Epidemiologic Studies of Low-Back Pain

Frymoyer, John W.; Pope, Malcolm H.; Costanza, Michael C.; Rosen, James C.; Goggin, Joyce E.; Wilder, David G.

doi:10.1097/00007632-198009000-00005

Cited by 471 publications

(168 citation statements)

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“…Vascular insufficiency as a result of atheromas should also be considered. [16][17][18][19][20] Analogous with our results, these presumptions may account for smoking as a cause of rLDH. In contrast with these findings, however, some studies found no relationship between smoking and rLDH.…”

Section: Discussionsupporting

confidence: 89%

Factors that influence recurrent lumbar disc herniation

Yaman

Kazanci²,

Yaman

et al. 2017

Hong Kong Med J

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Section: Discussionsupporting

confidence: 89%

Factors that influence recurrent lumbar disc herniation

Yaman

Kazanci²,

Yaman

et al. 2017

Hong Kong Med J

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“…This association could not be explained by differences in age, body mass, smoking history, or socioeconomic status between those with and those without children. The findings on the effect of parity in women confirm results from other studies (18).…”

Section: Discussionsupporting

confidence: 90%

Number of children as a risk factor for low back pain in men and women

Silman

Ferry

Papageorgiou

et al. 1995

Arthritis & Rheumatism

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Objective. To estimate the influence of the number of liveborn children on the risk of low back pain.Methods. The study design was a cross-sectional population-based survey. The 4,501 respondents to a postal survey were asked to provide data on the occurrence of low back pain and on any children they had. Data on some potential confounding variables were also obtained.Results. There was an increased risk of low back pain in those who were married compared with those who were unmarried, among both men (odds ratio 1.7) and women (adds ratio 1.6). Among married individuals, there was a linear trend of increasing risk with increasing numbers of children.Conclusion. The risk of low back pain is related more to childrearing than to childbearing, although this effect might be partially mediated by unknown confounders associated with increasing family size.Low back pain occurs frequently in the general population, but in the majority of cases an identifiable cause is not found (1,2). Most epidemiologic surveys have demonstrated that the prevalence of low back pain is greater in women than in men at all ages (3,4). There is, however, considerable variation in the estimates of the extent of this female excess and how it is influenced by age. In a comprehensive review of the published data, no consistent pattern could be found (5). Some of the inconsistency may be explained by differences between the sexes in the type of episode, i.e., the female excess is more marked in those with chronic pain (6), whereas a male excess is more likely to be observed for acute episodes (73). The reasons for these patterns are unclear, but may be related to occupational factors.Pregnancy, however, can initiate a "back pain career" in a substantial proportion of women (9), and approximately one-third of mothers have persistent low back pain 6 1 2 months postpartum (10,ll). The longer-term effects of childbirth on low back pain risk are uncertain. One report has suggested an association between increasing parity and low back pain in middleaged women (12), but other studies have demonstrated no effect (13). Any effect of increasing parity on low back pain may be mediated by hormonal influences on the soft tissues supporting the spine, by altered posture, or by direct pressure from the enlarging uterus (14). Childrearing itself, however, is associated with frequent lifting and carrying, factors thought to be of major importance in the susceptibility to low back pain, at least in men (15,16). In the present study, we retrospectively investigated the influence of the number of live births on subsequent low back pain in women and considered the modifying impact of body size, smoking, and age at birth of the first child. We also investigated whether the number of children influences the occurrence of low back pain in men. SUBJECTS AND METHODSStudy design. A cross-sectional population-based postal survey was used in this study. Details of the survey design have been described elsewhere (17).Subjects. The study population consisted of all adults bet...

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“…With regard to smoking, previously published papers have correlated smoking with increased low back pain, visual analog scale, ODI, and disc degeneration when compared with not smoking [5,6,14]. Akmal et al [2] also demonstrated the toxicity of nicotine on bovine in vitro intervertebral disc cells.…”

Section: Discussionmentioning

confidence: 99%

What Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study

Kerr

Zhao

Lurie

2015

Clinical Orthopaedics &Amp; Related Research

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Background Although previous studies have illustrated improvements in surgical cohorts for patients with intervertebral disc herniation, there are limited data on predictors of longterm outcomes comparing surgical and nonsurgical outcomes. Questions/purposes We assessed outcomes of operative and nonoperative treatment for patients with intervertebral disc herniation and symptomatic radiculopathy at 8 years from the Spine Patient Outcomes Research Trial. We specifically examined subgroups to determine whether certain populations had a better long-term outcome with surgery or nonoperative treatment.Methods Patients with symptomatic lumbar radiculopathy for at least 6 weeks associated with nerve root irritation or neurologic deficit on examination and a confirmed disc herniation on cross-sectional imaging were enrolled at 13 different clinical sites. Patients consenting to participate in the randomized cohort were assigned to surgical or nonoperative treatment using variable permuted block randomization stratified by site. Those who declined randomization entered the observational cohort group based on treatment preference but were otherwise treated and followed identically to the randomized cohort. Of those in the randomized cohort, 309 of 501 (62%) provided 8-year data and in the observational group 469 of 743 (63%). Patients were treated with either surgical discectomy or usual nonoperative care. By 8 years, only 148 of 245 (60%) of those randomized to surgery had undergone surgery, whereas 122 of 256 (48%) of those randomized to nonoperative treatment had undergone surgery. The primary outcome measures were SF-36 bodily pain, SF-36 physical function, and Oswestry Disability Index collected at 6 weeks, 3 months, 6 months, 12 months, and then annually. Further analysis studied the following factors to determine if any were predictive of long-term outcomes: sex, herniation location, depression, smoking, work status, other joint problems, herniation level, herniation type, and duration of symptoms. Results The intent-to-treat analysis of the randomized cohort at 8 years showed no difference between surgical and nonoperative treatment for the primary outcome measures. Secondary outcome measures of sciatica bothersomeness, leg pain, satisfaction with symptoms, and selfrated improvement showed greater improvement in the group randomized to surgery despite high levels of crossover. The as-treated analysis of the combined randomized and observational cohorts, adjusted for potential

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Epidemiologic Studies of Low-Back Pain

Cited by 471 publications

References 0 publications

Factors that influence recurrent lumbar disc herniation

Factors that influence recurrent lumbar disc herniation

Number of children as a risk factor for low back pain in men and women

What Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study

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