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Risk Factor Analysis in Sedentary Office Workers with Low Back Pain

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ABSTRACT Background and Objectives: Low back pain is one of the common musculoskeletal disorders in the office workers and it is the leading cause for long term sick leave. The life time prevalence of low back pain is estimated 60—85% and is the most common cause for work related disability in people under age of 45 years. Various studies have found that office workers are more prone to have low back pain symptoms. There was no study focus on the risk factor evaluation on the low back pain. The objectives of the study were to determine the prevalence and risk factors of low back pain among sedentary office workers. Materials and Methods: A cross-sectional study was designed with 120 Participants. Study was conducted on various locales like Schools, colleges, bank and office where the working was in an office environment, people included were working for more than 6 hours in a day or 30 hours in a week. A self-developed structured questionnaire was given to all participants with low back pain. Risk factors including personal factors, working factors, job stress, healthy behavior, and work environment were analyzed using descriptive analysis.Results: Results finds that 62% of man and 80% of women complains of low back pain, where as 47% of male are obese and 43% of female are overweight. Conclusion: Study concludes that back pain is strongly associated with various risk factors like obesity, poor posture and other factors.
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Journal of Chalmeda Anand Rao Institute of Medical Sciences Vol 13 Issue 1 January - June 2017 ISSN (Print) : 2278-5310 15
INTRODUCTION
The world wide impact of musculoskeletal injuries is
about 4th in global health population. 75%-85% of the
global population experience low back pain at some point
during their lifetime. Approximately 50% of people have
recurrence of the symptoms.[1]
Low back pain is one of the commonest musculoskeletal
injuries in the sedentary individuals, usually associated
with high medical cost.[2] Chronic back pain result in
severe disability, this makes the individuals to find
difficult even a minimal task.[3]
Low back pain is the most common reason for sickness
absenteeism and it is one of the important causes for
disability in industrialized countries.[4]
Office workers are the professionals who sit in front of
the computer for longer working hours. Individuals who
occupy the static positioning for the longer duration will
end up with several musculoskeletal injuries. Obtaining
static posture like sitting, standing, bending and awkward
lifting causes strain to the muscles and other structures.
The injuries relate to the occupation occur because of
various reasons like static postures, awkward posture,
repetition of activity, monotonous job tasks, extended
work durations and job stress. Lengthened sitting or poor
sitting produce imbalance between the muscle strength
Risk Factor Analysis in Sedentary
Office Workers with Low Back Pain
Subramanian S1, Arun B2
1 Lecturer
MAHSA University
Kuala Lumpur
Malaysia
2 Professor
K.G. College of Physiotherapy
Coimbatore
Tamilnadu, India.
CORRESPONDENCE:
1 S.Subramanian, MPT
Lecturer
MAHSA University
Kuala Lumpur
Malaysia.
E-mail: kavisubbu06@gmail.com
Original Article
ABSTRACT
Background and Objectives: Low back pain is one of the common musculoskeletal
disorders in the office workers and it is the leading cause for long term sick leave. The life
time prevalence of low back pain is estimated 60—85% and is the most common cause for
work related disability in people under age of 45 years. Various studies have found that
office workers are more prone to have low back pain symptoms. There was no study focus
on the risk factor evaluation on the low back pain. The objectives of the study were to
determine the prevalence and risk factors of low back pain among sedentary office workers.
Materials and Methods: A cross-sectional study was designed with 120 participants.
Study was conducted on various locales like Schools, colleges, bank and office where the
working was in an office environment, people included were working for more than 6
hours in a day or 30 hours in a week. A self-developed structured questionnaire was given
to all participants with low back pain. Risk factors including personal factors, working
factors, job stress, healthy behavior, and work environment were analyzed using descriptive
analysis.
Results: Results finds that 62% of man and 80% of women complains of low back pain,
where as 47% of male are obese and 43% of female are overweight.
Conclusion: Study concludes that back pain is strongly associated with various risk
factors like obesity, poor posture and other factors.
Keywords: Low back pain, sedentary workers, obesity, BMI, risk factors
Subramanian S et. al
Journal of Chalmeda Anand Rao Institute of Medical Sciences Vol 13 Issue 1 January - June 2017 16
and flexibility will eventually lead to low back pain with
no movement loss or abnormal signs.[5] Various studies
focuses on prolong sitting and confirmed that it could be
one of the risk factor for low back pain.[6, 7]
Risk factors are many in the magnitude of low back pain.
Many epidemiological studies have identified several risk
factors for the prevalence of low back pain in various
occupational pursuits.[8] Literatures find common risk
factors and these were analyzed quantitatively and
qualitatively, like gender, age and BMI.[9,10] Few literatures
also suggest that individuals with high body mass index
have strongly associated with poor health and poor
musculoskeletal function.
Researches also added that obese people are more
frequent in seeking medical care for the joint pain and
muscle complains.[11] Evidences show that there is strong
relation between the overweight and low back pain12.
Body fat distribution also showed associations with low
back pain.[13,14]
There are lack of evidences for the prevalence and risk
factors of low back pain in sedentary individuals, as well
as in office workers. This study is designed to find out
the list of risk factors for the low back pain in sedentary
office workers especially working in computers.
MATERIALS AND METHODS
A Cross sectional study was conducted over a period of
12 months. Samples were selected from various
occupational perspectives based on convenient sampling
method. No single occupation was selected in this study.
Study was conducted on various locales like Schools,
colleges, bank and office where the working was in an
office environment.
A total of 120 samples were selected and self-developed
structured questionnaire on back pain was given to all
participants.
The selection criteria includes office workers working at
least 6 hours in a day or 30 hours in a week, office workers
working in computers, participants with no active
exercises, subjects who excluded from the study are the
individuals with pre existing arthritis or any other
physiological problems like diabetes or hypertension, any
history of trauma, history of cancer, and patients who
use corticosteroids for longer period for other
physiological problems.
Interview was conducted with self administered
questionnaire along with it weight and height was
measured. The interviewer explained about the study
clearly, and the consent form was filled by all the
participants.
The questionnaire consists of two parts, the first part
includes demographic data and the second part includes
the low back pain questionnaire. The components
includedwerefood habits, Duration of work, years of
experience, stress, Body mass index, personal habits and
foot wear types.
Data were analyzed using the SPSS. Difference in
categorical variables was examined using descriptive
analysis. The desired precision of confidence interval was
set as 95% which was statistically significant.
RESULTS AND DISCUSSION
The data were analyzed using the descriptive statistics,
the analysis was done using SPSS. 19.1. Various risk
factors analysis was done based on Gender, Age, Year of
experience, Stress, BMI, Smoking, Alcoholism, food
habits, and type of foot wear. The analysis was shown in
Table I & Table II.
Out of 120 individuals were included in the study 82
subjects complain of pain within a year. The number of
male participants was assessed are 76 and the number of
female are 44, out of which 47 males and 35 females
complains of low back pain at least felt once in the 12
months. About 62% and 80% of population in male and
female are affected respectively.
Table 1 : Demographic profile
Male Female
1 Subjects with pain 62% 80%
2 Body Mass Index
Normal 17% 17%
Over weight 36% 43%
Obese 47% 40%
3 Duration of work
6—8 hours 4% 6%
8—9 hours 24% 31%
9—10 hours 38% 34%
>10 hours 34% 29%
4 Year of experience
7 years 7% 17%
8—10 year 19% 14%
11—13 years 21% 40%
>14 years 53% 29%
5 Foot wear
Shoe 51% 23%
Sandals 38% 57%
Flip tops 11% 20%
6 Work Stress
Yes 83% 80%
No 17% 20%
Characteristics Gender Percentage (%)
Sl.
No.
Risk Factor Analysis in Sedentary Office Workers with Low Back Pain
Journal of Chalmeda Anand Rao Institute of Medical Sciences Vol 13 Issue 1 January - June 2017 17
Table 2 : Various risk factors and percentage
1 Personal Habits
Smoking
Yes 49%
No 51%
Alcoholism
Yes 3 7%
No 63%
2 Food habit
Veg 46%
Non Veg 39%
Only Egg 15%
Characteristics Percentage (%)
Sl.
No.
Year of work experience were analyzed in table 1, which
shows that 53% of male participants who work more than
14 years complains of more pain, followed by 21%, 19%
and 7% for 11-13 year, 8-10 years and 7 years, whereas
the female participants who work more than 11-13 years
complain more pain at 40%, which was followed by 29%
in more than 14 years, 17 % in 7 years and 14% in 8-10
years.
Duration of the work (hours of work) per day were
assessed and analyzed in table 1, which shows that 38%
of males and 34% of female work 9-10 hours per day,
34% of male complain back pain who work more than 10
hours where as 31% of female complains pain who works
for 8-9 hours. 24% of males complain pain when they
work for 8-9 hrs where as 29% of female complains of
pain when they work for more than 10 hrs, and 4% of
males and 6% of females complain pain when they work
for 6-8 hrs in a day.
Body mass index were assessed in the participants using
weighing scale and the height in centimeters. Around 47
male participants 39 participants were not normal
(Overweight or Obese), only 8 were normal. Overall 83%
of the participants are overweight or obese individual, 47%
of participants were obese and 36% were overweight. Out
of 35 female participants 29 were obese or overweight, that
is 83% of participant’s falls in overweight or obese criteria.
Whereas 43% of participants were in overweight category
and 40% of them belong to obese category.
Obesity has moderately associated with low back pain,
studies shows that there was increase risk of obesity in
there is a persistent increase of body weight.[15,16] Few
studies have stated that the relationship is not well
understood; whereas the back pain in obese individual
may be because of accumulation of adipose tissues that
cause over load in the spine17. Still there are unclear
evidences of relationship between obesity and low back
pain. A recent Meta analysis found that obesity and
overweight has strong association with low back pain.[18]
Personal habits were analyzed in table II, two of the habits
were analyzed, Smoking and Alcoholism. Out of 82
participants around 40 participants were smokers which
average 51% and 49% are non smokers. 30 participants
were alcoholic which ranges about 37% of overall
participants, and 52% are non alcoholic. Out of 82
participants 38 person who is 46% are non vegetarians
and39% are vegetarians and 15% of participants
consumes only egg. Smoking and alcoholism is the weak
indicator for the low back pain.[16]
Stress is one of the risk factor for musculoskeletal
problem. Out of 82 participants 67 of them had complains
of stress in job and 15 did not complain of stress in job.
Further analyses were done in which 39 males and 28
females were complaining of stress. About 82% of
participants complain of stress.
Psychological factors like stress has significant relation
with the musculoskeletal disorders, Stress produce
increase tension in the muscle, which may predispose to
injury. [19] Studies showed that stress at work has relation
on consequences of low back pain.[20, 21] Studies also found
that occupational stressors like environment, poor
ergonomics are the important predictors of the
musculoskeletal pain.[22]
Foot wear was not much concerned with back pain history
and incidence where as upon analysis the study found
that out of 82 participants 38 were wearing sandals which
means 46% of participants wore shoes, 32 with shoes and
12 with flip top, which states 39% in shoes and 15% with
flip top. Similar type of study done by Marius in 2010
showed that 41% of individuals having symptoms at least
one in past 12 months. Life time prevalence of the low
back pain incidence is 58.3% and 62% in United
Kingdom.[23] Other countries also show prevalence of low
back pain includes 19.7 in Nigeria, 34% in Netherland
and 19% in Finland. [24, 25]
Many occupational analyses show that low back pain is
the most common musculoskeletal complains followed
by neck and shoulder.[26] Absenteeism, reduced turnover,
increased costs and reduced morale are reasons to the
pain and disability that occurred due to long term use of
computer and acquiring static posture at work.
Use of questionnaire in evaluating the persons with low
back pain, no particular occupations were selected in this
study, the quantity of work is not measured,non-inclusion
of recreational activities are some of the limitations of
this study. The same study can be replicated as
experimental study by using interventions and can also
done in other occupational disorders to identify the
relationship of risk factors of occupations.
CONCLUSION
The findings of this study clearly states that low back pain
was influenced by variety of factors. One of the important
risk factor noted is the obesity and overweight, the
participants who are overweight has strong positive
influence on the back pain related symptoms. Other
factors like stress also plays a role in back injury.
CONFLICT OF INTEREST :
The authors declared no conflict of interest
FUNDING : None
REFERENCES
1. Marius AW. Low Back Pain In The Corporate Workplace; A South
African Review, 2003, available: http:Low Back Pain in the Corporate
Workplace.html.
2. Woolf A, Pfleger B. Burden of major musculoskeletal conditions.
Bull World Health Organ. 2011; 81:646-656.
3. Katz R. Impairment and disability rating in low back pain. Clin
Occupational Environmental Med. 2006; 5: 719-740.
4. Barbara A, Niland J, Patricia J. Fundamentals of Industrial Hygiene.
National safety council. Saunders, Washington, USA, 2003.
5. Mckenzie RA, May S. Lumbar Spine mechanical diagnosis and
therapy. 2nd edition. Walkane: Spinal publication, NZ, 2003.
6. Corlett EN. Background to sitting at work: research requirements
for the design of work seats. Ergonomics. 2006 ; 49: 1538-1546.
7. Pope,MH, Goh, KL, Magnusson, ML. Spine ergonomics.Annual
Review Biomed Eng. 2002; 4: 49-68.
8. Mortimer M, Wiktorin C, Pernold G, Svensson H, Vingard E.
Sport’s activities, body weight and smoking in relation to low
back pain: a population based case referent study. Result
from the MUSIC-Norrtalje study. Scand JMed Sci Sports. 2001;
11:178-192.
9. Kerr MS, Frank JW, Shannon HS, Norman W R, Wells R P,
Neumann W P, Bombardier C, and Ontario Universities Back
Pain Study Group Ontario Universities Back Pain Study Group.
Biomechanical and psychosocial risk factors for low back pain
at work. Am J Public Health. 2001; 91:1069-1075
10. IJzelenberg W, Molenaar D, Burdorf A. Different risk factors for
musculoskeletal complaints and musculoskeletal sickness
absence. Scand J Work Environ Health. 2004; 30:56-63.
11. Seidell JC, De Groot LCPGM, Van Sonsbeek JLA, Deurenberg P,
Hautvast JGAJ. Associations of moderate and severe overweight
with self-reported illness and medical care in Dutch adults. Am J
Public Health. 1986; 76: 264-269.
12. Popkess-Vawter S, Patzel B. Compounded problem: low back
pain and overweight in adult females. Orthop Nurs. 1992; 11:31-
35.
13. Wright D, Barrow S, Fisher AD, Horsley SD, Jayson MI. Influence
of physical, psychological and behavioral factors on consultation
for back pain. Br J Rheumatol. 1995; 34:156-161.
14. HelioÈvaara M. Body height, obesity, and risk of herniated
lumbar intervertebral disc. Spine. 1987; 12:469-472.
15. Bener A, Alwash R, Gaber T, Lovasz G. Obesity and low back
pain. CollAntropol. 2003; 27:95-104.
16. Leboeuf-Yde C Smoking and low back pain. A systematic
literature review of 41 journal articles reporting 47
epidemiologic studies. Spine. 1999; 24:1463-70.
17. Adams MA, Roughley PJ. What is intervertebral disc
degeneration, and what causes it. Spine. 2006; 3:2151–61.
18. Shiri R, Karppinen J, Leino-Arjas P, et al. The association between
obesity and low back pain: A meta-analysis. Am J Epidemiol. 2010;
2:135–54.
19. Rick J, Thomson L, Briner RB, O’Regan S, Daniels K. Review of
existing supporting scientific knowledge to underpin standards of good
practice for key work-related stressors-Phase I. Contract Research
Report 427, Health and Safety Executive Books, Sudbury, UK,
2002.
20. Elfering A, Grebner S, Semmer NK, et al. Time control,
catecholamines and back pain among young nurses. Scand J Work
Environ Health. 2002; 28:386–93.
21. Wickstrom GJ, Pentti J. Occupational factors affecting sick leave
attributed to low-back pain. Scand J Work Environ Health. 1998;
24:145–52.
22. Wu Chen, I Yu, T Wong. Impact of occupational stress and other
psychosocial factors on musculoskeletal pain among Chinese
offshore oil installation workers. Occup Environ Med. 2005; 62:
251–256.
23. McKinnon ME, Vickers MR. Community studies of the health
service implication of low back pain. Spine. 1997; 22:2161-2166.
24. Omokhodion FO, Sanya AO. Risk factors for low back pain
among office workers in Ibadan, Southwest Nigeria. Occup Med
(Lond). 2003; 53:287-289
25. Burdorf A, Naaktgeboren B, de Groot HC. Occupational risk
factors for low back pain among sedentary workers. J Occup Med.
1993; 35:1213-20.
26. Smith DR, Kondo N, Tanaka E, et al. Musculoskeletal disorders
among hospital nurses in rural Japan. Rural Remote Health. 2003;
3: 241.
Subramanian S et. al
Journal of Chalmeda Anand Rao Institute of Medical Sciences Vol 13 Issue 1 January - June 2017 18
... Previous studies revealed that seated working periods of longer than 7 hours per day has increased the risk of low back pain [15], [16], [17]. This may have resulted in most participants feeling fatigued in their back and lower back. ...
... Previous research has shown that both prolonged sitting and working time increase the risk of developing neck pain. 7,36 The present findings suggest that the 2 interventions studied may mitigate the negative effects of longer working hours. Given the previous findings that increasing daily walking steps reduces the onset neck pain in office workers, 40 it seems possible that the beneficial effects of taking breaks on neck pain could be mediated by increases in walking steps that could occur during those breaks. ...
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Introduction: Neck and low back pain are significant health problem in sedentary office workers. Active break and postural shift interventions has been proved to reduce the incidence of new onset of both neck and low back pain. Objectives: To identify variables that moderate the effects of active breaks and postural shift interventions on the development of neck and low back pain in office workers. Methods: Using data from a 3-arm (active break, postural shift, and control group) cluster randomized controlled trial (N = 193), we evaluated the moderating effects of age, job position, education level, sex, perceived psychological work demands, number of working hours, and using a chair with lumbar support on the benefits of 2 interventions designed to prevent the development of neck and low back pain in office workers. Moderation analyses were conducted using the Hayes PROCESS macro, with post hoc Johnson-Neyman techniques and logistic regressions. Results: Significant interactions between intervention groups and 3 moderators assessed at baseline emerged. For the prevention of neck pain, the effect of the active break intervention was moderated by the number of working hours and the effect of the postural shift intervention was moderated by the level of perceived psychological work demands and the number of working hours. For the prevention of low back pain, the effect of postural shift intervention was moderated by having or not having a chair with lumbar support. Conclusions: The study findings can be used to help determine who might benefit the most from 2 treatments that can reduce the risk of developing neck and low back pain in sedentary workers and may also help us to understand the mechanisms underlying the benefits of these interventions.
... With the increase in the amount of time spent sitting, the rate of musculoskeletal system injuries is becoming higher and higher [3,4]. Studies report that jobs with seated working periods longer than 7 h daily increase the risk of low-back pain [5,6]. According to the Spanish Society of Rheumatology (SER), 80% of the Spanish population has suffered back pain at least once and the remaining 20% has acquired chronic pain [7]. ...
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Nowadays, the percentage of time that the population spends sitting has increased substantially due to the use of computers as the main tool for work or leisure and the increase in jobs with a high office workload. As a consequence, it is common to suffer musculoskeletal pain, mainly in the back, which can lead to both temporary and chronic damage. This pain is related to holding a posture during a prolonged period of sitting, usually in front of a computer. This work presents a IoT posture monitoring system while sitting. The system consists of a device equipped with Force Sensitive Resistors (FSR) that, placed on a chair seat, detects the points where the user exerts pressure when sitting. The system is complemented with a Machine Learning model based on Artificial Neural Networks, which was trained to recognize the neutral correct posture as well as the six most frequent postures that involve risk of damage to the locomotor system. In this study, data was collected from 12 participants for each of the seven positions considered, using the developed sensing device. Several neural network models were trained and evaluated in order to improve the classification effectiveness. Hold-Out technique was used to guide the training and evaluation process. The results achieved a mean accuracy of 81% by means of a model consisting of two hidden layers of 128 neurons each. These results demonstrate that is feasible to distinguish different sitting postures using few sensors allocated in the surface of a seat, which implies lower costs and less complexity of the system.
... It is believed that exacerbation of back pain leads to a decrease in productivity due to difficulties in employment and has a significant socio-economic impact 4) . Among workers, those who spend 80% of their working hours in a sitting position are defined as desk workers (DWs) 5) , and DWs are said to be more likely to develop low back pain due to their prolonged sitting posture 6,7) . In recent years, it has been reported that the prevalence of low back pain in DWs has increased with the development of Information Technology equipment 8) . ...
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... While it might be expected that LBP and sedentary office work are highly related, the literature offers only little evidence. On the one hand, recent studies report that seated working periods of longer than 7 h per day significantly increase the risk of LBP (Odds Ratio = 1.89) (Cho et al., 2012;Subramanian and Arun, 2017). On the other hand, several systematic reviews have failed to prove that sitting duration on its own is linked to the onset of LBP and found no significant association between sitting itself and the risk of LBP in office workers (Chen et al., 2009;Lis et al., 2007;da Costa and Vieira, 2009;Bakker et al., 2009;Kwon et al., 2011;Hartvigsen et al., 2000). ...
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... While it might be expected that LBP and sedentary office work are highly related, the literature offers only little evidence. On the one hand, recent studies report that seated working periods of longer than 7 h per day significantly increase the risk of LBP (Odds Ratio = 1.89) (Cho et al., 2012;Subramanian and Arun, 2017). On the other hand, several systematic reviews have failed to prove that sitting duration on its own is linked to the onset of LBP and found no significant association between sitting itself and the risk of LBP in office workers (Chen et al., 2009;Lis et al., 2007;da Costa and Vieira, 2009;Bakker et al., 2009;Kwon et al., 2011;Hartvigsen et al., 2000). ...
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Data on height, weight, illness, medical care consumption, and demographic variables for 19,126 Dutch adults aged 20 years or older were obtained from three annual Health Interview Surveys. Data on severely overweight (Body Mass Index 30.0-40.0 kg/m2) and moderately overweight (BMI 25.0-29.9 kg/m2) subjects were compared with those on non-overweight persons (BMI 20.0-24.9 kg/m2), taking into account effects of sex, age, and educational level. In men, severe overweight was associated with hypertension, especially in men under 50 years of age. In women, severe overweight was associated with hypertension, diabetes, varicose veins, asthma/bronchitis, and hemorrhoids. Increased utilization of medical care and medications were also associated with severe overweight. For moderately overweight subjects, these associations were less clear or absent.
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The study aims to describe the influence of sports activities, high body weight and smoking on low-back pain. The results were obtained from a population-based case-referent study, the Musculoskeletal Intervention Center (MUSIC)-Norrtälje study. In all, 342 male and 449 female cases, and 662 male and 948 female referents participated. Neither low-intensity training many hours/week (>=5 h) nor high-intensity training few (1–2 h), intermediate (3–4 h) or many hours (>=5 h) per week affected the risk of low-back pain among men. Few (1–2) hours with high-intensity training increased the relative risk of low-back pain among women, RR 1.6 (1.1–2.4). An increased risk of low-back pain was found for men with high body weight, RR 2.2 (CI 1.2–3.9) but not for women. Smoking did not influence the risk of low-back pain.
Article
Overweight adult females may have negative self-concepts and body images compounded by chronic low back pain and obesity. This subgroup of clients need special attention and nursing interventions to adjust to chronic low back pain and to achieve permanent weight control. Interventions designed to improve female clients' self-concepts and body images also support their efforts toward weight control, and, in turn, improve their negative perceptions of chronic pain. Orthopaedic nurses are in an excellent position to explore the relationships among body image, overweight, and chronic low back pain.
Article
Anthropometric measurements were studied for their prediction of herniated lumbar intervertebral disc in 332 men and women who had been discharged from hospital with this diagnosis during an 11-year follow-up. The patients were compared with 1,205 controls matched individually for sex, age, and place of residence. Men with a height of 180 cm or more showed a relative risk of 2.3 (95% confidence limits, 1.4-3.9) and women with a height of 170 cm or more 3.7 (1.6-8.6), compared with those who were more than 10 cm shorter (1.0). In men, but not in women, increased body mass index proved to be an independent risk factor for herniated lumbar disc, whereas the thickness of triceps skinfold had no predictive significance. Height and heavy body mass may be important contributors to the herniation of lumbar intervertebral disc.
Article
Over 34,000 questionnaires were used to study occurrence and consultations for back pain in the community. The 12-month period prevalence was 24% and 13% of the sample consulted a doctor. Elderly women were at greatest risk of back pain. The consultation rate increased in both sexes throughout middle age, but declined in men over the age of 55 yr. Back pain was associated with the Goldberg General Health Health Questionnaire score suggesting psychiatric morbidity [odds ratio (OR) = 2.05; confidence interval (CI) 1.89-2.23], obesity (OR = 1.59; CI 1.40-1.79), and cigarette smoking (OR = 1.52; CI 1.36-1.70). Vigorous daily activity was positively associated with back pain in men aged 18-39 yr (OR = 1.37; CI 1.02-1.85), and women aged 18-39 yr (OR = 1.50; CI 1.08-2.09), but was negatively associated with back pain in women aged over 65 yr (OR = 0.35; CI 0.16-0.76). Alcohol consumption was also negatively associated with back pain (OR = 0.72; CI 0.62-0.85). The prevalence of arthritis, constipation and respiratory disorders was increased in those who consulted for back pain corrected for the other variables. Thus back pain was substantially more common in women compared to men over 55 yr. Psychiatric morbidity, cigarette smoking and obesity were associated with back pain at all ages, but the effect of physical exercise appeared to change with age. Further studies are required to explain the sex differences and nature of the associations.
Article
In a cross-sectional study, the relationship of low back pain and sedentary work was examined among crane operators (n = 94), straddle-carrier drivers (n = 95), and a reference group of office workers (n = 86), aged 25 to 60 years. Information about history of low back pain, individual characteristics, and working conditions in past and present was obtained by a standardized interview. Assessment of postural load on the back was performed by observation of non-neutral postures of the trunk during normal work activities. Measurements of exposure to whole-body vibration in cranes and straddle-carriers were conducted. The 12-month prevalence of low back pain among crane operators was 50%; among straddle-carrier drivers, 44%; and among office workers, 34%. After adjustment for age and confounders, the odds ratio for newly developed cases of low back pain in the current job among crane operators was 3.29 (95% confidence interval, 1.52 to 7.12), and among straddle-carrier drivers 2.51 (95% confidence interval, 1.17 to 5.38). In both occupations the daily exposure to whole-body vibration was low, and therefore not considered an important risk factor for low back pain in this study. The observations showed that non-neutral postures of the trunk were frequently adopted among all workers. The results of this study suggest that sustained sedentary work in a forced non-neutral trunk posture is a risk factor for low back pain.
Article
Retrospective study using primary care physician case notes and a self-report questionnaire on the same randomly selected population sample. To assess the prevalence, management, and outcomes of low back pain in the community, comparing, in the same random sample of registered patients, self-report questionnaire data and primary care physicians' records. The financial and resource implications of low back pain are extensive. Data on consultations, investigations, and the management of low back pain are fragmentary and there are no comparisons estimating prevalence from case notes and self-report. A retrospective study of prevalence, management, referral, and outcome covering the previous 12 months was carried out in three general practices using case notes and a self-report postal questionnaire on a sample of 900 patients over 18 years. Lifetime prevalence of low back pain was 62%. Annual prevalence was 48%, with 16% reporting low back pain at the time of report. Twenty-four percent consulted their primary care physician for low back pain, of whom 17% were referred to a hospital specialist. The annual consultation rate of patients with low back pain was similar to the rate for patients with chronic conditions. The activities of daily living were restricted in less than half, with few taking sick leave. The general health status of those reporting recent low back pain was significantly lower than those not reporting low back pain. Most felt that low back pain was self-limiting and would not consult health professionals for future episodes. There were substantial discrepancies between case notes recorded at consultation with the primary care physician and self-report regarding consultation and investigations. Prevalence rates were comparable with those reported in other studies. The significant discrepancies between data sources suggest patient recall bias or underrecording in case notes. The low consultation rate, time off, and day-to-day disability indicate that most episodes are self-limiting.