COVID-19 Pandemic Increases the Impact of Low Back Pain: A Systematic Review and Metanalysis

Abstract

In March 2019, the World Health Organization (WHO) recognized the COVID-19 pandemic as a global issue. To reduce the spread of this disease, health safety pathways were implemented worldwide. These extraordinary measures changed people’s lifestyles, e.g., by being forced to isolate, and in many cases, to work remotely from home. Low back pain (LBP), the most common cause of disability worldwide, is often a symptom of COVID-19. Moreover, it is often associated with different lifestyle features (type of job, physical activity, body weight). Therefore, the purpose of this systematic review and meta-analysis was to estimate the effect of the COVID-19 lockdown on LBP intensity and prevalence compared with LBP rates before the pandemic. A systematic search was performed on Scopus, PubMed, and Cochrane Central. Overall, eight studies with 2365 patients were included in the analysis. We used the Joanna Briggs Institute (JBI) critical appraisal tool to evaluate the risk of bias: six studies (75%) were at moderate risk of bias and two studies (25%) were at low risk of bias. These studies showed an increase in both the prevalence and intensity of LBP during the COVID-19 lockdown.

Impact of the coronavirus disease 2019 (COVID-19) pandemic on the diagnosis of neck and low back pain in outpatient practices in Germany

“…Based on this study, the number of new diagnoses of neck and low back pain decreased in general and orthopedic practices in Germany in 2020 and 2021 compared with 2019. This decrease is of particular concern, because other bodies of research have found high rates of self-reported musculoskeletal pain in the general population since the beginning of the pandemic ( Papalia et al, 2022 , Šagát et al, 2020 ). Furthermore, post-COVID-19 syndrome following SARS-CoV-2 infection can also include musculoskeletal pain ( Aiyegbusi, O.L., Hughes, S.E., Turner, G., Rivera, S.C., McMullan, C., Chandan, J.S., Haroon, S., Price, G., Davies, E.H., Nirantharakumar, K., Sapey, E., Calvert, M.J., TLC Study Group, 2021 , Karaarslan et al, 2022 ).…”

“…For example, one study, using data obtained at two tertiary care centers in the United States, found a decreasing trend in the number of new cases of multiple musculoskeletal conditions (e.g., knee osteoarthritis, shoulder sprain, and carpal tunnel syndrome) ( Yu et al, 2021 ). Less is known about how the COVID-19 crisis has affected the diagnosis of neck and low back pain, although some literature indicates that the pandemic has led to an increase in the prevalence of self-reported low back pain ( Papalia et al, 2022 ) and an aggravation of symptoms in people already affected by low back pain ( Bailly et al, 2022 ). To the best of the authors’ knowledge, the three only studies on this topic have been conducted in hospital settings ( Borsa et al, 2020 , Jäntti et al, 2022 , Sharma et al, 2021 ), and no data is available from primary care and specialized practices.…”

“…To the best of the authors’ knowledge, the three only studies on this topic have been conducted in hospital settings ( Borsa et al, 2020 , Jäntti et al, 2022 , Sharma et al, 2021 ), and no data is available from primary care and specialized practices. This lack of data is of concern because the prevalence of self-reported musculoskeletal pain has been high in the worldwide population since the beginning of the COVID-19 pandemic ( Papalia et al, 2022 , Šagát et al, 2020 ), while neck and low back pain are risk factors for physical disability ( Wu et al, 2020 ), poor mental health ( Demyttenaere et al, 2007 ), and low quality of life ( Pedisic et al, 2013 ). The high prevalence mentioned above may be explained by multiple factors such as low physical activity ( Alzahrani et al, 2019 , Roggio et al, 2021 , Sonza and da Cunha de Sá-Caputo, D., Sartorio, A., Tamini, S., Seixas, A., Sanudo, B., Süßenbach, J., Provenza, M.M., Xavier, V.L., Taiar, R., Bernardo-Filho, M., , 2021 , Wilke et al, 2021 ), increased stress ( Choi et al, 2021 , Xiong et al, 2020 ) and increased smoking ( Bar-Zeev et al, 2022 , Shiri et al, 2010 ).…”

Comparação dos hábitos posturais e de dor em distintos grupos de idosos antes e durante a pandemia da Covid-19

“…Em uma recente revisão sistemática com metanálise 28 pandemia e pandêmico (p = 0,0004 e p = 0,04, respectivamente).…”

Remote work and back pain during the COVID-19 pandemic in adults and older population in South Brazil

“…Previous studies have shown a higher risk of painful symptoms in the cervical regions and largely in the lumbar region 1,3,6,10,11 . However, the specificity of acute pain has not been investigated, which may not show the emergence of pain in the pandemic period in specific locations 1,3,6,10,11 . In addition, compliance with the presence of pain in overweight/obese individuals has been presented in situations of chronic pain 10,11 .…”