scholarly journals 953 The relationship between early prescription dispensing patterns and work disability in a cohort of low back pain workers’ compensation claimants

Author(s):  
Nancy Carnide ◽  
Sheilah Hogg-Johnson ◽  
Mieke Koehoorn ◽  
Andrea Furlan ◽  
Pierre Côté
2019 ◽  
Vol 76 (8) ◽  
pp. 573-581 ◽  
Author(s):  
Nancy Carnide ◽  
Sheilah Hogg-Johnson ◽  
Mieke Koehoorn ◽  
Andrea D Furlan ◽  
Pierre Côté

ObjectivesTo examine and compare whether dispensing of prescription opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs) within 8 weeks after a work-related low back pain (LBP) injury is associated with work disability.MethodsA historical cohort study of 55 571 workers’ compensation claimants with LBP claims in British Columbia from 1998 to 2009 was conducted using linked compensation, dispensing and healthcare data. Four exposures were constructed to estimate the effect on receipt of benefits and days on benefits 1 year after injury: drug class(es) dispensed, days' supply, strength of opioids dispensed and average daily morphine-equivalent dose.ResultsCompared with claimants receiving NSAIDs and/or SMRs, the incidence rate ratio (IRR) of days on benefits was 1.09 (95% CI 1.04 to 1.14) for claimants dispensed opioids only and 1.26 (95% CI 1.22 to 1.30) for claimants dispensed opioids with NSAIDs and/or SMRs. Compared with weak opioids only, the IRR for claimants dispensed strong opioids only or strong and weak opioids combined was 1.21 (95% CI 1.12 to 1.30) and 1.29 (95% CI 1.20 to 1.39), respectively. The incident rate of days on benefits associated with each 7-day increase in days supplied of opioids, NSAIDs and SMRs was 10%, 4% and 3%, respectively. Similar results were seen for receipt of benefits, though effect sizes were larger.ConclusionsFindings suggest provision of early opioids leads to prolonged work disability compared with NSAIDs and SMRs, though longer supplies of all drug classes are also associated with work disability. Residual confounding likely partially explains the findings. Research is needed that accounts for prescriber, system and workplace factors.


2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.


2013 ◽  
Vol 25 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Hee Sung Lim ◽  
Su Yeon Roh ◽  
Suk Min Lee

2018 ◽  
Vol 34 (3) ◽  
pp. 237-261 ◽  
Author(s):  
Sin Ki Ng ◽  
Donna M. Urquhart ◽  
Paul B. Fitzgerald ◽  
Flavia M. Cicuttini ◽  
Sultana M. Hussain ◽  
...  

2015 ◽  
Vol 28 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Vanessa Patrícia Soares de Sousa ◽  
Silvia Oliveira Ribeiro ◽  
Carla Monique Ribeiro de Aquino ◽  
Elizabel de Souza Ramalho Viana

Introduction Pregnancy is characterized by several changes in her body. These changes contribute to the emergence of low back pain, which may influence the quality of sleep during pregnancy. Objective To compare the quality of sleep among pregnant women with and without low back pain during pregnancy, examining the relationship between two variables. Materials methods Thirty volunteers aged between 19 and 36 years, divided into control group (CG – n = 16) and Study Group (SG – n = 14), residents in the cities of Natal, were evaluated in the second trimester of pregnancy. To sleep evaluation were used to index the Pittsburgh Sleep Quality and the Epworth Sleepiness Scale. Low back pain was evaluated using the pressure algometer, Visual Analogue Scale (VAS) and Oswestry Disability Index. Statistical analysis used the Shapiro Wilk test, Student’s T test for independent samples and Pearson correlation test. Results The mean gestational and chronological ages were 28.2 ± 3.4 years and 19.9 ± 3.7 weeks, respectively. Sleep quality was lower in SG (8.21 ± 4.8) when compared to CG (5.94 ± 1.7) and was statistically significant (P = 0.021). Analyzing the relationship between sleep quality and pain intensity, it was observed that the variables have a positive correlation between them (r = 0.372, P = 0.043). Conclusion Our findings indicate that sleep quality is decreased in women with low back pain compared to those without pain.


1991 ◽  
Vol 16 (3-4) ◽  
pp. 103-110 ◽  
Author(s):  
Robert N. Jamison ◽  
Barbara A. Stetson ◽  
Winston C.V. Parris

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