Comparison of facet joint degeneration in firefighters and hospital office workers

Abstract

BackgroundThere are few published studies on the relationship between occupational lumbar load and facet joint degeneration (FJD). This cross-sectional study was conducted to evaluate the effect of physical lumbar load on FJD by comparing magnetic resonance imaging (MRI) findings of firefighters (FFs) and hospital office workers (HOWs).MethodsWe randomly sampled 341 male FFs and 80 male HOWs by age stratification. A questionnaire and clinical examination, including MRI of the lumbar spine (T12-S1), were conducted. FJD was diagnosed and graded by using the classification of Pathria et al., and reclassified into two groups as follows: no FJD (grade 0) and FJD (grades 1, 2, and 3). The prevalence of FJD was analyzed according to occupational group.ResultsThe prevalence of FJD ranged from 31% (L1–L2) to 75% (L4–L5) in the FFs, and from 18% (L1–L2) to 69% (L4–L5) in the HOWs. After adjustment for age, body mass index, and frequency of physical exercise, the adjusted odds ratios (OR) for FJD in the FFs were significantly higher than those in the HOWs at all lumbar spinal levels, except for L3–L4 (L1–L2: OR, 2.644; 95% confidence interval [CI], 1.317–5.310; L2–L3: OR, 2.285; 95% CI, 1.304–4.006; L4–L5: OR, 1.918; 95% CI, 1.037–3.544; L5–S1: OR, 1.811; 95% CI, 1.031–3.181).ConclusionThis study shows that FFs exhibit a greater likelihood of having FJD than HOWs after controlling for other risk factors of FJD. This suggests that the physical occupational demands of FFs affect their risk of developing FJD.

Including exercise prescription in the management of non‐specific low back pain

“…Imaging in NSLBP is universally advised against 22 . Identifying pathologies such as disc bulges, facet joint arthropathy and pars defects on imaging frequently leads to inappropriate further treatment 19,23–26 . These imaging findings are more common the older the patient is and with some athletic endeavours 19,25,27 .…”

“…22 Identifying pathologies such as disc bulges, facet joint arthropathy and pars defects on imaging frequently leads to inappropriate further treatment. 19,[23][24][25][26] These imaging findings are more common the older the patient is and with some athletic endeavours. 19,25,27 The high incidence of these imaging findings in asymptomatic individuals means these radiologic findings are mostly associations, not causations of pain.…”

“…19,[23][24][25][26] These imaging findings are more common the older the patient is and with some athletic endeavours. 19,25,27 The high incidence of these imaging findings in asymptomatic individuals means these radiologic findings are mostly associations, not causations of pain. If imaging is thought necessary, 'ageappropriate change' is a good way to describe what the image shows, do not use those imaging findings that have been traditionally called diagnoses to describe the image to the patient.…”

“…• Educating a patient that many imaging findings are the source of their back pain can be harmful. 19,20…”

An overview of compensated work-related injuries among Korean firefighters from 2010 to 2015

“…The incidence of work-related injuries per 1000 firefighters is 1.6 times the average incidence of all industrial accidents per 1000 persons in South Korea. In addition, firefighters have a higher incidence of musculoskeletal diseases and noise-induced hearing loss due to the nature of the work, which exposed to various harmful factors than other occupations [ 4 – 8 ]. Although there is growing interest in work-related injuries among firefighters, there are only few studies that provide an overview of injuries to firefighters.…”