Occupational Correlates of Low Back Pain Among U.S. Marines Following Combat Deployment

Abstract

Many U.S. Marines have experienced routine combat deployments during Operation Iraqi Freedom, which present numerous occupational hazards that may result in low back pain (LBP). The objective of this retrospective cohort study was to identify new-onset LBP among Marines following initial deployment to Operation Iraqi Freedom. Active duty Marines deployed to Iraq or Kuwait between 2005 and 2008 were identified from deployment records and linked to medical databases (n = 36,680). The outcome of interest was an International Classification of Diseases, 9th Revision, Clinical Modification code indicating LBP (724.2) within 1 year postdeployment. Multivariate logistic regression examined the effect of occupation on LBP. Overall, 4.1% (n = 1,517) of Marines were diagnosed with LBP. After adjusting for covariates, the service/supply (odds ratio 1.33, 95% confidence interval, 1.12-1.59) and electrical/mechanical/craftsworker occupations (odds ratio 1.31, 95% confidence interval, 1.12-1.53) had higher odds of LBP when compared to the administrative/other referent group. Within these groups, the highest LBP prevalence was in the construction (8.6%) and law enforcement (6.2%) subgroups. Although infantry occupations purposefully engage the enemy and often face sustained physical rigors of combat, LBP was most prevalent in noninfantry occupations. Future studies should include detailed exposure histories to elucidate occupation-specific etiologies of LBP in order to guide prevention efforts.

Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study

“…Previous research also found higher odds of low back pain among U.S. Marines service/supply versus administrative/other occupations. 13 We identified reduced odds of back pain in electrical/mechanical versus functional support/administrative occupations, inconsistent with previous research. 13 …”

“…13 We identified reduced odds of back pain in electrical/mechanical versus functional support/administrative occupations, inconsistent with previous research. 13 …”

“…8,9 Activities during deployment that may increase the risk for back pain include driving specialized vehicles, long and frequent flying hours, wearing of body armor, or carrying heavy loads. 10–13 Our study uses prospective data to assess self-reported recent back pain following deployment and combat experience in support of the operations in Iraq and Afghanistan.…”

Musculoskeletal Pain and Headache in the Active Duty Military Population: An Integrative Review

“…Nevin and Means () determined greater risk for pain frequency in anatomical areas including the lower back (RR, 1.80; 95% CI [1.14, 2.84]; p = .011) and legs (RR, 2.60; 95% CI [1.17, 5.77]; p = .014) among Army helicopter aviators deployed to Afghanistan with increased flight hour. Relative to administrative or other occupations, Marines within 1 year of combat deployment showed higher odds for developing LBP in noninfantry occupations such as the service/supply (OR, 1.33; 95% CI [1.12, 1.59]) and electrical/mechanical/craftsworker (OR, 1.31; 95% CI [1.12, 1.53]; MacGregor, Dougherty, Mayo, Rauh, & Galarneau, ) occupations. Although people in infantry occupations typically walk longer distances carrying heavy loads in combat, new onset LBP was more commonly observed with noninfantry occupations (MacGregor et al., ).…”

Veterans and chronic pain

“…1 Specifically, lower back pain is not necessarily associated with the physical aspects of combat or infantry load-carrying; a study of 37,000 US Marines with back pain (all having been deployed to Iraq), indicated the highest rates in service/supply and electrical/mechanical trades, rather than infantry. 5 However, there are no equivalent data for a British population. Therefore, this paper reviews existing data that may clarify the broad range of chronic pain problems in veterans being treated in the public health system.…”