Mechanical factors and vitamin D deficiency in schoolchildren with low back pain: biochemical and cross-sectional survey analysis

Background: Low back pain (LBP) is the highest contributor to disability worldwide, with current intervention strategies only providing small to moderate analgesic effects. The use of vitamin D supplementation for LBP has gained interest due to its proposed anti-inflammatory and neuromodulatory properties. However, it is still unclear whether vitamin D levels differ between those with and without LBP or if vitamin D levels are associated with pain intensity. Objectives: We aim to investigate the association between vitamin D levels and LBP and to determine if vitamin D levels correlate with pain intensity in individuals with LBP. Study Design: This study was conducted in accordance with the guidelines for performing a Metaanalysis and Systematic Review Of Observational Studies in Epidemiology (MOOSE). Methods: We performed electronic database searches combined keywords relating to vitamin D and LBP in MEDLINE, CINAHL, EMBASE, AMED, WEB OF SCIENCE, and SCOPUS from the earliest record to March 2017. Studies were included if they reported any quantitative measure of vitamin D, such as serum 25-hydroxyvitamin D [25(OH)D], with adequate data in patients with and without LBP or adequate data on pain intensity in patients with LBP. No restriction on the type or duration of LBP, nor the age and gender of patients was applied. Two reviewers independently performed the selection of studies, extracted data, and assessed the methodological quality of the included studies using a modified 15-item Downs and Black checklist. Results: After the removal of duplicates and the screening of titles and abstracts, 105 full texts were evaluated. There were 29 articles included in this systemic review (22 entered into a meta-analysis), including 19 cross-sectional studies, 9 case-control studies, and one single-arm surgical trial where the pre-operative data were used in our analyses. The pooled results from 19 studies showed that individuals with LBP were more likely to have vitamin D deficiency (pooled OR = 1.60, 95% CI: 1.20 - 2.12, P = 0.001, n = 19), severe deficiency (pooled OR = 2.08, 95% CI: 1.19 - 3.64, P = 0.010, n = 7), and lower serum concentrations of 25(OH)D (weighted MD = 3.86, 95% CI: 0.20 - 7.52, P = 0.039, n = 12) compared to those without LBP (where “n” is the number of studies). The association between vitamin D deficiency (pooled OR = 1.83, 95% CI: 1.26 - 2.66, P = 0.002, n = 9) or serum 25(OH)D (weighted MD = 7.64, 95% CI: 4.02 - 11.26, P < 0.001, n = 4) and LBP was stronger for women but failed to be statistically significant for men (pooled OR = 1.06, 95% CI: 0.62 - 1.81, P = 0.213, n = 3). In addition, there were strong associations between vitamin D deficiency and LBP in patients < 60 years old (particularly women). We found minimal evidence to support an association between vitamin D levels and pain intensity in patients with LBP. Limitations: We were unable to investigate whether vitamin D deficiency increases the risk of developing LBP as there were no longitudinal studies included in this review. Conclusion: Vitamin D deficiency is associated with LBP, with stronger associations observed in younger women and those with severe levels of deficiency. The association between vitamin D levels and pain intensity is inconsistent. These results may guide the implementation of future studies on vitamin D supplementation for LBP. PROSPERO Registration No: CRD42016046874. Key words: Vitamin D, low back pain, deficiency, pain intensity, serum 25-hydroxyvitamin D, supplementation, cross-sectional study, case-control study

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Wearable Technology to Increase Self-Awareness of Low Back Pain: A Survey of Technology Needs among Health Care Workers

Sensors ◽

10.3390/s21248412 ◽

2021 ◽

Vol 21 (24) ◽

pp. 8412

Author(s):

Andrea Ferrone ◽

Christopher Napier ◽

Carlo Menon

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Economic Cost ◽

Machine Learning Techniques ◽

Self Awareness ◽

Low Back ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Learning Techniques ◽

Monitoring Technologies

Low back pain (LBP) is a leading contributor to musculoskeletal injury worldwide and carries a high economic cost. The healthcare industry is the most burdened, with nurses, in particular, being highly prone to LBP. Wearable technologies have the potential to address the challenges of monitoring postures that contribute to LBP and increase self-awareness of workplace postures and movements. We aimed to gain insight into workers’ perceptions of LBP and whether they would consider using wearable monitoring technologies to reduce injury risks. We conducted a cross-sectional survey to gather information from a selected population of nurses. Sixty-four participants completed the survey, and data were analyzed with the support of Machine Learning techniques. Findings from this study indicate that the surveyed population (64 nurses) is interested in these new approaches to monitor movement and posture in the workplace. This technology can potentially change the way ergonomic guidelines are implemented in this population.

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Attitudes Toward Chiropractic

Journal of Evidence-Based Complementary & Alternative Medicine ◽

10.1177/2156587215604073 ◽

2015 ◽

Vol 21 (2) ◽

pp. 92-104 ◽

Cited By ~ 4

Author(s):

Carol Ann Weis ◽

Kent Stuber ◽

Jon Barrett ◽

Alexandra Greco ◽

Alexander Kipershlak ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spinal Manipulation ◽

Response Rate ◽

Interprofessional Relations ◽

Chiropractic Care ◽

Low Back ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Written Comments

We assessed the attitudes of Canadian obstetricians toward chiropractic with a 38-item cross-sectional survey. Ninety-one obstetricians completed the survey, for a response rate of 14% (91 of 659). Overall, 30% of respondents held positive views toward chiropractic, 37% were neutral, and 33% reported negative views. Most (77%) reported that chiropractic care was effective for some musculoskeletal complaints, but 74% disagreed that chiropractic had a role in treatment of non-musculoskeletal conditions. Forty percent of respondents referred at least some patients for chiropractic care each year, and 56% were interested in learning more about chiropractic care. Written comments from respondents revealed concerns regarding safety of spinal manipulation and variability among chiropractors. Canadian obstetricians’ attitudes toward chiropractic are diverse and referrals to chiropractic care for their patients who suffer from pregnancy-related low back pain are limited. Improved interprofessional relations may help optimize care of pregnant patients suffering from low back pain.

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Pain knowledge and fear-avoidance beliefs of French osteopathy students and educators towards chronic low back pain: An osteopathic educational institution-based cross-sectional survey

International Journal of Osteopathic Medicine ◽

10.1016/j.ijosm.2021.12.002 ◽

2021 ◽

Author(s):

Hakim Mhadhbi ◽

Benoit Thierry-Hildenbrand ◽

Jerry Draper-Rodi ◽

Jorge E. Esteves ◽

Mathieu Ménard

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Educational Institution ◽

Low Back ◽

Fear Avoidance ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Fear Avoidance Beliefs ◽

Pain Knowledge

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A Cross-Sectional Survey of Low Back Pain in Nurses Working in Orthopedic Departments

Workplace Health & Safety ◽

10.1177/2165079918807231 ◽

2018 ◽

Vol 67 (5) ◽

pp. 218-230 ◽

Cited By ~ 2

Author(s):

Lingli Li ◽

Xiaofan Deng ◽

Hongxia Zhang ◽

Hui Yang ◽

Jiali Chen ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Sichuan Province ◽

Annual Number ◽

Low Back ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Fear Avoidance Beliefs ◽

Tertiary Hospitals ◽

Disability Questionnaire

The study aimed to gain knowledge about low back pain (LBP) in nurses working in the orthopedic departments of tertiary hospitals in Sichuan province, China. We used a cross-sectional survey to examine the prevalence of LBP among 797 inpatient nurses who had worked for 1 year in an orthopedic department in one of 29 hospitals (Grade 3A) in Sichuan province. The survey included a questionnaire to determine the prevalence of LBP and factors related to LBP, a screening graph of LBP symptoms, the Roland Morris Disability Questionnaire (RMDQ), and the Fear Avoidance Beliefs Questionnaire (FABQ) for LBP. The 1-year period prevalence of LBP in the nursing population was 66.8% and the point prevalence was 51.3%. Among the 523 nurses who had experienced LBP, the mean total number of days that LBP had been experienced during the past year was 20.2 ± 16.3 days (range = 1-90 days). The annual number of episodes of LBP was 5.7 ± 4.5 times/year (range = 1-20 times/year). More than half the orthopedic nurses (51.1%) planned to quit, and 5.8% thought of leaving their job due to LBP. These study findings indicate that nurses in this region experience a burden of LBP similar to those in other regions in the world.

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Low back pain characteristics from undergraduate student to working nurse in Australia: A cross-sectional survey

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2008.03.001 ◽

2008 ◽

Vol 45 (11) ◽

pp. 1636-1644 ◽

Cited By ~ 55

Author(s):

Tim Mitchell ◽

Peter B. O'Sullivan ◽

Angus F. Burnett ◽

Leon Straker ◽

Cobie Rudd

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Undergraduate Student ◽

Low Back ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Pain Characteristics

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Low back pain in Australian Football: A cross-sectional survey from the junior to elite senior level with non-athletic controls

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2006.12.085 ◽

2006 ◽

Vol 9 ◽

pp. 36

Author(s):

W. Hoskins ◽

H. Pollard ◽

C. Daff ◽

A. Odell ◽

P. Garbutt ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Australian Football

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Vitamin D Deficiency Is Associated with Muscle Atrophy and Reduced Mitochondrial Function in Patients with Chronic Low Back Pain

Oxidative Medicine and Cellular Longevity ◽

10.1155/2019/6835341 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 10

Author(s):

Katarzyna Patrycja Dzik ◽

Wojciech Skrobot ◽

Katarzyna Barbara Kaczor ◽

Damian Jozef Flis ◽

Mateusz Jakub Karnia ◽

...

Keyword(s):

Vitamin D ◽

Low Back Pain ◽

Back Pain ◽

Protein Content ◽

Vitamin D Deficiency ◽

Muscle Atrophy ◽

Mitochondrial Function ◽

Chronic Low Back Pain ◽

Low Back ◽

Multifidus Muscle

Recent studies show that vitamin D deficiency may be responsible for muscle atrophy. The purpose of this study was to investigate markers of muscle atrophy, signalling proteins, and mitochondrial capacity in patients with chronic low back pain with a focus on gender and serum vitamin D level. The study involved patients with chronic low back pain (LBP) qualified for posterior lumbar interbody fusion (PLIF). Patients were divided into three groups: supplemented (SUPL) with vitamin D (3200 IU/day for 5 weeks), placebo with normal levels of vitamin D (SUF), and the placebo group with vitamin D deficiency (DEF). The marker of muscle atrophy including atrogin-1 and protein content for IGF-1, Akt, FOXO3a, PGC-1α, and citrate synthase (CS) activity were determined in collected multifidus muscle. In the paraspinal muscle, IGF-1 levels were higher in the SUF group as compared to both the SUPL and DEF groups (p<0.05). In the SUPL group, we found significantly increased protein content for pAkt (p<0.05) and decreased level of FOXO3a (p<0.05). Atrogin-1 content was significantly different between men and women (p<0.05). The protein content of PGC-1α was significantly higher in the SUF group as compared to the DEF group (p<0.05). CS activity in the paraspinal muscle was higher in the SUPL group than in the DEF group (p<0.05). Our results suggest that vitamin D deficiency is associated with elevated oxidative stress, muscle atrophy, and reduced mitochondrial function in the multifidus muscle. Therefore, vitamin D-deficient LBP patients might have reduced possibilities on early and effective rehabilitation after PLIF surgery.

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