Title: Various Underlying Pathologies Causing Chronic Low Back Pain and their Relationship with Demographic Parameters and Co-Morbidities: A Cross Sectional Study
Authors: Dr Asoke Kumar Middya, Dr Dilip Kumar Khatua, Dr Kshetra Madhab Das
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.74
Abstract
Introduction: Chronic low back pain (LBP) is very common in Indian community. It is a major cause of activity limitation and is a very common musculoskeletal disorder requiring physiatric intervention. Most of the referred cases of low back pain coming to the physical medicine & rehabilitation (PMR) department, after careful evaluation and investigations, reveal a myriad of pathological condition.
Aims and Objectives: To find out the distribution and incidence of various pathological conditions presenting as chronic low back pain and its relationship with demographic parameters and pre-existing pathologies and co-morbidities.
Materials & Methods: Total three hundred patients of all genders of chronic LBP with functional impairment were included in this cross sectional observational study. Appropriate clinical examinations, radiological and other necessary investigations were done. Descriptive statistical tools were used for data analysis.
Results: Majority were ageing adults with higher incidence of female patients. Lumbar degeneration or spondylosis, the leading cause of permanent spinal damage, seems to be the major cause of chronic LBP. Atraumatic vertebral fractures were associated with underlying pathologies. Those with systemic diseases had more prevalence of gross vertebral osteoporosis.
Conclusion: Predominance of vertebral and paravertebral tissue pathologies as the major cause of chronic LBP may be related with its typical biomechanics. Relation was seen between atraumatic vertebral fracture and underlying pathologies. Systemic pathology predisposes to gross vertebral osteoporosis.
Keywords: Chronic Low Back Pain, Mechanical Low Back Pain, Lumbar Spine, Spondylosis, Osteoporosis, Biomechanics
References
- Van den Heijden GJMG, Bouter LM, Terpstra-Lindeman E. The efficacy of traction for low back pain: results of randomized blinded pilot study. Ned T Physiotherapy 1991; 101:37-43.
- Von Korff M, Dworkin SF, Le Resche L, et al. An epidemiologic comparison of pain complaints. Pain 1988; 32(2): 173-183.
- Walter BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. j Spinal disorder 2000; 13(3): 205-217.
- Anderson G.B.: Epidemiological features of low-back pain. Lancet 1999; 354:581-585.
- U.S. Department of Health and Human Services: Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2002. Vital and Health Statistics Series 10, No. 222 [DHHS Publication No. (PHS) 2004-1550]. Hyattsville, Md,
- U.S. Department of Health and Human Services, 2004. Available at: www.cdc.gov/nchs/data/series/sr_10/sr10_222.pdf. Accessed January 8, 2007.
- National Academy of Sciences and Institute of Medicine: Musculoskeletal Disorders and the Workplace. Washington, DC, National Academy Press, 2001.
- Kent PM, Keating JL. The epidemiology of low back pain in primary care. Chiropractic and osteopathy2005; 13:13.
- Gilgil E, Kacar C, Butun B et al. prevalence of low back pain in a developing urban setting. Spine 2005; 30: 1093- 8.
- Nagasu M, Sakai K, Ito A et al. prevalence and risk factors for low back pain among professional cooks working in school lunch services. BMC Public Health 2007; 7: 171.
- Waddell G, Burton K. Information and advice for patients. In: the back pain revolution. Edinburgh: Churchill Livingstone; 2004:323-342.
- Magee DJ, Magee DJ, ed. Orthopaedic clinical assessment. 4th edn. Philadelphia: Elsevier; 2002:467-566.
- McCall IW, Park WM, O’Brien JP. Induced pain reffered from posterior lumber elements in normal subjects. Spine 1979, 4(5): 441-446.
- Mooney V, Robertson J. the facet syndrome. Clin. Orthop 1976; Mar-Apr(115): 149-156.
- Old JI, Calvert M, Vertebral compression fractures in the elderly. Am Fam Physician 2004; 69(1):111-116.
- Patel SR,Benjamin RS. Soft tissue and bone sarcomas and bone metastasis, In: Braunwald E, Fauci AS, Kasper DL, et al eds. Harrison’s principles of internal medicine. 15th edn. New york: McGraw-Hill; 2001: 625-628.