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Prevalence of low back pain and its relation to quality of life and disability among women in rural area of Puducherry, India

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Abstract

Background: The level of quality of life (QOL) and disability among women with low back pain is an important health issue at global level. Objective: To find out the prevalence of low back pain and to assess the relationship of low back pain with disability and QOL among women. Materials and Methods: A community-based cross-sectional study was conducted among 250 women in age group of 30-65 years residing in field practice area of a Tertiary Care Medical Institution, Puducherry. Severity of the pain was assessed using Numerical Pain Scale. Modified Oswestry Low Back Pain Disability Questionnaire was used to measure the disability level and WHO-BREF scale to assess the QOL among women with low back pain. Results: Overall, the prevalence of low back pain was found to be 42%. The majority of women (60.9%) with low back pain experienced moderate disability. Almost 72% of women with low back pain perceived their QOL as good and overall mean QOL score was 88.41 (standard deviation = 12.9). The low back pain was influenced by the demographic variables that include age, marital status, illiteracy, total family income, type of delivery, number of children and household chores, menopausal status, and chronic illness ( P P Conclusions: Prevalence of low back pain among women was comparatively more than other studies in India. Although moderate disability was more among those with low back pain, overall QOL was good.
© 2016 Indian Journal of Pain | Published by Wolters Kluwer - Medknow 111
Prevalence of low back pain and its relation
to quality of life and disability among women
in rural area of Puducherry, India
Introduction
A woman is the nucleus of the family, especially in
rural India. The daily work schedule of rural women
is very arduous and demanding in nature. In addition
to household and agriculture works, the other time
spends as energy‑demanding activity for rural women
is care of livestock, which is not only strenuous, but
also repetitive and makes them overburdened as well as
leading them a continuous health risk.[1] The nonneutral
posture of the trunk frequently adopted by women is
risk for developing a low back pain.[2] Lack of facilities
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DOI:
10.4103/0970-5333.186467
ABSTRACT
Background:Thelevelofqualityoflife(QOL)anddisabilityamongwomenwithlowbackpainisanimportanthealthissueatglobal
level.Objective:TondouttheprevalenceoflowbackpainandtoassesstherelationshipoflowbackpainwithdisabilityandQOL
among women. Materials and Methods:Acommunity‑basedcross‑sectionalstudywasconductedamong250womeninagegroupof
30‑65years residingineldpracticeareaofaTertiaryCareMedical Institution,Puducherry.Severityofthepainwasassessed using
NumericalPainScale.ModiedOswestryLowBackPainDisabilityQuestionnairewasusedtomeasurethedisabilitylevelandWHO‑
BREFscaletoassesstheQOLamongwomenwithlowbackpain.Results:Overall,theprevalenceoflowbackpainwasfoundtobe
42%.Themajorityofwomen(60.9%)withlowbackpainexperiencedmoderatedisability.Almost72%ofwomenwithlowbackpain
perceivedtheirQOLasgoodandoverallmeanQOLscorewas88.41(standarddeviation=12.9).Thelowbackpainwasinuencedbythe
demographicvariablesthatincludeage,maritalstatus,illiteracy,totalfamilyincome,typeofdelivery,numberofchildrenandhousehold
chores,menopausalstatus,andchronicillness(P<0.05).Disabilitywasinuencedbyage,education,andoccupation,whereasQOL
wasinuencedbyeducationofthewomenwithlowbackpain(P<0.05).Conclusions:Prevalenceoflowbackpainamongwomenwas
comparativelymorethanotherstudiesinIndia.Althoughmoderatedisabilitywasmoreamongthosewithlowbackpain,overallQOL
was good.
Key words:Disability,lowbackpain,qualityoflife
Guna Sankar Ahdhi, Revathi Subramanian, Ganesh Kumar Saya1, Thiruvanthipuram Venkatesan Yamuna
Departments of Community Health Nursing and 1Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical
Education and Research, Puducherry, India
with their traditional techniques like, drawing water
from the wells, carrying heavy loads on their back may
lead to back pain.[3]
Original Article
Address for correspondence:
Dr. Ganesh Kumar S,
Department of Social and Preventive Medicine, Jawaharlal
Institute of Postgraduate Medical Education and Research,
Puducherry - 605 006, India.
E-mail: sssgan@yahoo.com
This is an open access article distributed under the terms of the
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License, which allows others to remix, tweak, and build upon the
work non-commercially, as long as the author is credited and the
new creations are licensed under the identical terms.
For reprints contact: reprints@medknow.com
How to cite this article: Ahdhi GS, Subramanian R, Saya GK,
Yamuna TV. Prevalence of low back pain and its relation to quality
of life and disability among women in rural area of Puducherry, India.
Indian J Pain 2016;30:111-5.
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Ahdhi, et al.: Prevalence of low back pain
112 Indian Journal of Pain | May-August 2016 | Vol 30 | Issue 2
International surveys of low back pain reported that
1‑month prevalence was 19‑43% and point prevalence
was 15‑30%. The estimated worldwide lifetime prevalence
of low back pain varies from 50% to 84%.[4] Studies
in developed countries have shown that the low back
pain point prevalence was 6.8% in North America, 13.7%
in Denmark, 12% in Sweden, 14% in the United Kingdom,
33% in Belgium, and 28.4% in Canada. Similarly, some
studies in developing countries have revealed much higher
incidence of 72.4% in Nigeria, 64% in China, and 56.2%
in Thailand.[5] The occurrence of low back pain in India is
also alarming with nearly 60% of the people in India have
suered from low back pain at some time during their
lifespan.[6]
Low back pain also restricts mobility, interferes
with normal functioning and results in lifelong pain
and permanent disability.[7] In India, most of the
low‑income group people are engaged in physically
demanding jobs which may increase the risk of low
back pain and disability.[8] Low back pain also affects
the quality of life (QOL) of not only the women
themselves, but their families as well.[9,10] In Indian,
very few studies have been done with regard to this.
With this background, the present study aimed to
assess the prevalence of low back pain, and disability
and QOL among women with low back pain in rural
Puducherry, India.
Materials and Methods
Study design and seing
A community‑based cross‑sectional study was conducted
in a field practice area of a Tertiary Care Medical
Institution during the period from July 2013 to December
2013. The target population was the women in age group
of 30‑65 years residing in Ramanathapuram Village of
Puducherry, India.
Sample size estimation and sampling technique
Among four villages present in rural eld practice area
of the Medical Institution, Ramanathapuram Village
was selected for feasibility purpose. Considering 22.5%
prevalence of low back pain,[11] 25% relative precision,
and 10% of nonresponse error, a minimum of 250 subjects
were included in this study. The total number, name, and
address of women in age group 30‑65 years were obtained
from the Rural Health Centre records. The total number of
women in the age group of 30‑65 years in Ramanathapuram
Village was 518. Out of these, 250 women were selected by
simple random technique.
Ethical issues
Institutional ethical clearance was obtained before starting
the study. Permission from concerned authorities was
sought after explaining the objectives as well as the method
of study. Informed written permission was obtained from
the study subjects.
Method of data collection
The interview was conducted by the principle investigator
in the houses of the subjects. Initially rapport was
developed with the study subjects. The written informed
consent was obtained and the purpose of an interview
was explained to each study subject. Each participant was
interviewed condentially in Tamil language.
In the rst step, sociodemographic factors were collected
and low back pain among women was assessed in the
preceding month based on Numerical Pain Scale rating
from 0 to 10. Body height and weight of each subject was
taken by standard methods. A modied Oswestry Low
Back Pain Disability Questionnaire was used to measure
the disability level and WHO‑BREF questionnaire was used
to assess the QOL among women who reported low back
pain. The interview lasted for 30‑45 min for each study
subject. Average of 6‑8 women was interviewed each day.
Statistical analysis
All the statistical analyses were done using IBM PASW
Statistics (SPSS)‑19.0 version and was carried out at 5%
level of signicance. The data on subjects’ background
variables was expressed as frequencies and percentages.
The data on the level of disability and QOL was expressed
as a percentage and mean with standard deviation (SD).
The relationship among low back pain, disability, and QOL
was analyzed using Karl Pearson’s correlation coecient.
Association between the prevalence of low back pain,
disability and QOL between the sociodemographic factors
was assessed by analysis of variance or independent t‑test.
Results
All the 250 subjects participated in the study. Out of 250
study subjects, 35.6% (n = 89) of the women were in the age
group of 30‑40 years. Regarding education, 50% (n = 125)
of participants had education up to secondary level and
19.6% (n = 49) of them were illiterate. By occupation, 56.8%
(n = 142) were housewives. With regard to menopausal
status, 64.8% of women did not attain menopause.
Regarding body mass index (BMI), 39.2% of them were
overweight. In relation to co‑morbid conditions, only 14.1%
of them were having chronic illness.
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Ahdhi, et al.: Prevalence of low back pain
Indian Journal of Pain | May-August 2016 | Vol 30 | Issue 2 113
The 1‑month period prevalence of low back pain among
women was 42% (105). Majority of women (60%, 63/105)
had moderate pain followed by severe (23.8%, 25/105) and
mild (16.2%, 17/105) pain. Subjects with low back pain
experienced moderate disability (60.1%, 64/105) followed
by severe disability (23.8%, 25/105), minimal disability
(12.4%, 13/105), and crippled (2.8%, 3/105). About 72.4%
(76/105) of women perceived their QOL as good, 21.9%
(23/105) of them were perceived as neither poor nor good
and only 5.7% (6/105) perceived as poor.
The significant associations were found between low
back pain and demographic variables such as age, lower
education, marital status, less income, delivery type, and
number of children, durations of sweeping the house,
washing clothes and washing vessels per day, menopausal
status, and co‑morbid condition [Tables 1 and 2].
Furthermore, there was a signicant dierence between
the mean score of level of disability with age, education,
and occupation of the women (P < 0.05). A signicant
dierence was also found between mean scores of QOL
and education (P < 0.05).
The overall mean score of QOL of women with low back
pain was 88.41 (SD = 12.9) and comparable across all the
four domains. The mean scores of physical domain of
QOL were higher when compared to other domains of
QOL [Table 3]. There was a signicant positive correlation
between pain and disability and a negative correlation
between pain and QOL and also there was a signicant
negative correlation between the level of disability and
QOL [Table 4].
Discussion
There is a paucity of literature on community‑based
studies regarding the assessment of the prevalence of low
back pain among women in India. This study showed that
1‑month period prevalence of low back pain among women
was 42%, which is much higher when compared to study
ndings of Badley et al.[4] This study in United States found
that low back pain point prevalence among the general
population was 15‑30%, and pain in the last 30 days was
found between 19% and 43%. Similarly, Stranjalis et al.[12]
reported that 32% of adults had suered from low back
pain for 1‑month period in Greece. Furthermore, Sadigi,
et al.[13] revealed that among the populations under study,
28.4% of them had low back pain in the last 14 days. A
study was conducted by Mathew et al.[14] to estimate the
prevalence and correlates of low back pain among adults
aged 20 years and above in Coimbatore, Tamil Nadu
revealed that 1‑year prevalence of low back pain among
women was 52.9% with highest prevalence (50%) among
age group of 41‑50 years.
The present study ndings found that the most (60.9%)
of the women with low back pain experienced moderate
disability and 12.3% of them with minimal disability and
23.8% of them experienced severe disability, only 2.8% of
them experienced crippled. These ndings are consistent
with the study conducted by Koley S and Sandhu NS
(2009).[6]
In this study, 72% of women with low back pain had
perceived the QOL as good and 21% of them perceived
as neither poor nor good. 5.7% of them perceived the
QOL as very good and none of them perceived as poor
or very poor. A study conducted by Sultana (2012)[15] in
Bangladesh to explore the QOL among 70 low back pain
patients aged 18‑70 years reported that, 17.6% participants
had no problem in their QOL and 82.4% participants had
a problem in their QOL.
Table 1: Association of low back pain with sociodemographic
factors among women (
n
= 250)
Background variables
n
Low back pain
t
or
F P
Mean SD
Age (in years)
30‑40 89 1.55 2.624 7.451 0.001***
40‑50 84 1.98 2.527
50‑65 77 3.14 3.012
Marital status
Unmarried 0 0.0 0.0 −2.646 0.009***
Married 211 1.99 2.670
Others (widow,
separated)
39 3.26 3.185
Education
Illiterate 49 3.41 2.986 7.047 0.001***
Primary/secondary 178 1.98 2.708
Higher secondary/
college
23 1.17 2.188
Religion
Hindu 241 2.17 2.802 −0.407 0.685
Christian 9 2.56 2.506
Income (Rs./month)
5156 and above 13 2.23 3.032 5.931 0.001***
2578‑5155 151 1.62 2.503
1547‑2577 61 3.21 2.916
773‑1546 25 3.04 3.195
Occupation
Housewives 142 2.00 2.788 0.727 0.484
Coolie 66 2.47 2.673
Others 42 2.35 2.975
Family type
Nuclear 191 2.02 2.752 −1.724 0.086
Joint 59 2.73 2.858
SD: Standard deviation, ***Pvalue<0.05isconsideredassignicant
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Ahdhi, et al.: Prevalence of low back pain
114 Indian Journal of Pain | May-August 2016 | Vol 30 | Issue 2
The present study revealed that signicant correlations
were found among the low back pain, QOL, and disability.
These ndings were supported by a study conducted by
Darzinaghibi, et al., (2012)[16] which demonstrated that
there was a signicant correlation between all aspects
of QOL and functional disability except environment
health. Correlation between functional disability and
all aspects of QOL was negative. The study concluded
that higher functional disability can lead to lower QOL
and vice versa.
The study showed that there was a signicant association
between the mean score of low back pain and age, marital
status, education, total family income, type of delivery,
number of children, hours of sweeping house, washing
clothes and washing vessels per day, menopause status, and
chronic illness (P < 0.001). These ndings were consistent
with the study conducted by Gourmelen, et al. (2007),[17]
Liu, et al., (2012)[18] and Cho et al., (2012)[19] in France, China,
and Korea, respectively, which reported that advanced
age and females sex were associated with low back pain.
Similarly, a study conducted by Sadigi, et al.,[13] in Tabriz
found that there was a signicant association between
marital status, housewives, number of pregnancy and
delivery type, and low back pain. Furthermore, these
ndings were corroborated with the study carried out by
Biglarian, et al. (2012)[20] in Iran and it was reported that
as factors such as age, females, marital status, obesity,
low family income, smoking, and lower education were
associated to low back pain.
This study showed that there was no association between
BMI and low back pain. This nding was consistent with
the study carried out by Birabi, et al. (2012)[21] in Nigeria
and Mathew, et al.[14] in India.
Limitations and Conclusions
The intensity of the low back pain might have inuenced
by the recall bias of women. Similarly, there may be
subjective bias while assessing the disability and QOL. It
was concluded that prevalence was comparatively more
than other studies in India. Although moderate disability
was more among those with low back pain, overall QOL
was good. Disability intervention measures may help in
reducing the impact of low back pain and improving the
QOL among women with low back pain.
Acknowledgments
We sincerely acknowledge the support provided by the stas at
Rural Health Centre and also all women for their participation
in this study.
Table 2: Prevalence of low back pain with associated factors
among women
Background variables
n
Low back pain
t
or
F P
Mean SD
Type of delivery
Normal 232 2.01 2.765 −3.658 0.000***
LSCS 18 4.44 2.036
Number of children
No children 0 0 0 −4.650 0.000***
2 children 195 1.77 2.657
>2 children 55 3.69 2.760
Duration of sweeping house (min/day)
Nil 3 1.06 1.732 5.759 0.004**
10 185 1.86 2.664
>10 62 3.19 2.969
Duration of washing
clothes (min/day)
Nil 3 2.33 4.041 5.818 0.001***
<15 15 1.80 2.783
15‑30 118 1.48 2.538
>30 114 2.96 2.842
Duration of washing vessels (min/day)
Nil 3 4.00 3.606 2.718 0.045*
<10 105 1.68 2.574
10‑15 50 2.18 2.960
>15 92 2.71 2.831
Menopause
Yes 88 3.06 2.969 3.742 0.000***
No 162 1.71 2.572
BMI
<18.5 8 0.75 2.121 1.135 0.336
18.6‑24.9 127 2.08 2.727
25‑29.9 98 2.47 2.912
>30 17 2.00 2.716
Chronic illness
No 214 1.88 2.691 4.303 0.000***
Yes (DM, HTN, asthma) 36 3.97 2.720
*P < 0.05, **P < 0.01, ***P < 0.001. BMI: Body mass index, LSCS: Lower
segment caesarean section, DM: Diabetes mellitus, HTN: Hypertension
Table 3: Mean scores of domains of QOL of women among low
back pain subjects (
n
= 105)
Domains Mean (SD) Possible
range
Minimum-
maximum
Overall QOL 88.41 (12.90) 1‑130 54‑109
Physical domain 61.88 (7.77) 0‑100 38‑81
Psychological domain 61.19 (13.55) 0‑100 31‑100
Social domain 61.33 (15.99) 0‑100 25‑94
Environmental domain 57.16 (13.39) 0‑100 19‑81
SD: Standard deviation, QOL: Quality of life
Table4:Thecorrelationcoefcientbetweenlowbackpain,
disability, and QOL of women with low back pain (
n
= 105)
Variables Low back pain Disability QOL
Low back pain 0.78** −0.59**
Disability 0.78** −0.77**
QOL −0.59** −0.77**
**P < 0.01 level. QOL: Quality of life
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Ahdhi, et al.: Prevalence of low back pain
Indian Journal of Pain | May-August 2016 | Vol 30 | Issue 2 115
Financial support and sponsorship
Nil.
Conicts of interest
There are no conicts of interest.
References
1. BhopeRR,PalkIA.“Socio‑Economic Dimensions of Farm
WomenLabour.”RuralIndia,September‑October,1998;p.192‑6.
2. SutharN,Kaushik V.Theimpact ofphysicalworkexposure
onmusculoskeletalproblemsamongtribalwomenofUdaipur
District.IntNGOJ2011;6:43‑7.
3. AnjanaS.BackProblemsMoreAmongRuralWomen;2012.
Availablefrom:http://www.boldsky.com/health/wellness/2012/
back‑problem‑pain‑causes‑280212.html[Lastaccessed2014
March10].
4. BadleyEM,RasoolyI, WebsterGK. Relative importance of
musculoskeletaldisordersasacauseofchronichealthproblems,
disability,andhealthcareutilization:Findingsfromthe1990
OntarioHealthSurvey.JRheumatol2010;2:505‑14.
5. LoneyPL, StratfordPW.Theprevalenceoflowbackpainin
adults:A methodological reviewoftheliterature.PhysTher
1999;79:384‑96.
6. KoleyS,SandhuNS. An associationofbodycomposition
componentswiththe menopausal statusofpatientswith low
backpaininTaran,Punjab,India.JLifeSci2009;1:129‑32.
7. KoleyS,KaurJ,SandhuJS.Biologicalriskindicatorsfornon‑
speciclowbackpaininyoungadultsofAmritsar,Punjab,India.
JLifeSci2010;2:43‑8.
8. SharmaSC,SinghR,SharmaAK,MittalR.Incidenceoflow
backpaininworkagewomeninruralNorthIndia.IndianJMed
Sci2003;57:145‑7.
9. Nidhi S, Vandana K. Musculoskeletal Problems among
AgriculturalFemaleWorkers in Rajastan, India.StudHome
CommunitySci2013;7:145‑9.
10. CosteJ,DelecoeuillerieG, Cohen de LaraA,LeParcJM,
PaolaggiJB.Clinicalcourseandprognosticfactorsinacutelow
backpain:Aninceptioncohortstudyinprimarycarepractice.
BMJ1994;308:577‑80.
11. UrquhartDM,BellR,CicuttiniFM,CuiJ,ForbesA,DavisSR.
Lowbackpainanddisabilityin community‑based women:
Arevalenceandassociatedfactors.Menopause2009;16:24‑9.
12. StranjalisG,TsamandourakiK,SakasDE,AlamanosY.Lowback
paininarepresentativesampleofGreekpopulation:Analysis
accordingtopersonalandsocioeconomiccharacteristics.Spine
(PhilaPa1976)2004;29:1355‑60.
13. SadigiA, Moradi A,OstadRahimiAR, Zargami, Lotnia I.
Prevalenceoflowbackpainamongwomenoffertilityagein
tabrizandtherelatedriskfactors.MedJTabrizUnivMedSci
2008;30:17‑20.
14. MathewAC,SafarRS,AnithadeviTS,BanuMS,ShankarSL,
RaiBD,ChackoTV.Theprevalenceandcorrelatesoflowback
paininadults:AcrosssectionalstudyfromSouthernIndia.Int
JMedPublicHealth2013;3:342‑6.
15. Sultana M. Quality of Life amongtheLowerBackPain
PatientAttended at CRP (CentreforRehabilitationforthe
Paralyzed),BangladeshHealthProfessionsInstitute (BHPI).
DepartmentofPhysiotherapy;2012Savar,Dhaka.Bangladesh.
Availablefrom: http://library.crp‑bangladesh.org:8080/
bitstream/handle/123456789/24/609%20Mohosina%20Sultana.
pdf?sequence=1[Lastaccessedon2014March12].
16. DarzinaghibiMT,SamanehP,SomayehH,MahmoudH.
Correlationbetweenfunctionaldisabilityandquality of life
innon‑specic lowbackpainpatients.JPhysiother2012;27:
238‑44.
17. GourmelenJ, ChastangJF,OzgulerA,Lanoë JL,Ravaud JF,
LeclercA.Frequencyoflowbackpainamongmenandwomen
aged30to64yearsinFrance.Resultsoftwonationalsurveys.
AnnReadaptMedPhys2007;50:640‑4,633‑9.
18. LiuX,WangL,StallonesL,WheelerKK,ZhaoW,SmithGA,
et al.Backpain among farmersinanorthern area ofChina.
Spine(PhilaPa1976)2012;37:508‑14.
19. Cho NH, JungYO,LimSH, Chung CK, Kim HA. The
prevalenceandriskfactorsoflowbackpain in rural
communityresidentsofKorea.Spine(PhilaPa1976)2012;37:
2001‑10.
20. BiglarianA,SeiB,BakhshiE,MohammadK,RahgozarM,
KarimlouM, et al.Lowbackpainprevalenceandassociated
factorsinIranianpopulation:Findingsfromthenationalhealth
survey.PainResTreat2012;2012:653060.
21. BirabiBN,DienyePO,NdukwuGU.Prevalenceoflowback
painamongpeasantfarmersinaruralcommunityinSouthSouth
Nigeria.RuralRemoteHealth2012;12:1920.
[Downloaded free from http://www.indianjpain.org on Tuesday, January 24, 2017, IP: 156.222.147.45]
... Others reported a devastating impact of rheumatoid arthritis on a patient's physical ability and their QoL (CDC 2000;Scott and Garrood 2000;Umay et al. 2015). Other conditions and chronic diseases have been reported to impact QoL scores, including bronchial asthma (Doz et al. 2013) and obesity (Pimenta et al. 2015;Ahdhi et al. 2016). ...
... Similarly, Baykara et al. (2013) reported that the association of rheumatic pain with low back pain leads to a significant decrease in the functional capacity and QoL, as well as an increase in depression risk. However, it was observed that QoL was good in patients with low back pain regardless of their moderate disability (Ahdhi et al. 2016). ...
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Objectives This study aimed to assess the health-related quality of life (QoL) among Jordanian adults with chronic disorders. Methods and sampling A cross-sectional design using the convenience sampling technique was implemented and face-to-face interviews were carried out with 915 Jordanians who attended several shopping centers in Northern Jordan. The QoL was assessed using the Short Form 36 (SF-36) Health Survey. Results Data were obtained from 915 Jordanian adults from the general public with a mean age of 33.8 years (standard deviation, SD ± 28.2). Obesity was prevalent in 23.0% of the participants and approximately 35% suffered from musculoskeletal pain. The total SF-36 score for the whole population was 71.2. Physical health was dramatically affected by having different health problems, including rheumatoid arthritis, obesity, and back pain; (p < 0.05). Conclusion Musculoskeletal pain, obesity, and asthma are considered to be major factors associated with decreased perception of general health and impairment in both the physical and mental domains of health-related QoL in Northern Jordan.
... The use of centrally acting skeletal muscle relaxants, though efficacious, is associated with frequent development of dose-related adverse drug reactions like sedation, impairment of voluntary motor functions, and ataxia. Hence, there is a need for newer better drugs for the treatment of conditions associated with muscle spasm [1,2]. ...
... The estimated worldwide lifetime prevalence of low back pain varies from 50% to 84%. The occurrence of low back pain in India is also alarming with nearly 60% of the people in India have suffered from low back pain at some time during their lifespan [2][3][4]. ...
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OBJECTIVES: The objectives of this study were to compare the efficacy and safety of Tolperisone tablets 50 mg three times daily versus Tizanidine 2 mg tablets thrice daily for the treatment of acute low back pain with muscle spasm. METHODS: The comparative study was carried out in 50 patients from orthopedics Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada. Only those patients fulfilling the inclusion/exclusion criteria were enrolled into the study. Participants suffering from acute low back pain with muscle spasm were divided into two groups. The participants were followed up on Day-14 as final analysis. RESULTS: Subjects receiving Tolperisone showed a mean value of 16.43±1.16 in the Roland Morris low back pain and disability questionnaire both groups on day 1 and was reduced to 7.82±1.15 (51.94%) on day 7 and 2.56±1.53 (84.46%) on day 14. Similarly, the patients in the tizanidine group had mean value of 15.93±1.61 on day 1, which was reduced to 6.77±1.68 (57.64%) on day 7, and 2.88±1.92 (81.95%) on day 14, as comparable to the Tolperisone group. There was no statistically significant difference between the two groups, (p>0.05) for pain at rest, pain at night, restrictions of movement, changes in stiffness, changes in numbness, and changes in tenderness. There was a statistically significant difference between the two groups, (p<0.05) for pain on movement and kinesalgia. CONCLUSIONS: Tolperisone was found comparable in efficacy to Tizanidine in improving the clinical symptoms of changes in pain Self-assessment by the patient on different applied parameters.
... 7 In India, most of the low-income group people are engaged in jobs with strenuous physical activity, which may increase the risk of low back pain and disability. 8 www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i5.233 ...
... 1 However, in a study conducted in Puducherry in 2013 has shown overall prevalence of low back pain amongst women is 42%, which is somewhat similar to the present study. 8 In this study, the highest prevalence is seen in 61-70 years age group both in cases of recent and yearly episodes. The prevalence of restricted activities of daily living is highest (61.78%) in this age group. ...
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Low back pain (LBP) is the one of the most frequent work related musculoskeletal problem and is one of the leading causes of health related problems. It affects a large number of people each year and is the cause of great discomfort and economic loss. The study aims to determine the prevalence of low back pain among non-working adult women in rural community and to find out the extent of disability due to low back pain. The association of BMI and low back pain in this community is also determined. This study was a descriptive-observational study with cross-sectional in design. The study period was January 2015 to April 2015 and carried out in Bhatar Community Development Block of Purba Barddhaman District of West Bengal. Descriptive analysis of the responses revealed that the prevalence of recent (in last 7 days) and yearly episodes of low back pain in women of Bhatar is 31% and 40% respectively. Prevalence of both the recent episode and yearly episodes of low back pain is highest in 61 to 70 years age group. High BMI is significantly associated with low back pain. Health education measures about correct posture, daily activity and seeking medical care in times of need could help rural housewives to prevent disability due to low back pain.
... The prevalence of LBP in India is reported to be between 6.2 and 92%; the huge variation is attributed to the heterogeneity of the conducted studies [7]. In a study conducted among rural women in Puducherry, India, the prevalence was reported as 42% [8]. Indian youth are at higher risk of development of LBP similar to their western counterparts [9]. ...
Article
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Background Low back pain (LBP) is a prominent public health problem which causes disability around the globe. The prevalence of LBP is on the rise in lower to middle-income countries. India has a varied prevalence of LBP among the rural as well as urban population ranging from 6.2 to 92%. There has been a marked increase in young adults getting LBP with a proportion converting to chronic LBP later in life. Beliefs associated with any disorder affect the course, management, and need for imaging studies. Negative beliefs about LBP in any population may lead to unnecessary psychologic distress and an increase in disease burden. Focusing these negative beliefs on the younger population can help curb the chronicity and lessen the disability caused by it. This cross-sectional study explored the presence of myths in 516 college-going Indian young adults from Lovely Professional University. Results A total of 516 individuals participated in the study. The mean (SD) age of the participants was 22.69 years (2.417). Among them, 47.5% (245) were females and 52.5% (271) were males. The findings show that a high percentage of college-going young adults have false beliefs in most of the ten domains (myths) explored. The most prevalent myths were “LBP is caused by weak ‘core’ muscles and having a strong core protects against future LBP” (81.2%) and “LBP is caused by poor posture when sitting, standing, and lifting” with 80.6% agreeing to it. Conclusion Our study demonstrated that the myths of low back pain are widespread among the studied population. The findings suggest that community education programs must be developed to address these myths, hence reducing the disease burden associated with back pain.
... Similar association were reported by Ahlawat et al. [21] and Wang et al. [22]. The current study showed that low backache in menopausal transition group was associated with higher parity and in post-menopausal group was associated with low education and history of smoking, which was similar to the observations of Ahdhi et al. [23]. The present study showed that hypertension was more common in those who were better educated, probably due to less physical activity among them. ...
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Objectives: The quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women. Methods: This community-based cross-sectional study included menopausal women aged 45-55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews. Results: A total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase. Conclusions: This study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage. Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.
... Backache is a common problem that affects daily activity and decreases performance due to disability. In the current study, the disability was worse in women than men and this agree with Biglarian et al. [15], Shiri et al. [16], Ahdhi et al. [17], and Koley and Sandhu [18] studies. This gender difference could be related to gonadal steroid hormones such as estradiol and testosterone which modulate sensitivity to pain and analgesia [19]. ...
Article
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Objectives: Disability related to chronic low back pain (LBP) is a complex and multidimensional phenomenon all over the world. The prevalence of backache in middle age and elderly is up to 84%. This study aims to evaluate the associations of X-ray features of lumbar disk degeneration with severity of disability among patients with mechanical LBP. Patients and Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical LBP. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0–10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar X-rays. Results: The mean age of our sample was 52.45±7.87 and 71.7% of involved patients were women. Most patients were recorded as overweight or obese. The findings of disk space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two-third of cases were focused on minimal disability, followed by moderate, severe, and crippled as (26%), (6%), and (2%), respectively. There was highly significant association between women and pain radiation to legs (p=0.004). Obesity and overweight had meaningless effects on all markers. Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disk space narrowing on X-ray, and disk degenerative disease score on X-ray, while age, presence of osteophytes and spondylolisthesis, body mass index, and pain duration were not associated with severity of disability.
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Aim of the study was to validate Hindi version of WHOQOL-BREF in chronic low back pain patients (CLBP). In this cross-sectional study, 111 patients with CLBP were recruited. In addition to demographic information, two questionnaires Hi WHOQOL-BREF and SF-36 (Reference scale) were administered at day 0 and day 3. NRS was used for pain evaluation. Cronbach’s alpha coefficient was used for scale reliability. Construct validity was analysed using Pearson correlation coefficient. Confirmatory factor analysis was performed to determine the relationships between the eight domains of SF-36 and four domains of the WHOQOL-BREF. Cronbach’s alpha coefficients were acceptable for all domains of both Hi WHOQOL-BREF (0.869 - 0.938) and SF-36 (0.752 - 0.943) questionnaires. Pearson correlation coefficients of both instruments were partly to strongly correlate with most domains (r ≥0.40). Correlations for domains with similar constructs were stronger than those measuring varied constructs. Confirmatory factor analysis recommended approximately good relationships among the SF-36 and WHOQOL-BREF domains. Our study suggests that WHOQOL-BREF Hindi version is a reliable and valid tool for clinical and research use in CLBP.
Article
Aim: Isometric and Core strengthening exercises for lower back pain provides relief to patients, whereas combing it with analgesics also provides relief of pain, thereby in this study the efficacy of isometric and core strengthening exercises alone is evaluated. Method: A cross-sectional study involving 200 subjects was conducted in the OPD of department of Orthopaedics, Saveetha Medical college and hospital. Assessment of lower back pain was done using ODI (Oswestry Disability Index) among patients receiving Isometric and Core strengthening exercises with and without analgesics for a period of 3 months. Results: There is no significance difference in the reduction of pain among group A who received analgesics along with isometric and core strengthening exercises and group B who received only isometric and core strengthening exercises. Conclusion: Isometric and core strengthening exercises alone is as effective as its combination with analgesics.
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Low back pain is a major public health problem all over the world. It is generally assumed that overweight, height and low back pain are related. However, the scientific evidence to support this relationship is not fully conclusive. The aim of this study is to estimate the prevalence of low back pain and its association with height, fat distribution, reproductive history and socioeconomic influence. A representative sample of 401 men and 403 women aged 20 years and above were selected and studied. It is found that 28.4% and 52.9% respectively were having low back pain. Height and fat distribution were found to have no association with low back pain. Both men and women, whose household were in the lower socio economic status reported more back pain (Adjusted odds ratio (AOR) for men 1.61, 95% confidence interval (CI): 1.02, 2.55 and AOR for women 1.57, 95% CI: 1.02, 2.34). Men with lower educational qualification reported more back pain (AOR 1.89, 95% CI: 1.08, 3.31). In women, those who have undergone caesarean section (AOR 1.661, 95% CI: 1.02, 2.72) and sterilization (AOR 1.63, 95% CI: 1.09, 2.44) were found to be a positively associated with low back pain. The only socioeconomic link with back pain among women seemed to be manual occupation (AOR 3.33, 95% CI: 1.49, 7.4). The finding confirms the higher burden of back pain on the socially disadvantaged, but cannot yet be explained by known risk factors.
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Background. There are very few studies that had a sample size sufficient to explore the association between factors related to low back pain in a representative sample of the Iranian population. Objective. To examine the relationship between sociodemographic factors, smoking, obesity, and low back pain in Iranian people. Methods. We used Iranian adults respondents (n = 25307) from the National Health Survey. Adjusted odds ratios and 95% confidence intervals were estimated by using logistic regression. Results. The prevalence of low back pain was found in 29.3% of the studied sample. High age, female sex, being married, obesity, low-economic index, being smoker, in a rural residence, and low educational attainment, all increased the odds of low back pain. Conclusions. Our findings add to the evidence on the importance of obesity in relation to low back pain. These results can be used as a basis to reinforce health programs to prevent obesity.
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This study was undertaken to assess the prevalence and predominant causes of low back pain (LBP) among peasant farmers in Ebubu community in South-south Nigeria. This was a community based cross-sectional study of 310 consenting, adult, full-time farmers, recruited using a two-stage cluster sampling scheme developed by WHO. Specially trained community health extension workers interviewed participants using a pre-tested questionnaire designed by the authors to solicit information on defined LBP. Socio-demographic characteristics were also obtained. A clinical history was recorded, including: duration of LBP and mode of onset, pain severity, knowledge of LBP causes and care-seeking practices. Participants' BMI were calculated. Data were entered into Microsoft Excel and analyzed using the Statistical Package for Social Sciences v15 (www.spss.com). Of the 310 apparently healthy farmers (age range 18-58 years [mean 36.71±8.98]; 132 males) sampled, 208 had LBP (67.10%). Low back pain was more prevalent in the 31-40 years age group (49.04%), females (50.96%), those who were non-obese (68.95%) or tall (73.2%) and those who had practiced farming for a long duration. Severe LBP was significantly (p<0.05) linked to aging (51-60 years group), low BMI and those above average height (1.60 m). This study indicates that LBP is a prevalent health problem among rural peasant farmers. It was more prevalent in the middle-aged groups, and among females, the non-obese and tall individuals, and those who had been farming for a long duration. Severe LBP was linked to aging, high BMI and those above average height.
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Work related musculoskeletal disorders are group of painful disorders of muscles, tendons and nerves. Work activities, which are frequent and repetitive or activities with awkward postures cause these disorders, which may be painful during work or at rest. In the home and farm where women performs tasks while sitting, standing, bending, twisting, awkward posture, duration of work and inadequate rest pause are associated with the occurrence of serious musculoskeletal problems and musculoskeletal disorders. In the current study, a sample of 30 tribal women was selected to draw the results of the study. Incidence of musculoskeletal symptoms, information on causes of pain, work load and severity of pain were assessed by self structured questionnaire and body map technique. Results indicated that work related musculoskeletal problems and disorders affect all the parts of body viz. hands, wrists, elbow, neck, shoulder and back in upper body region, hips, knees and calf muscles in lower body region.
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The purpose of the present study was to evaluate and correlate the various biological risk indicators of non-specific low back pain (NSLBP) in young adults. The study was based on a total of 100 purposively selected young adults (50 males and 50 females) aged 18 – 25 years with non-specific low back pain and 100 matched controls (50 males and 50 females) asymptomatic with no history of low back pain taken from Amritsar, Punjab, India. To solve the purpose, some anthropometric measurements, viz. height, weight, BMI, four skinfold measurements, (i.e. biceps, triceps, subscapular and suprailiac), back strength, flexibility measure and abdominal muscle endurance were taken on each subject. Results indicated statistically significant differences (p<0.05) in abdominal muscle endurance (t= 2.58) between NSLBP boys and controls and in weight (t=3.22), biceps skinfold (t=3.04), height (t=2.67), triceps skinfold (t=2.83), subscapular skinfold (t=2.32) and in percent lean body mass (t= 2.80) between NSLBP girls and controls. Both in boys and girls with non-specific low back pain, back strength has positively significant correlations (p<0.05) with height (r=0.487 and 0.360 respectively), weight (r=0.495 and 0.213 respectively), BMI (r=0.299 and 0.461 respectively) and flexibility measure (r=0.386 and 0.388 respectively) and negatively significant correlation (r=-0.417 only in NSLBP girls) with percent body fat.
Article
A scrutiny of occupational profile of population in India where maximum population depends for their livelihood on agriculture only points out that women make up 46 percent of total agriculture work force and there is hardly any activity in agriculture except ploughing and household chores in which women are not actively involved. At the same time this sector is considered as the most hazardous occupation and reason of various health problems like MSPs and MSDs in women workers. Thus a study was conducted on sixty farm women to identify the extent of musculoskeletal problems in them. Incidence of musculoskeletal symptoms, information on causes of pain, work load and severity of pain were assessed by self structured questionnaire and body map technique. The findings of the study indicated that farm women remain fully occupied and over-burdened with three-fold responsibility of farm, home and livestock management before they attain the age sixteen. Awareness about musculoskeletal problems was found to be very low among female workers albeit these women workers they were suffering from discomforts/pain in various parts of the body. Education on health and awareness about developed women friendly technologies for farm, home and livestock would help in minimizing the extent of musculoskeletal problems among agricultural female workers.
Article
The present study deals with the association of menopausal status of 146 patients (74 pre- and 72 postmenopausal women) with low back pain aged 35-55 years residing in and around Tarn Taran, Punjab, India, and their body composition components, viz. percent body fat and percent lean body mass. The results indicate strong association of percent body fat with all the ten pain measuring variables, viz. pain intensity (r=0.668), personal care (r=0.519), lifting (r=0.620), walking (r=0.648), sitting (r= 0.515), standing (r=0.471), sleeping (r= 0.533), sex life (r= 0.255), social life (r=0.664) and travelling (0.583) in post-menopausal patients with low back pain.
Article
ABSTRACT A scrutiny of occupational profile of population in India where maximum population depends for their livelihood on agriculture only points out that women make up 46 percent of total agriculture work force and there is hardly any activity in agriculture except ploughing and household chores in which women are not actively involved. At the same time this sector is considered as the most hazardous occupation and reason of various health problems like MSPs and MSDs in women workers. Thus a study was conducted on sixty farm women to identify the extent of musculoskeletal problems in them. Incidence of musculoskeletal symptoms, information on causes of pain, work load and severity of pain were assessed by self structured questionnaire and body map technique. The findings of the study indicated that farm women remain fully occupied and over-burdened with three- fold responsibility of farm, home and livestock management before they attain the age sixteen. Awareness about musculoskeletal problems was found to be very low among female workers albeit these women workers they were suffering from discomforts/pain in various parts of the body. Education on health and awareness about developed women friendly technologies for farm, home and livestock would help in minimizing the extent of musculoskeletal problems among agricultural female workers.
Article
Study design: A community-based, cross-sectional study that is part of the prospective Korean Health and Genome Study. Objective: To determine the prevalence of low back pain (LBP) among middle-aged and elderly rural community residents in Korea and to examine the relevant risk factors, including activities reflecting the Asian lifestyle, and the relationship between radiographical features of degenerative changes in the lumbar spine and LBP. Summary of background data: The prevalence and implication of LBP among the elderly, particularly Asians, are under-represented in previous reports. Methods: Data for LBP were collected for 4181 subjects from a rural farming community. The point and cumulative lifetime prevalences of LBP were obtained in addition to measurement of the severity of LBP. Lateral lumbar spine radiographs were obtained according to a standard protocol. Results: The mean age of the study subjects was 56 years and 55% were women. The lifetime prevalence of LBP was 61.3%, with women having a higher prevalence. The point and 6-month prevalences were also higher among women. The lifetime, point, and 6-month prevalences increased with age in both sexes, except for lifetime prevalence in men. The prevalence of LBP of grade 3 or more was significantly higher in women and increased significantly with age, particularly in women. Both lifetime and point of prevalence of LBP were significantly associated with age, female sex, and time spent squatting. After adjusting for age and sex, the presence of disc space narrowing, osteophytes, and advanced Kellgren-Lawrence grade in lumbar radiograph was associated with LBP. Conclusion: The prevalence of LBP is comparable between these Korean community residents and other population groups. Risk factors associated with LBP included advanced age, female sex, squatting, the presence of osteophytes, joint space narrowing, and advanced Kellgren-Lawrence grading on lumbar radiograph.
Article
This was a population-based survey conducted in 2008 in a northern area of China. To investigate back pain prevalence and to examine the associations between potential risk factors and back pain among Chinese farmers. Few studies have investigated back pain and its associated risk factors among farmers in low-income and developing nations. Farmers ages 15 years and older were chosen from 800 families in Heilongjiang province of the People's Republic of China using cluster sampling methods. Complete survey data were obtained from 2045 farmers. The prevalence of self-reported back pain during the previous 3 months was reported. Associations between back pain and potential risk factors, which included age, gender, education levels, perceived stress, main farm activities, smoking, and drinking status, were examined in logistic regression models. A total of 786 (38.4%) farmers reported back pain. Two-thirds of those with back pain (66.0%) reported that back pain affected work quantity and quality. The adjusted odds ratios of reporting back pain increased with advancing age. Females and farmers who experienced stress regularly were also more likely to report back pain. Back pain is a common problem among Chinese farmers and is reported more frequently by females. Significant positive associations of gender, age, and perceived stress with back pain warrant additional study.