider clinic. SETTING Academic interdisciplinary musculoskeletal health program. PATIENTS Patients referred to program with at least one follow-up visit over a 2-year period. INTERVENTIONS Interdisciplinary musculoskeletal program involving physiatry, pain anesthesia, nutrition, psychology, rheumatology, sleep medicine, nursing, and physical therapy. MAIN OUTCOME MEASUREMENTS Patient Specific Functional Scale (PSFS), Oswestry Low Back Disability Index (ODI), number of magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, opioid prescriptions; Press Ganey scores. RESULTS One hundred and seventy-three patients were enrolled and had at least one follow-up visit. Twenty-four percent of patients with any musculoskeletal complaint demonstrated clinically significant improvements in total PSFS. Mean improvement in PSFS was + 0.864 (SD 1.94), which was a statistically significant improvement (P = .0005), but not clinically significant. Magnetic resonance imaging was ordered for 5% of patients, and no computed tomography scans were ordered. Six percent of patients received opioid prescriptions. Press Ganey scores: 96% responded favorably in regard to physician communication quality, 86% of patients responded favorably for access to care, and 78% responded favorably for care coordination. 27.8% of patients with low back pain in the interdisciplinary program achieved a significant decrease in their ODI, compared to 26.6% in the single provider clinic (P = .87). CONCLUSIONS Interdisciplinary musculoskeletal programs are a promising model to improve the functioning of patients with musculoskeletal pain and decrease downstream utilization. These programs may be more appropriate for patients at higher risk of developing chronic pain.
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Affiliation(s)
- Matthew T Santa Barbara
- Henry Ford Health System, West Bloomfield, MI.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Megan Cortazzo
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Trent Emerick
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jessica Furnier
- Health Services Division, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jesse Duff
- Health Services Division, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Steve Shapiro
- Health Services Division, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Christine K Zigler
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Andrea Badway
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA.,Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Gwendolyn Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA.,Ferguson Laboratory for Orthopaedic and Spine Research, UPMC Rehabilitation Institute, Pittsburgh, PA
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Rodondi PY, Bill AS, Danon N, Dubois J, Pasquier J, Matthey-de-l'Endroit F, Herzig L, Burnand B. Primary care patients' use of conventional and complementary medicine for chronic low back pain. J Pain Res 2019; 12:2101-2112. [PMID: 31372027 PMCID: PMC6628195 DOI: 10.2147/jpr.s200375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/21/2019] [Indexed: 12/29/2022] Open
Abstract
Purpose To investigate among primary care patients and their physicians in western Switzerland the prevalence of use, perceived usefulness, and communication about common treatments for chronic or recurrent low back pain (crLBP) including complementary medicine (CM). Patients and methods A cross-sectional cluster observational study involving 499 crLBP patients visiting 45 primary care physicians (PCPs) was conducted from November 1, 2015, to May 31, 2016. Patients and primary care physicians completed questionnaires about lifetime use and usefulness of 30 crLBP therapies. We conducted multivariate analyses of factors associated with therapy use, including sociodemographic variables, pain duration, insurance coverage, and primary care physicians’ characteristics. Results The five most frequent modalities used at least once by patients were physiotherapy (81.8%), osteopathic treatment (63.4%), exercise therapy (53.4%), opioids (52.5%), and therapeutic massage (50.8%). For their PCPs, the five most useful therapies were physiotherapy, osteopathic treatment, yoga, meditation, and manual therapy. In multivariate analysis, the use of physiotherapy was significantly associated with longer pain duration; osteopathic treatment was associated with age under 75 years, female gender, higher education, and CM insurance coverage. Exercise therapy was associated with non-smoking and longer pain duration. Smokers were more likely and patients of PCPs with CM training were less likely to have used opioids. During their lifetime, 86.6% of the participants had used at least one CM therapy to manage their crLBP, with a mean of 3.3 (SD=2.9) therapies used per participant; 46.1% of participants reported that their PCP did not enquire about CM use. Among CM users, 64.7% informed their PCP about it. Conclusion Patients with crLBP use a variety of treatments, including self-prescribed and unreimbursed therapies, most frequently physiotherapy and osteopathy. The results suggest that PCPs should systematically discuss with their patients the treatments they tried to manage crLBP, including CM.
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Affiliation(s)
- Pierre-Yves Rodondi
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Anne-Sylvie Bill
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nadia Danon
- Pain Center and Center for integrative and complementary medicine, Department of Anesthesiology, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Julie Dubois
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Jérôme Pasquier
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | | | - Lilli Herzig
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Bernard Burnand
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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11
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Müssener U, Linderoth C, Bendtsen M. Exploring the Experiences of Individuals Allocated to a Control Setting: Findings From a Mobile Health Smoking Cessation Trial. JMIR Hum Factors 2019; 6:e12139. [PMID: 30938682 PMCID: PMC6465977 DOI: 10.2196/12139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/05/2018] [Accepted: 12/29/2018] [Indexed: 11/13/2022] Open
Abstract
Background Tobacco smoking is the primary cause of preventable premature disease and death worldwide. Evidence of the efficacy of text messaging interventions to reduce smoking behavior is well established, but there is still a need for studies targeting young people, especially because young adult smokers are less likely to seek treatment than older adults. A mobile health intervention, Nicotine Exit (NEXit), targeting smoking among university students was developed to support university students to quit smoking. Short-term effectiveness was measured through a randomized controlled trial, which found that immediately after the 12-week intervention, 26% of smokers in the intervention group had prolonged abstinence compared with 15% in the control group. Objective The objective of this study was to explore the experience of being allocated to the control group in the NEXit smoking cessation intervention. Methods We asked students who were allocated to the control group in the main NEXit randomized controlled trial to report their experiences. An email was sent to the participants with an electronic link to a short questionnaire. We assessed the distribution of the responses to the questionnaire by descriptive analysis. We analyzed free-text comments to 4 questions. Results The response rate for the questionnaire was 33.8% (258/763), and we collected 143 free-text comments. Of the responders, 60.9% (157/258) experienced frustration, disappointment, and irritation about being allocated to the control group; they felt they were being denied support by having to wait for the intervention. Monthly text messages during the waiting period thanking them for taking part in the trial were perceived as negative by 72.3% (189/258), but for some the messages served as a reminder about the decision to quit smoking. Of the responders, 61.2% (158/258) chose to wait to quit smoking until they had access to the intervention, and 29.8% (77/258) decided to try to quit smoking without support. Of the respondents, 77.5% (200/258) claimed they were still smoking and had signed up or were thinking about signing up for the smoking cessation program at the time of the questionnaire. Conclusions Most of the respondents reported negative feelings about having to wait for the support of the intervention and that they had decided to continue smoking. A similar number decided to wait to quit smoking until they had access to the intervention, and these respondents reported a high interest in the intervention. Free-text comments indicated that some control group participants believed that they had been excluded from the trial, while others were confused when asked to sign up for the intervention again. Trial Registration ISRCTN Registry ISRCTN75766527; http://www.isrctn.com/ISRCTN75766527 (Archived by WebCite at http://www.webcitation.org/7678sUKbR)
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Affiliation(s)
- Ulrika Müssener
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Catharina Linderoth
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Tavares C, Salvi CS, Nisihara R, Skare T. Low back pain in Brazilian medical students: a cross-sectional study in 629 individuals. Clin Rheumatol 2018; 38:939-942. [DOI: 10.1007/s10067-018-4323-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/17/2018] [Accepted: 10/03/2018] [Indexed: 10/28/2022]
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Abstract
STUDY DESIGN A nationwide cross-sectional study. OBJECTIVES To measure the associations between cigarette smoking (defined as serum cotinine concentration >15 ng/mL) and the 3-month prevalence of spinal pain (neck pain, low back pain, low back pain with pain below knee, and self-reported diagnosis of arthritis/rheumatism) and related limitations, and to verify whether these associations are mediated by serum concentrations of vitamin C. SUMMARY OF BACKGROUND DATA Cigarette smoking has been consistently associated with back pain, but this association has never been explained. Because vitamin C has recently been reported to be associated with spinal pain and related functional limitations, and the metabolism of vitamin C differs between smokers and nonsmokers, we hypothesized that the prevalence of spinal pain and related limitations might be greater among smokers because they are more susceptible to be in a state of hypovitaminosis C. METHODS We conducted secondary analyses of National Health and Nutrition Examination Survey (NHANES) 2003 to 2004 data on 4438 individuals aged ≥20 years. RESULTS Serum concentrations of vitamin C and cotinine were strongly and inversely correlated (r = -0.35, P < 0.0001). Smoking was statistically associated with the prevalence of neck pain [adjusted odds ratio: aOR: 1.25; 95% confidence interval (95% CI): 1.06-1.47], low back pain (aOR: 1.20; 95% CI: 1.04-1.39), and low back pain with pain below knee (aOR: 1.58; 95% CI: 1.13-2.22) and related limitations, with a dose-response relationship (P < 0.05). However, the associations between smoking and spinal pain were not mediated by concentrations of vitamin C. CONCLUSION These results confirm the relationship between smoking and spinal pain, but they do not support a mediating effect of vitamin C on this relationship. LEVEL OF EVIDENCE 2.
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Role of Stress and Smoking as Modifiable Risk Factors for Nonpersistent and Persistent Back Pain in Women. Clin J Pain 2016; 32:232-7. [PMID: 25882868 DOI: 10.1097/ajp.0000000000000245] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the association between smoking and stress with nonpersistent and persistent back pain. MATERIALS AND METHODS Participants included 3703 women who took part in the Kentucky Women's Health Registry in 2008 and 2011. Multivariate logistic regression modeling was used to examine whether smoking status and stress levels were predictive of nonpersistent and persistent back pain, controlling for sociodemographic characteristics. RESULTS Stress level was associated with both nonpersistent and persistent back pain, whereas smoking was associated with only persistent back pain. Current smokers were 1.5 times more likely to report persistent back pain compared with never smokers, controlling for age, race, body mass index, educational attainment, and employment status. Women experiencing large or overwhelming amounts of stress were 1.8 times more likely to have nonpersistent back pain and 1.6 times more likely to report persistent back pain, compared with women experiencing small amounts of stress. DISCUSSION This study further substantiates the findings of prior research that describes a significant relationship between back pain, stress, and smoking. Understanding the role of modifiable risk factors (ie, smoking and stress) and their impact on back pain provides an opportunity to offer a comprehensive and tailored treatment plan.
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Abstract
OBJECTIVE To explore the relationship between migraine and anxiety disorders, mood disorders and perceived mental health in a population-based sample of adolescents. METHODS The Canadian Community Health Survey (CCHS) is a cross-sectional health survey sampling a nationally representative group of Canadians. In this observational study, data on all 61,375 participants aged 12-19 years from six survey cycles were analyzed. The relationships between self-reported migraine, perceived mental health, and mood/anxiety disorders were modeled using univariate and multivariate logistic regression. The migraine-depression association was also explored in a subset of participants using the Composite International Diagnostic Interview-Short Form (CIDI-SF) depression scale. RESULTS The odds of migraine were higher among those with mood disorders, with the strongest association in 2011-2 (adjusted odds ratio [aOR]=4.59; 95% confidence interval [CI 95%]=3.44-6.12), and the weakest in 2009-10 (aOR=3.06, CI 95%=2.06-4.55). The migraine-mood disorders association was also significant throughout all cycles, other than 2011-2, when the CIDI-SF depression scale was employed. The odds of migraine were higher among those with anxiety disorders, with the strongest association in 2011-2 (aOR=4.21, CI 95%=3.31-5.35) and the weakest in 2010 (aOR=1.87, CI 95%=1.10-3.37). The inverse association between high perceived mental health and the odds of migraine was observed in all CCHS cycles, with the strongest association in 2011-2 (aOR=0.58, CI 95%=0.48-0.69) and the weakest in 2003-4 (aOR=0.75, CI 95%=0.62-0.91). CONCLUSIONS This study provides evidence, derived from a large population-based sample of adolescents, for a link between migraine and mood/anxiety disorders.
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Jadhav AV. Comparative cross-sectional study for understanding the burden of low back pain among public bus transport drivers. Indian J Occup Environ Med 2016; 20:26-30. [PMID: 27390476 PMCID: PMC4922272 DOI: 10.4103/0019-5278.183833] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Even though low back pain (LBP) is common, some occupations pose a higher risk. Identifying these occupations and specific factors will help to reduce the suffering and burden. This study aims to compare the prevalence of chronic LBP among bus drivers and to find its association with some occupational factors. MATERIALS AND METHODS It is a cross-sectional study to compare prevalence of LBP and factors associated with it, in two groups of drivers (n = 178) and nondrivers (n = 184). RESULTS The 10 years' percentage prevalence of LBP was found to be 70.8 and 51.6 among drivers and nondrivers respectively, whereas point prevalence in the same was 64.0 and 44.6. Drivers are at a higher risk for LBP with Odds ratio-2.270 (1.471-3.502). Risk factors such as prolonged sitting in one posture, night shifts, job dissatisfaction, tobacco use, and lack of exercise were significantly higher among drivers. Though the prevalence and intensity of LBP was higher among drivers, their number of leaves and hospital admitted days were less among drivers. CONCLUSION This is a potential group for intervention as prevalence of LBP, neck pain, and most of the suspected risk factors were higher among the drivers. Drivers got less recovery time and had higher sequelae.
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Affiliation(s)
- Abhijeet V Jadhav
- Department Jamsetji Tata School of Disaster Management, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
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Petre B, Torbey S, Griffith JW, De Oliveira G, Herrmann K, Mansour A, Baria AT, Baliki MN, Schnitzer TJ, Apkarian AV. Smoking increases risk of pain chronification through shared corticostriatal circuitry. Hum Brain Mapp 2014; 36:683-94. [PMID: 25307796 DOI: 10.1002/hbm.22656] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/26/2014] [Accepted: 09/30/2014] [Indexed: 12/23/2022] Open
Abstract
Smoking is associated with increased incidence of chronic pain. However, the evidence is cross-sectional in nature, and underlying mechanisms remain unclear. In a longitudinal observational study, we examined the relationship between smoking, transition to chronic pain, and brain physiology. In 160 subjects with subacute back pain (SBP: back pain lasting 4-12 weeks, and no prior back pain [BP] for at least 1 year) pain characteristics, smoking status, and brain functional properties were measured repeatedly over 1 year. Sixty-eight completed the study, subdivided into recovering (SBPr, n = 31) and persisting (SBPp, n = 37), based on >20% decrease in BP over the year. Thirty-two chronic back pain (CBP: duration > 5 years) and 35 healthy controls were similarly monitored. Smoking prevalence was higher in SBP and CBP but not related to intensity of BP. In SBP, smoking status at baseline was predictive of persistence of BP 1 year from symptom onset (differentiating SBPp and SBPr with 0.62 accuracy). Smoking status combined with affective properties of pain and medication use improved prediction accuracy (0.82). Mediation analysis indicated the prediction of BP persistence by smoking was largely due to synchrony of fMRI activity between two brain areas (nucleus accumbens and medial prefrontal cortex, NAc-mPFC). In SBP or CBP who ceased smoking strength of NAc-mPFC decreased from precessation to postcessation of smoking. We conclude that smoking increases risk of transitioning to CBP, an effect mediated by corticostriatal circuitry involved in addictive behavior and motivated learning.
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Affiliation(s)
- Bogdan Petre
- Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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Parkerson HA, Zvolensky MJ, Asmundson GJG. Understanding the relationship between smoking and pain. Expert Rev Neurother 2014; 13:1407-14. [PMID: 24236905 DOI: 10.1586/14737175.2013.859524] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This review provides an overview of evidence regarding several key mechanisms pertinent to understanding the co-occurrence of smoking dependence and pain, both potentially costly conditions, and highlights treatment implications and future research directions. We describe each of pain and smoking dependence and introduce a revised integrative reciprocal model that explains their co-occurrence. We then provide a selective review of evidence pertinent to direct and indirect pathways between variables postulated in the model. We also provide general recommendations for improving assessment and treatment of smokers with clinically significant pain. We conclude with a targeted agenda for future investigation of the co-occurrence of smoking and pain. Empirical efforts directed at testing postulates of the proposed integrative model may yield a better understanding of the nature of the relationship between these prevalent and costly health conditions as well as evidence-based preventive and treatment strategies for people who experience nicotine dependence and pain-related disability.
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Affiliation(s)
- Holly A Parkerson
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada S4S 0A2
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Green BN, Johnson CD. Establishing a theoretical basis for research in musculoskeletal epidemiology: a proposal for the use of biopsychosocial theory in investigations of back pain and smoking. JOURNAL OF CHIROPRACTIC HUMANITIES 2013; 20:1-8. [PMID: 25067926 PMCID: PMC4111074 DOI: 10.1016/j.echu.2013.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/12/2013] [Accepted: 10/14/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This article discusses the need for theoretical foundations in epidemiological research of musculoskeletal conditions and suggests the use of biopsychosocial theory when designing epidemiological studies. The association between smoking and back pain is used as an example. DISCUSSION Theory-driven musculoskeletal epidemiologic research is not common. In the epidemiological study of musculoskeletal conditions, there are multiple potential causes of a disease or disorder. Classic biomedical theory is not well suited to explain such phenomena. Biopsychosocial theory is a means through which investigators might formulate hypotheses for testing relationships between smoking, back pain, and other variables. Various types of conceptual frameworks and analytical models can be informed by biopsychosocial theory. CONCLUSION Biopsychosocial theory is well suited for public health and epidemiological studies on musculoskeletal conditions, such as the relation between back pain and smoking, and may be useful to address the multivariable inputs for this association. Although it is not a perfect model, it provides theoretical guidance to inform the research question, an element of research design that is lacking in modern-day epidemiologic reports.
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Affiliation(s)
- Bart N. Green
- Associate Editor, National University of Health Sciences, Lombard, IL
| | - Claire D. Johnson
- Professor and Editor, National University of Health Sciences, Lombard, IL
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Dunn KM, Hestbaek L, Cassidy JD. WITHDRAWN: Low back pain across the lifecourse. Best Pract Res Clin Rheumatol 2013. [DOI: 10.1016/j.berh.2013.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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