Title

Epidemiological differences between localized and nonlocalized low back pain.

Authors

David Coggon, University of Southampton, Southampton, UK
Georgia Ntani, University of Southampton, Southampton, UK
Karen Walker-Bone, University of Southampton, Southampton, UK
Keith T. Palmer, University of Southampton, Southampton, UK
Vanda E. Felli, University of São Paulo, São Paulo, Brazil
Raul Harari, IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
Lope H. Barrero, Pontificia Universidad Javeriana, Bogotá, Colombia
Sarah A. Felknor, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
David Gimeno, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
Anna Cattrell, Goodmayes Hospital, Ilford, Essex, UK
Sergio Vargas-Prada, Universitat Pompeu Fabra, Barcelona, Spain
Matteo Bonzini, University of Insubria, Varese, Italy
Eleni Solidaki, University of Crete, Heraklion, Greece
Eda Merisalu, Estonian University of Life Sciences, Tartu, Estonia
Rima R. Habib, American University of Beirut, Beirut, Lebanon
Farideh Sadeghian, Shahroud University of Medical Sciences, Shahroud, Iran
Muhammad Masood Kadir, Aga Khan UnviversityFollow
Sudath SP Warnakulasuriya, University of Sri Jayawardenepura, Gangodawila, Nugegoda, Sri Lanka
Ko Matsudaira, The University of Tokyo Hospital, Tokyo, Japan
Busisiwe Nyantumbu, National Health Laboratory Service, Johannesburg, South Africa
Malcolm R. Sim, Monash University, Melbourne, Victoria, Australia
Helen Harcombe, University of Otago, Dunedin, New Zealand
Ken Cox, University of Southampton, Southampton, UK
Leila M.M. Sarquis, Federal University of Paraná, Curitiba-PR, Brazil
Maria H. Marziale, University of São Paulo, São Paulo, Brazil
Florencia Harari, IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
Rocio Freire, IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
Natalia Harari, IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
Magda V. Monroy, Pontificia Universidad Javeriana, Bogotá, Colombia
Leonardo A. Quintana, Pontificia Universidad Javeriana, Bogotá, Colombia
Marianela Rojas, National University of Costa Rica, Heredia, Costa Rica
Elizabeth Clare Harris, University of Southampton, Southampton, UK
Consol Serra, Universitat Pompeu Fabra, Barcelona, Spain
Jose´ Miguel Martinez, MC Mutual, Barcelona, Spain
George Delclos, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
Fernando G. Benavides, Universitat Pompeu Fabra, Barcelona, Spain
Michele Carugno, Università degli Studi di Milano, Milan, Italy
Marco M. Ferrario, University of Insubria, Varese, Italy
Angela C. Pesatori, Università degli Studi di Milano, Milan, Italy
Leda Chatzi, University of Crete, Heraklion, Greece
Panos Bitsios, University of Auckland, Auckland, New Zealand
Manolis Kogevinas, CIBER of Epidemiology and Public Health, Barcelona, Spain
Kristel Oha, North Estonia Medical Centre, Tallinn, Estonia
Tiina Freimann, Tartu University Hospital, Tartu, Estonia
Ali Sadeghian, Klinikum Leverkusen, Leverkusen, Germany
Roshini J. Peiris-John, University of Otago, Dunedin, New Zealand
Nalini Sathiakumar, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
A. Rajitha Wickremasinghe, University of Kelaniya, Kelaniya, Sri Lanka
Noriko Yoshimura, Tartu University Hospital, Tartu, Estonia
Helen L. Kelsall, Monash University, Melbourne, Victoria, Australia
Victor C.W. Hoe, Klinikum Leverkusen, Leverkusen, Germany
Donna M. Urquhart, Monash University, Melbourne, Victoria, Australia
Sarah Derrett, University of Otago, Dunedin, New Zealand
David McBride, University of Otago, Dunedin, New Zealand
Peter Herbison, University of Otago, Dunedin, New Zealand
Andrew Gray, University of Otago, Dunedin, New Zealand
Eduardo J. Salazar Vega, Health Safety and Environment Department, AkzoNobel, Houston, TX.

Document Type

Article

Department

Community Health Sciences

Abstract

STUDY DESIGN:

A cross-sectional survey with a longitudinal follow-up.

OBJECTIVES:

The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites SUMMARY OF BACKGROUND DATA.: Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain.

METHODS:

We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries.

RESULTS:

Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group.

CONCLUSION:

Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations.

LEVEL OF EVIDENCE:

2.

Publication

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