1. The contribution of thoracic vertebral deformity and arthropathy to trunk pain in patients with chronic obstructive pulmonary disease (COPD).
- Author
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Chen YW, Coxson HO, Coupal TM, Lam S, Munk PL, Leipsic J, and Reid WD
- Subjects
- Aged, Canada epidemiology, Congenital Abnormalities, Cross-Sectional Studies, Female, Humans, Joint Diseases pathology, Male, Middle Aged, Observer Variation, Osteoporosis complications, Osteoporosis diagnostic imaging, Outcome Assessment, Health Care, Pain epidemiology, Pain etiology, Pain Perception physiology, Prevalence, Pulmonary Disease, Chronic Obstructive diagnostic imaging, Smoking epidemiology, Thoracic Vertebrae diagnostic imaging, Thoracic Vertebrae pathology, Tomography, X-Ray Computed methods, Joint Diseases complications, Pain diagnosis, Pulmonary Disease, Chronic Obstructive physiopathology, Thoracic Vertebrae abnormalities
- Abstract
Background: Pain, commonly localized to the trunk in individuals with COPD, may be due to osteoporosis-related vertebral deformity and chest wall hyper-expansion causing misalignment of joints between the ribs and vertebrae. The purpose of this study was to determine if thoracic vertebral deformity and arthropathy were independent contributors to trunk pain in COPD patients compared to people with a significant smoking history., Method: Participants completed the Brief Pain Inventory (BPI) on the same day as chest CT scans and spirometry. Current and ex-smokers were separated into COPD (n = 91) or non-COPD (n = 80) groups based on spirometry. Subsequently, CT images were assessed for thoracic vertebral deformity, bone attenuation values, and arthropathy of thoracic vertebral joints., Results: The trunk area was the most common pain location in both COPD and non-COPD groups. Thoracic vertebral deformity and costotransverse joint arthropathy were independent contributors to trunk pain in COPD patients (adjusted OR = 3.55 and 1.30, respectively) whereas alcohol consumption contributed to trunk pain in the non-COPD group (adjusted OR = 0.35 in occasional alcohol drinkers; 0.08 in non-alcohol drinkers). The spinal deformity index and the number of narrowed disc spaces were significantly positively related to the BPI intensity, interference, and total scores significantly in COPD patients., Conclusion: Trunk pain, at least in part, is caused by thoracic vertebral deformity, and costotransverse and intervertebral arthropathy in patients living with COPD. The results of this study provided the foundation for the management of pain, which requires further exploration., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2018
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