Search

Study DesignCross-sectional.PurposeThe purpose of the study was to determine the prevalence of low back pain (LBP) in the primary care setting with emphasis on the socio-demographic contributing factors and impact of LBP on lifestyle habits.Overview of LiteratureLBP is one of the most common medical conditions seen in the Primary Health Care Clinic.MethodsA representative sample of 2,600 patients were approached and 1,829 subjects agreed to participate in this study (70.0%). Data on socio-demographic characteristics, life style habits and type of treatment were collected through a questionnaire.ResultsThe prevalence of LBP in the study sample was 56.5% (95% confidence interval, 54.2-58.8). LBP was more prevalent among women (53.9%) compared to men (46.1%). There was significant difference between male and female patients of LBP in terms of ethnicity (p

Study Design: Cross-sectional. Purpose: The purpose of the study was to determine the prevalence of low back pain (LBP) in the primary care setting with emphasis on the socio-demographic contributing factors and impact of LBP on lifestyle habits. Overview of Literature: LBP is one of the most common medical conditions seen in the Primary Health Care Clinic. Methods: A representative sample of 2,600 patients were approached and 1,829 subjects agreed to participate in this study (70.0%). Data on socio-demographic characteristics, life style habits and type of treatment were collected through a questionnaire. Results: The prevalence of LBP in the study sample was 56.5% (95% confidence interval, 54.2-58.8). LBP was more prevalent among women (53.9%) compared to men (46.1%). There was significant difference between male and female patients of LBP in terms of ethnicity (p <0.001), marital status (p =0.010), occupation (p <0.001), monthly household income (p =0.004), and cigarette/sheesha smokers (p <0.001). The percentages of different aspects of functional disabilities were statistically significantly higher among females compared to male patients with LBP. Almost a quarter of female patients with LBP (26%) and 18% male patients with LBP reported pain in the arms and legs (p =0.002). In addition, gastrointestinal complaints such as abdominal pain and food intolerance were significantly higher among female patients with LBP as compared to males (31% vs. 24.6%, p =0.018; and 25% vs. 18%, p =0.008, respectively). Complaints about headache and fainting were also significantly higher among female patients as compared to male LBP patients (43% vs. 36%, p =0.029; and 26% vs. 20%, p =0.016, respectively). The multivariate logistic regression revealed that being female, prolonged standing, prolonged sitting, heavy weight lifting, weakness in the legs, regular exercise, and cigarette/sheesh a smoking had a significant effect on the presence of LBP. Conclusions: LBP is highly prevalent among both genders and in older age. Also, weakness in the legs, smoking, prolonged standing and sitting had a significant effect on LBP. Furthermore, the current study findings support the fact that LBP continues to be an important clinical, social and economic, burden and a public health problem affecting the population of the entire world. [ABSTRACT FROM AUTHOR]

The value of range of motion (ROM) as an indicator of impairment associated with spinal problems, and in monitoring changes in response to treatment, is a controversial issue. The aim of this study was to examine the interrelationship between subjective disability (Roland-Morris scores) and objectively measured impairment (ROM), both before and in response to spinal decompression surgery, in an older group of patients with herniated lumbar disc (DH). Seventy-six individuals took part in the study: 33 patients (mean age 57 years, SD 9 years) presenting with DH and for whom decompression surgery was planned, and 43 controls (mean age 57 years, SD 7 years), with no history of back pain requiring medical treatment. In the patient group, pain intensity (leg and back; visual analog score), self-rated disability (Roland-Morris score), certain psychological attributes, and ROM of the spine (Spinal Mouse) were measured before and 2 months after decompression surgery. In addition, the patients rated the success of surgery on a 1–5 Likert scale. The pain-free control group performed only the tests of spinal mobility. Before surgery, compared with matched controls, significantly lower values were observed in the DH patients for standing lumbar lordosis ( p=0.01), and for range of flexion of the lumbar spine (ROFlumbar) ( p=0.0006), but not of the hips (ROFhip) ( p=0.14). Roland-Morris Disability scores correlated significantly with ROFlumbar ( r=0.61, p=0.0002), but less well with ROFhip( r=0.43, p=0.01). Two months after surgery, there were significant reductions in back pain and leg pain ( p=0.0001) and in Roland-Morris Disability scores ( p=0.019). There was also a significant decrease in the group mean values for lumbar lordosis angle (i.e., a “flatter” spine after surgery, p=0.002) and ROFlumbar ( p=0.038). ROFhip showed a (nonsignificant) tendency to increase ( p=0.08) towards normal control values. As a result of these two opposing changes, the range of total trunk flexion showed no significant changes from pre-surgery to 2 months post-surgery ( p=0.60). On an individual basis, there was a highly significant relationship between the change in self-rated disability scores and the change in ROFlumbar, pre-surgery- to 2 months post-surgery ( r= −0.82; p<0.0001). Changes in ROFhip showed no such relationship ( r= −0.30, p=0.10). The patients in the “poor” outcome group (“surgery didn’t help”; 9%) had a significantly greater reduction in ROFlumbar post-surgery compared with the “good” outcome group (“surgery helped”; 91%) ( p=0.04). In stepwise linear regression, the change in ROFlumbar was the only variable accounting for the change in self-rated disability pre-surgery to post-surgery (variables not included: pain intensity, psychological factors). The pivotal role of lumbar mobility in explaining disability emphasizes the importance of measuring lumbar and hip ranges of motion separately, as opposed to “global trunk motion.” In the patient group examined, the determination of lumbar spinal mobility provides a valid, objective measure of function, that shows differences from normal matched controls, that correlates well with self-rated disability, and the changes in which correlate extremely well with subjective changes in disability following surgery. [ABSTRACT FROM AUTHOR]