Concordance of patient beliefs and expectations regarding the management of low back pain with guideline recommendations – a cross-sectional study in Germany

Abstract Background Low back pain is a common reason for patients to seek medical care. Physician non-adherence to clinical guidelines has been observed. We investigated the extent to which patient expectations correspond to recommendations of the German national guideline for management of low back pain (G-LBP) and whether patient characteristics, history of LBP and previous treatment experience are associated with expectations. Methods A cross-sectional study including patients from 13 general practices was conducted. Data were collected using a questionnaire. Inverse probability weights were used to address non-response bias. Descriptive analysis and multivariate logistic regression models were performed. Results A total of 977 patients were included in analyses (median age 57 years, 39% male). 75% of patients reported experiencing LBP currently or within the last year. More than 65% indicated they would agree to forgo further examinations if their LBP was judged by their physician to be of no serious concern. This was associated with the highest level of education and no prior imaging, and negatively associated with good-to-poor health status and moderate-to-severe pain intensity. 40% of participants expected imaging. The highest educational level, female gender and no prior imaging were associated with a decreased expectation of imaging. 70% expected prescriptions for massages. Females, participants with good-to-poor health status, current LBP or LBP in the last 12 months had an increased expectation for massages. Expectations for injection therapy (45%) were mainly associated with previous injections. Expectations for physiotherapy (64%) were associated with female gender, lower educational level, good-to-poor health status, current LBP or in the last 12 months. The perspective that daily activities should be continued (66%) was associated with female gender and higher educational level. Participants who agreed to the statement ‘There is no effective treatment for LBP’ (11%) had a poor health status, current LBP and a severe pain intensity. Conclusion Patient views regarding LBP management are partially concordant with guideline recommendations and are strongly influenced by previous treatment experiences and education level. Exploration of patient expectations and experiences in LBP treatment may help minimize dissatisfaction of patients expecting treatments not endorsed by guidelines and simultaneously increase physician guideline adherence.

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Influence of Psychosocial and Sociodemographic Variables on Sickness Leave and Disability in Patients with Work-Related Neck and Low Back Pain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165966 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5966

Author(s):

Israel Macías-Toronjo ◽

José Luis Sánchez-Ramos ◽

María Jesús Rojas-Ocaña ◽

E. Begoña García-Navarro

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Educational Level ◽

Cross Sectional Study ◽

Study Data ◽

Low Back ◽

Cross Sectional ◽

Sociodemographic Variables ◽

Work Related ◽

Degree Of Disability

The purpose of this study was to describe the association between psychosocial factors in patients with work-related neck or low back pain (n = 129), in order to study sickness leave, its duration, the disability reported, and to analyze the relationship of these factors with different sociodemographic variables. This was a descriptive cross-sectional study. Data on kinesiophobia, catastrophizing, disability, and pain were gathered. Sociodemographic variables analyzed included sex, age, occupational, and educational level. Other data such as location of pain, sick leave status and duration of sickness absence were also collected. Educational level (p = 0.001), occupational level (p < 0.001), and kinesiophobia (p < 0.001) were found to be associated with sickness leave; kinesiophobia (b = 1.47, p = 0.002, r = 0.35) and catastrophizing (b = 0.72, p = 0.012, r = 0.28) were associated with the duration of sickness leave. Educational level (p =0.021), kinesiophobia (b = 1.69, p < 0.000, r = 0.505), catastrophizing (b = 0.76, p < 0.000, r = 0.372), and intensity of pain (b = 4.36, p < 0.000, r = 0.334) were associated with the degree of disability. In the context of occupational insurance providers, educational and occupational factors, as well as kinesiophobia and catastrophizing, may have an influence on sickness leave, its duration and the degree of disability reported.

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Gender Differences in the Prevalence and Characteristics of Pain in Spain: Report from a Population-Based Study

Pain Medicine ◽

10.1093/pm/pnz004 ◽

2019 ◽

Vol 20 (12) ◽

pp. 2349-2359 ◽

Cited By ~ 6

Author(s):

Isabel Jiménez-Trujillo ◽

Ana López-de-Andrés ◽

José Luis del Barrio ◽

Valentín Hernández-Barrera ◽

Marisa Valero-de-Bernabé ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Neck Pain ◽

Chronic Low Back Pain ◽

Female Gender ◽

Chronic Neck Pain ◽

Population Based ◽

Low Back ◽

Cross Sectional ◽

Self Rated Health

Abstract Objective To assess the prevalence and characteristics of chronic neck pain, chronic low back pain, and migraine or frequent headaches among Spanish adults in 2014 according to gender, to identify predictors for each of these types of pains, and to compare the prevalence with those found in 2009. Design Cross-sectional study. Setting Spain. Methods We used data collected from the 2014 European Health Interview Survey (N = 22,842). Sociodemographic features, self-rated health status, lifestyle habits, comorbid conditions, pain characteristics, and self-reported use of medications were analyzed. Results The prevalence of all types of pain was significantly higher among women than men. For chronic neck pain, the figures were 25.68% vs 12.54%, for chronic low back pain, 27.03% vs 18.83%, and for migraine or frequent headaches, 15.93% vs 6.74%, in women and men, respectively. Predictors of these types of pain included female gender, advanced age, poor self-rated health, psychological distress, comorbidities, and obesity. The prevalence of neck pain and low back pain increased from 2009 to 2014 for both sexes, and the prevalence of migraine or frequent headaches remained stable over time. Conclusions The prevalence and intensity of all the forms of chronic pain were higher among women. Women experiencing pain used prescribed medications for pain, anxiety, and/or depression and sleeping pills more than men. The prevalence of chronic neck and low back has increased in the last five years in Spain, and the prevalence of migraine or frequent headaches has remained stable.

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Is there a relationship between self-efficacy, disability, pain and sociodemographic characteristics in chronic low back pain? A multicenter retrospective analysis

Archives of Physiotherapy ◽

10.1186/s40945-019-0061-8 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Silvano Ferrari ◽

Carla Vanti ◽

Marta Pellizzer ◽

Luca Dozza ◽

Marco Monticone ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Retrospective Analysis ◽

Chronic Low Back Pain ◽

Educational Level ◽

Self Efficacy ◽

Clinical Characteristics ◽

Female Gender ◽

Low Back

Abstract Background Pain-related self-efficacy is defined as the beliefs held by people with chronic pain that certain activities can be carried out despite the pain. Poor self-efficacy is an obstacle to the recovery and predicts long-term disability. The aims of this study are to investigate the prevalence of poor pain self-efficacy in Italian subjects with chronic low back pain (LBP), and to inquire the relationships between self-efficacy, disability, pain, and main demographic and clinical characteristics. Methods A secondary multicenter retrospective analysis was done on 310 outpatients with chronic non-specific LBP. The pain self-efficacy measured with the Pain Self-Efficacy Questionnaire (PSEQ), the disability measured with the Roland & Morris Disability Questionnaire, and the pain intensity measured with the Numerical Rating Scale were considered variables to investigate, whereas demographic and clinical variables were considered predictors or potential confounders. A 40/60 PSEQ score was adopted as cut-off to distinguish between good and poor self-efficacy. Results 199 subjects (64.2% of the sample) showed poor self-efficacy. The odds of having poor self-efficacy appeared significantly related to female gender (OR = 1.80, 95%CI [1.12;2.90]; p = 0.015) and drugs use (OR = 1.68, 95%CI [1.06;2.70]; p = 0.029). Significant relationships also emerged between disability and higher age (β = 0.07, 95%CI [0.01; 0.12]; p = 0.02), being female (β = 1.80, 95%CI [0.32;3.29]; p = 0.018), low educational level (β = − 1.68, 95%CI [− 2.59;-3.29]; p < 0.001), higher height (β = − 0.08, 95%CI [− 0.158;-0.002]; p = 0.045), pain duration [mos] (β = 0.01, 95%CI [0.001;0.021]; p = 0.041), and drugs use (β = 2.86, 95%CI [1.44;4.27]; p < 0.001). The amount of pain appeared significantly related to educational level (β = − 0.47, 95%CI [− 0.76;-0.182]; p < 0.001), smoking (β = 0.56, 95%CI [0.09; 1.03]; p = 0.021), height (β = − 0.03, 95%CI [− 0.05; − 0.002]; p = 0.036), and drugs use (β = 0.81, 95%CI [0.399;1.22]; p < 0.001). No significant correlation appeared among weight, body mass index, and referred pain neither in relation to self-efficacy, nor in relation to pain/disability. Conclusions The majority of our sample, composed of Italian people complained of chronic LBP, shows poor self-efficacy. Female gender and drugs use are significantly related to poor self-efficacy, low educational level negatively influences the amount of perceived pain and disability, and older age and smoking are related to disability and pain intensity, respectively. The knowledge of these sociodemographic and clinical characteristics potentially influencing chronic LBP may be useful to address more efforts towards the most negatively impacted subjects, among the entire population complained of chronic LBP.

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Distribution of illness of orthopaedic outpatient department in a tertiary care teaching hospital in West Bengal: a cross sectional study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175720 ◽

2017 ◽

Vol 6 (1) ◽

pp. 206

Author(s):

Ajayar Kum ◽

Chanchal Kumar Dalai ◽

Santanu Banerjee

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Tertiary Care ◽

Female Gender ◽

Cross Sectional Study ◽

Outpatient Department ◽

Low Back ◽

Age Group ◽

Observation Study ◽

Cross Sectional

Background: Orthopaedic Outpatient Department (OPD) is an important part of health care system. Patients coming with different illness for treatment. Distribution pattern of illness represents the area from where patients come for treatment.Methods: Cross sectional, Observation Study. The patients who had willingly participated were enrolled on the basis of subject selection criteria. Prescriptions were collected from newly patients attending the Orthopaedics OPD. No follow up visit was done.Results: Male patients attended more than female gender (62% vs 38%). 18-30 years age group attended OPD much than another group (32.5%). Trauma is an important contributing factor (38.5%). History of trauma was seen more in male gender group and among 18-30 years age group. Low back pain is common problem. (29.5%).Conclusions: Low back pain is the common problem among patients attended Orthopaedic OPD. Trauma is an important contributing factor among 18-30 years age group.

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THE RELATIONSHIP BETWEEN CHRONIC LOW BACK PAIN AND PHYSICAL FACTORS IN COLLEGIATE POLE VAULTERS: A CROSS-SECTIONAL STUDY

International Journal of Sports Physical Therapy ◽

10.26603/ijspt20200537 ◽

2020 ◽

Vol 15 (4) ◽

pp. 537-547

Author(s):

Shota Enoki ◽

Rieko Kuramochi ◽

Yuki Murata ◽

Gaku Tokutake ◽

Takuya Shimizu

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Cross Sectional Study ◽

Physical Factors ◽

Low Back ◽

Sectional Study ◽

Cross Sectional ◽

The Relationship

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KELUHAN LOW BACK PAIN PADA PERAWAT RAWAT INAP RSUD SELASIH PANGKALAN KERINCI

Jurnal IPTEKS Terapan ◽

10.22216/jit.2017.v11i1.1466 ◽

2017 ◽

Vol 11 (1) ◽

pp. 75

Author(s):

Kursiah Warti Ningsih

Keyword(s):

Low Back Pain ◽

Back Pain ◽

General Hospital ◽

Quantitative Research ◽

District General Hospital ◽

Low Back ◽

Cross Sectional ◽

Exercise Habits ◽

Bivariate Correlation ◽

Surrounding Areas

Low back pain adalah rasa nyeri yang dirasakan pada punggung bawah yang sumbernya tulang belakang daerah spinal, otot, saraf, atau struktur lainnya disekitar daerah tersebut. Dari 10 perawat 6 perawat mengalami keluhan low back pain. Tujuan dari penelitian ini adalah untuk mengetahui faktor Keluhan Low back pain.Jenis penelitian kuantitatif dengan desain cross sectional, pada 25 juni- 3 juli di Rumah Sakit Umum Daerah Selasih Pangkalan Kerinci. Penelitian dilakukan pada 30 perawat dengan kuesioner. Analisa data yang digunakan secara univariat,Hasil penelitian: 13 orang (43,3%) mengalami keluhan low back pain. Hasil uji bivariat terdapat hubungan antara sikap kerja, dan kebiasaan olahraga terhadap kejadian low back pain. Hasil analisis multivariate menunjukkan variable sikap kerja merupakan variable yang paling mempengaruhi kejadian low back pain deng nilai OR 43 kali. Dimana variable IMT merupakan counfounding terhadap variable sikap kerja dan kebiasaan olah raga dan variable kebiasaan olahraga merupakan counfounding terhadap variable IMT.Peneliti mengharapkan pihak Rumah Sakit Umum Daerah Selasih Pangkalan Kerinci mengadakan seminar tentang sikap kerja yang baik, menjaga IMT karyawan <25 dan mengadakan kegiatan olah raga secara teratur di lingkungan Rumah Sakit Umum Daerah Selasih Pangkalan Kerinci. Low back pain is pain that felt in the lower back that is the source of the spine area of spinal, muscles, nerves, or other structures surrounding areas. of the 10 nurses 6 nurses complain of low back pain. the purpose of this study was to determine the factors complaint low backpain.Type quantitative research cross-sectionaldesign, on 25 June-3 July at the General Hospital of Selasih Pangkalan Kerinci. The study was conducted on 30 nurses by questionnaires. Data analysis used univariate, bivariate and multivariate.Eesults of the study: 13 patients (43.3%) had complaints of low backpain.The result of bivariate correlation between working attitude and exercise habits on the incidence of low backpain.Results of multivariate analysis showed variable working attitude is the variable that most influences the incidence of low back pain deng OR value 43 times. Where the variable BMI is counfounding to variable working attitude and exercise habits and variable exercise habits is counfounding to variable IMT.Researchers expect the Regional General Hospital Basil Pangkalan Kerinci hold a seminar on good working attitude, keep IMT employees <25 and hold sports activities regular exercise in the District General Hospital Basil Pangkalan Kerinci.

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Low Back Pain and Substance Use: Diagnostic and Administrative Coding for Opioid Use and Dependence Increased in U.S. Older Adults with Low Back Pain

Pain Medicine ◽

10.1093/pm/pnaa428 ◽

2021 ◽

Author(s):

Beth B Hogans ◽

Bernadette C Siaton ◽

Michelle N Taylor ◽

Leslie I Katzel ◽

John D Sorkin

Keyword(s):

Older Adults ◽

Substance Use ◽

Low Back Pain ◽

Back Pain ◽

National Sample ◽

Cross Sectional Study ◽

Diagnostic Code ◽

Low Back ◽

Opioid Use ◽

Cross Sectional

Abstract Objective Low back pain (LBP) is a leading cause of pain and disability. Substance use complicates the management of LBP, and potential risks increase with aging. Despite implications for an aging, diverse U.S. population, substance use and LBP comorbidity remain poorly defined. The objective of this study was to characterize LBP and substance use diagnoses in older U.S. adults by age, gender, and race. Design Cross-sectional study of a random national sample. Subjects Older adults including 1,477,594 U.S. Medicare Part B beneficiaries. Methods Bayesian analysis of 37,634,210 claims, with 10,775,869 administrative and 92,903,649 diagnostic code assignments. Results LBP was diagnosed in 14.8±0.06% of those more than 65 years of age, more in females than in males (15.8±0.08% vs. 13.4±0.09%), and slightly less in those more than 85 years of age (13.3±0.2%). Substance use diagnosis varied by substance: nicotine, 9.6±0.02%; opioid, 2.8±0.01%; and alcohol, 1.3±0.01%. Substance use diagnosis declined with advancing age cohort. Opioid use diagnosis was markedly higher for those in whom LBP was diagnosed (10.5%) than for those not diagnosed with LBP (1.5%). Most older adults (54.9%) with an opioid diagnosis were diagnosed with LBP. Gender differences were modest. Relative rates of substance use diagnoses in LBP were modest for nicotine and alcohol. Conclusions Older adults with LBP have high relative rates of opioid diagnoses, irrespective of gender or age. Most older adults with opioid-related diagnoses have LBP, compared with a minority of those not opioid diagnosed. In caring for older adults with LBP or opioid-related diagnoses, health systems must anticipate complexity and support clinicians, patients, and caregivers in managing pain comorbidities. Older adults may benefit from proactive incorporation of non-opioid pain treatments. Further study is needed.

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Smartphone usage duration is not associated with increased pain or proprioception deficit in young adults with chronic mechanical low back pain: a cross-sectional study

Bulletin of Faculty of Physical Therapy ◽

10.1186/s43161-020-00010-y ◽

2020 ◽

Vol 25 (1) ◽

Author(s):

Mina Magdy Wahba ◽

Dina Othman Shokri Morsi Galal ◽

Aliaa Rehan Youssef

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Cross Sectional Study ◽

Task Completion ◽

Smartphone Addiction ◽

Low Back ◽

Cross Sectional ◽

Pain Scores ◽

Smartphone Use ◽

Continuous Use

Abstract Background Smartphone use has been associated with pain in the upper quadrant; however, the relationship between usage duration and low back pain is still unclear. This study investigated the association between continuous smartphone use up to 30-min and back pain severity and proprioception acuity in patients with chronic low back pain. Fifty-eight patients with chronic mechanical LBP played a game for 10- and 30-min. In each session, pain and back repositioning errors were measured at baseline and immediately after task completion. Results Pain significantly but slightly increased following smartphone use, regardless to the duration (after 10 min: mean increase = 0.75 ± 1.17, P value < 0.001, 95% CI 0.44–1.06; after 30 min: mean increase = 0.96 ± 1.93, P value < 0.001, 95% CI 0.44–1.46). However, changes in perceived pain scores were not significantly different between the two tested durations (P value = 0.42). Proprioception repositioning error was not significantly different within the same testing session (mean change = 0.08 ± 1.83, 0.13 ± 1.77, P value = 0.73, 0.58, 95% CI − 0.40–0.56, − 0.60–0.33, for the 10 and 30 min, respectively). The changes in proprioception were not significant between the two-tested durations (P value = 0.56). Further, smartphone addiction did not significantly affect changes in pain and proprioception after game playing, regardless of the duration (P > 0.05). Conclusions These findings show that smartphone use slightly increases back pain immediately after continuous use; with no effect on back proprioception within the duration tested in this study. Changes in pain and proprioception were not influenced by smartphone addiction.

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Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04269-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

R. Meier ◽

C. Emch ◽

C. Gross-Wolf ◽

F. Pfeiffer ◽

A. Meichtry ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Cross Sectional Study ◽

Sensorimotor System ◽

Healthy Controls ◽

Low Back ◽

Sectional Study ◽

Clinical Tests ◽

Body Perception ◽

Cross Sectional

Abstract Background Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. Methods A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. Results MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. Conclusions Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. Trial registration No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015–243.

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Disability and quality of life in patients with low back pain: Focus on sex and gender: A cross-sectional study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200319 ◽

2021 ◽

pp. 1-8

Author(s):

Yen-Mou Lu ◽

Chung-Hwan Chen ◽

Yi-Jing Lue

Keyword(s):

Quality Of Life ◽

Low Back Pain ◽

Back Pain ◽

Gender Identity ◽

Gender Role ◽

Low Back ◽

Sex And Gender ◽

Cross Sectional ◽

And Gender

BACKGROUND: Sex and gender affect responses to pain, but little is known about disability and quality of life. OBJECTIVES: To investigate the effects of sex and gender on disability and health-related quality of life (HRQOL) in patients with low back pain. METHODS: Ninety-three patients with low back pain were included in this cross-sectional survey study. Disability, HRQOL and gender identity were respectively assessed with the Oswestry Disability Index, Short Form-36 and Bem Sex Role Inventory. The participants were classified into four gender role orientations (masculinity, femininity, androgyny and undifferentiated). One-way analysis of variance was used to analyze both the sex and the gender role orientation. RESULTS: Females had higher disability than males (p< 0.05), but in gender identity, no significant difference was found. Seven domains of HRQOL were lower than the healthy norms. Males experienced greater impacts than females on vitality and mental health (p< 0.05). For gender identity, five domains of HRQOL had significant differences (p< 0.05). Masculinity orientation had the least impact on four domains (p< 0.05), while undifferentiated orientation had the largest impact on all domains. CONCLUSION: Sex and gender effects can be used to analyze disability and HRQOL in patients with low back pain. Females have higher disability, while HRQOL is greatly influenced by different gender role orientations.

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