scholarly journals High Prevalence of Hypovitaminosis D in Patients with Low Back Pain: Evidence from Meta-Analysis

2018 ◽  
Vol 1 (21;1) ◽  
pp. E389-E399 ◽  
Author(s):  
Dipika Bansal
Keyword(s):  
Vitamin D ◽  
Sensitivity Analysis ◽  
Low Back Pain ◽  
Back Pain ◽  
Publication Bias ◽  
Meta Analysis ◽  
Hypovitaminosis D ◽  
Low Back ◽  
Pooled Prevalence ◽  
High Prevalence

Background: Emerging evidence suggests an association between vitamin D deficiency and low back pain (LBP). Objective: To pool evidence on the prevalence of hypovitaminosis D in patients with LBP. Study Design: Meta-analysis. Methods: A comprehensive literature search was done in PubMed, Cochrane Database, and Google scholar for observational studies including cohort, cross sectional (CS), and case control (CC) evaluating the prevalence of hypovitaminosis D in LBP patients. The primary outcome assessed was a prevalence of hypovitaminosis D in patients with LBP, presented as weighted pooled prevalence ratio (WPPR) with 95% confidence interval (CI) using the random effects model. Heterogeneity and inconsistency of the measurements were identified through Cochran’s Q statistic and I2 statistic. We also performed sensitivity analysis, publication bias (using funnel plot and Begg’s test), and subgroup analysis. Results: Fourteen studies (6 were CC, 6 CS, and 2 cohort) involving 2602 patients were included in the final analysis. The WPPR (95% CI) of hypovitaminosis D in patients with LBP was found to be 0.72 (0.60–0.83). Marked heterogeneity was observed, median quality score of all studies was 7.5 interquartile range (IQR) (6.2 - 8.7) on a scale of 0 to 11. Sensitivity analysis showed robustness of the results. The WPPR of hypovitaminosis D was lower in CS at 0.60 (0.35–0.85) as compared to CC studies at 0.81 (0.72–0.90) (P < 0.01). The WPPR was lower in men at 0.74 (0.63–0.86) as compared to women at 0.84 (0.78–0.89) (P < 0.01). No publication bias was observed. Limitations: Heterogeneity in the cut off level of vitamin D to classify the included patients as vitamin D deficient. Conclusions: The high prevalence of hypovitaminosis D was observed in patients with LBP. This provides a chance to screen the deficiency and correct it by supplementation, which can be therapeutic adjunct in the management of LBP patients. Key words: Low back pain, hypovitaminosis D, meta-analysis, pooled prevalence, systematic review

scholarly journals Occupational Related Upper and Low Back Pain Among Working Population of Ethiopia: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Dechasa Adare Mengistu ◽  
Yohannes Mulugeta Demmu ◽  
Addisu Alemu
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Well Being ◽  
Boolean Logic ◽  
Cochrane Library ◽  
Low Back ◽  
Working Population ◽  
Pooled Prevalence

Abstract Background: Back pains, such as low and upper back pains are among the most common musculoskeletal conditions that can cause major public health and socioeconomic problems. Back pain is one of the leading causes of disability that reduces worker performance and well-being and increases absence from work, which can cause an enormous economic burden. In developing countries, particularly in Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related low and upper back pains and remain less prioritized and empirically unrepresented. Therefore, this study aimed to determine the prevalence of occupational-related low and upper back pains among the working population of Ethiopia.Methods: This systematic review and meta-analysis considered studies conducted in Ethiopia, written in English, and published from 2017-2020. Articles were searched from nine electronic databases (Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database and Science Direct) using a combination of Boolean logic operators, Medical Subject Headings and main keywords. The quality assessment of the articles was performed using Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the articles to the study. A random effects model was used to estimate the pooled prevalence, the 95% confidence interval, and the degree of heterogeneity among the included studies. Sensitivity analyzes were performed to identify the influence of outliers and to identify sources of heterogeneity.Results: Of the 1,114 studies identified from the included databases, 20 studies were included in the systematic review and meta-analysis. The pooled prevalence of occupational-related upper and low back pain in the previous year was 27.1% [95% CI: 18.4, 37.9] and 54.2% [95% CI: 48.2, 60.0], respectively. Based on a subgroup analysis by publication year, study population and countries where the studies are conducted, the prevalence of upper back pain was 43.8% [95% CI: 39.3, 47.7], 34.7% [95% CI: 33.1, 36.2], and 36.2% [95% CI: 33.6, 39.0], respectively, while the prevalence of low back pain was 61.8% [95% CI: 58.9, 64.6], 52.8% [95% CI: 51.3, 54.3] and 55.2% [95% CI: 51.4, 59.0], respectively.Conclusions: This systematic review and meta-analysis found that 54.2% of the included study participants experienced low back pain in the previous year, while 27.1% experienced upper back pain. These problems may be reduced by considering proper observation of the principles of ergonomics in the workplace, and performing physical exercises on a regular basis.

scholarly journals High Prevalence of Hypovitaminosis D in Indian Chronic Low Back Patients

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E853-E862
Author(s):  
Dipika Bansal
Keyword(s):  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Pain Clinic ◽  
Care Hospital ◽  
Low Back

Background: Vitamin D has a significant role to play in bone metabolism and neuromuscular function. Several researchers have indicated that Vitamin D deficiency may be possibly related to chronic musculoskeletal pain including chronic low back pain (CLBP). Objectives: The present study was conducted to determine the prevalence of hypovitaminosis D and its contribution to chronic lower back pain. Study Design: Controlled study Setting: Outpatient pain clinic of tertiary care hospital. Methods: Data presented in this manuscript are from patients who were screened for inclusion in an open label, single arm clinical trial aimed to assess the effectiveness of vitamin D supplementation in patients with CLBP. Consecutive patients visiting the outpatient pain clinic of a tertiary care hospital with a diagnosis of CLBP with or without leg pain were recruited. A visual analogue scale (VAS) was used to measure low back pain intensity, and the Modified Oswestry disability questionnaire (MODQ) was used to measure functional ability. Plasma 25-OHD levels of all patients were measured and the prevalence of hypovitaminosis D was calculated. The multivariate logistic regression model was used to investigate the association between vitamin D deficiency and patient characteristics. Results: A total of 328 patients were included in the study. Mean age of the study population was 43.8 years. Two hundred eighty-two (86%) (men 153/172 [89%], women 129/156 [83%]) of patients had below normal plasma vitamin D levels. Among these, 217 (66%) (men 126 [73%], women 91 [58%]) were found to be deficient and 65 (20%) (men 27 [16%], women 38 [24%]) were had insufficient levels. Multivariate regression analysis found that men were significantly more prone to have deficiency as compared to women (OR = 1.78 (1.10 – 2.88), P = 0.02). We also found a significantly positive relationship between vitamin D deficiency and increased functional disability (OR = 1.53 (1.24 – 1.87), P = 0.01). However, we did not find any relationship with pain severity, presence of other co-morbidities and educational level. Limitations: Not possible to access a good quality data on sun exposure and vitamin D dietary inake dieat in study population. No bone scans were performed. Conclusion: The result of this study provides a message about the high prevalence of hypovitaminosis D in the Indian CLBP population. Clinical guidelines for managing CLBP should include assessment of vitamin D status, together with advice on appropriate vitamin D supplementation in those found to be deficient. Clinical trial registration: CTRI/2014/03/004459 Key words: Chronic low back pain, disability, hypovitaminosis D, India, pain severity, prevalence, vitamin D, visual analogue scale

scholarly journals Occupational Related Upper and Low Back Pain Among Working Population of Ethiopia: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Dechasa Adare Mengistu ◽  
Yohannes Mulugeta Demmu ◽  
Addisu Alemu
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Disorders ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Low Back ◽  
Working Population ◽  
Pooled Prevalence ◽  
Study Population

Abstract Background: Occupational-related musculoskeletal disorders (MSDs) are a major public health problem and result in the growing demands for utilization of healthcare services, causing temporary and permanent disability and reduced quality of life. In developing countries, particularly Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related MSDs and remains less prioritized and empirically unrepresented. Thus, this study aimed to determine the pooled prevalence of occupational-related musculoskeletal disorders, particularly low and upper back pain among the working population of Ethiopia.Methods: This systematic review and meta-analysis considered studies conducted in Ethiopia, written in English, and published in 2017-2020. The articles were searched using the following electronic databases such as Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database, and Science directly using a combination of Boolean logic operators, Medical Subject Headings, and main keywords. The quality assessment of the articles was performed using the Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the articles to the study.Results: In the current study, the pooled prevalence of occupational-related upper and lower back pain in the previous year was 27.1% [95% of the CI: 18.4, 37.9%] and 54.2% [95% of the CI: 48.2, 60.0%], respectively. However, the pooled prevalence of occupational-related upper back pain in the previous year according to the publication year, the study population and the study area was 43.8% [95% of CI: 39.3, 47.7%], 34.7%[95% of CI: 33.1, 36.2%] and 36.2% [95% of CI: 33.6, 39.0%] respectively while the prevalence of low back pain in the previous year according to the publication year, the study population and the study area was 61.8% [95% of CI: 58.9, 64.6%], 52.8% [95% of CI: 51.3, 54.3%] and 55.2% [95% of CI: 51.4, 59.0%] respectively.Conclusions: This systematic review and meta-analysis found that more than half of the included study participants had experienced low back pain in the previous year, while more than one-fourth of the included participants had experienced upper back pain. Therefore, the application of occupational health and safety practices in the workplace plays an important role in reducing MSDs related to work and other occupational hazards.

scholarly journals Occupational Related Upper and Low Back Pain Among Working Population of Ethiopia: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Dechasa Adare Mengistu ◽  
Yohannes Mulugeta Demmu ◽  
Addisu Alemu
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Boolean Logic ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Low Back ◽  
Working Population ◽  
Pooled Prevalence

Abstract Background: Back pain such as low and upper back pains are among the most common disabling musculoskeletal conditions that can cause a major public health and socio-economic problems. Back pain is one of the leading causes of disability that reduces worker performance, well-being, and increase absence from work, which can cause an enormous economic burden. In developing countries, particularly in Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related low and upper back pains and remain less prioritized and empirically unrepresented. Therefore, this study aimed to determine the prevalence of occupational-related low and upper back pains among the working population of Ethiopia.Methods: This systematic review and meta-analysis considered studies conducted in Ethiopia, written in English language, and published from 2017-2020. Articles were searched from nine electronic databases (Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database and Science Direct) using a combination of Boolean logic operators, Medical Subject Headings and main keywords. The quality assessment of the articles was performed using Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the articles to the study. A random effects model was used to estimate the pooled prevalence, 95% confidence interval, and the degree of heterogeneity among the included studies. Sensitivity analyses were performed to identify the influence of outliers and to identify the sources of heterogeneity.Results: Of the 1,114 studies identified from the included databases, 20 studies were included in the systematic review and meta-analysis. The pooled prevalence of occupational-related upper and low back pain in the previous year was 27.1% [95% CI: 18.4, 37.9] and 54.2% [95% CI: 48.2, 60.0], respectively. Based on a subgroup analysis by publication year, study population and countries where the studies are conducted, the prevalence of upper back pain was 43.8% [95% CI: 39.3, 47.7], 34.7% [95% CI: 33.1, 36.2] and 36.2% [95% CI: 33.6, 39.0], respectively, while the prevalence of low back pain was 61.8% [95% CI: 58.9, 64.6], 52.8% [95% CI: 51.3, 54.3] and 55.2% [95% CI: 51.4, 59.0], respectively.Conclusions: This systematic review and meta-analysis found that more than half of the included study participants experienced low back pain in the previous year, while more than one-fourth experienced upper back pain. Therefore, implementation of engineering and administrative controls, modifying individual factors, ergonomics, physical examinations and identifying risk factors can reduce back pains.

scholarly journals Prevalence of Occupational Related Upper and Low Back Musculoskeletal Disorders in Ethiopia: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Dechasa Adare Mengistu ◽  
Yohannes Mulugeta Demmu
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Disorders ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Low Back ◽  
Pooled Prevalence ◽  
Study Population ◽  
One Year

Abstract Background: Occupational related musculoskeletal disorders (MSDs) are a major public health problem and result in the growing demands of healthcare service utilization, causing temporary and permanent disability and reduced quality of life. In developing countries, particularly in Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related MSDs and remains less prioritized and empirically unrepresented. Thus, this study aimed to determine the pooled prevalence of occupational-related musculoskeletal disorders, particularly low and upper back musculoskeletal disorders in Ethiopia.Methods: This systematic review and meta-analysis considered studies conducted in Ethiopia, written in the English language, and published from 2017-2020. The articles were searched using the following electronic databases such as Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database, and Science direct using a combination of Boolean logic operators, Medical Subject Headings, and main keywords. Quality assessment of the articles was done using the Joanna Briggs Institute Critical Appraisal tools to determine the relevance of articles to the study.Results: The current study found the pooled prevalence of occupational-related upper back pain and low back pain in the previous one year was 27.1% [95% of CI: 18.4, 37.9%] and 54.2% [95% of CI: 48.2, 60.0%] respectively. However, the pooled prevalence of occupational-related upper back pain in the previous one year after subgroup analysis based on publication year, study population, and study area was 43.8% [95% of CI: 39.3, 47.7%], 34.7%[95% of CI: 33.1, 36.2%] and 36.2% [95% of CI: 33.6, 39.0%] respectively while the pooled prevalence of occupational-related low back pain in previous one year based on subgroup analysis by publication year, study population, and study area was 61.8% [95% of CI: 58.9, 64.6%], 52.8% [95% of CI: 51.3, 54.3%] and 55.2% [95% of CI: 51.4, 59.0%] respectively.Conclusion: This systematic review and meta-analysis found that, more than half of the included study participants were experienced low back pain in the previous year, whereas more than one-fourth of the included participants were experienced upper back pain. Thus, applying occupational health and safety practices in the working environment plays an important role in reducing work-related MSDs and other occupational hazards.

scholarly journals Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 121-145 ◽  
Author(s):  
Joshua Robert Zadro
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Low Back ◽  
Pharmacological Interventions ◽  
Meta Analyses

Background: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Current intervention strategies are failing to reduce the enormous global burden of LBP and are prompting researchers to investigate alternative management strategies, such as vitamin D supplementation. Vitamin D supplementation appears to down regulate pro-inflammatory cytokines which lead to pain and up regulate anti-inflammatory cytokines that reduce inflammation. These mechanisms might explain the increasing interest in the use of vitamin D supplementation for LBP. Objectives: To determine whether vitamin D supplementation improves pain more than a control intervention for individuals with LBP. Study Design: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Methods: We performed searches in numerous electronic databases combining key words relating to “vitamin D” and “LBP” until March 2017. Studies were included if they investigated vitamin D supplementation in participants with LBP, provided there was a comparison intervention. There was no restriction on the type of LBP, the intervention parameters investigated, or the type of clinical trial (e.g., randomized, non-randomized). Two reviewers independently performed the selection of studies, extracted data, rated the methodological quality of the included studies, and evaluated the overall quality of the evidence using the Grading of Recommendations Assessment, Delevopment, and Evaulation (GRADE) approach. Results: After screening 3,534 articles, 8 clinical trials were included in this systematic review. There is very low quality evidence (based on the GRADE approach) that vitamin D supplementation is not more effective than any intervention (including placebo, no intervention, and other conservative/ pharmacological interventions) (continuous pain measures [0–100]: mean difference [MD] = -2.65, 95% confidence interval [CI]: -10.42 to 5.12, P = 0.504, n = 5; self-reported reduction in pain: pooled odds ratio [OR] = 1.07, 95% CI: 0.35 to 3.26, P = 0.906, n = 5) or placebo/no intervention for individuals with LBP (continuous pain measures: MD = 1.29, 95% CI: -3.81 to 6.39, P = 0.620, n = 4; self-reported reduction in pain: pooled OR = 1.53, 95% CI: 0.38 to 6.20, P = 0.550, n = 4), where ‘n’ is the number of studies included in the meta-analysis. These results did not change when we stratified the meta-analyses by the type of vitamin supplementation (vitamin D3 vs. alfacalcidol) or the type of LBP (non-specific vs. LBP resulting from osteoporosis or vertebral fractures). Limitations: The overall quality of evidence was “very low” due to the poor methodological quality and small sample sizes of the included studies. Conclusions: Vitamin D supplementation is not more effective than placebo, no intervention, or other conservative/pharmacological interventions for LBP (based on very low quality evidence). These results are consistent, regardless of the type of LBP or vitamin D supplementation. Until well-designed and adequately powered clinical trials suggest otherwise, the prescription of vitamin D for LBP cannot be recommended. PROSPERO Registration No: CRD42016046874. www.crd.york.ac.uk/PROSPERO/display_record. asp?ID = CRD42016046874 Key words: Vitamin D, low back pain, chronic low back pain, alfacalcidol, osteoporosis, vertebral fractures, serum 25-hydroxyvitamin D, systematic review

scholarly journals Occupational Related Upper and Low Back Pain Among the Working Population of Ethiopia: Systematic Review and Meta-Analysis

2021 ◽  
Vol 15 ◽  
pp. 117863022110678
Author(s):  
Dechasa Adare Mengistu ◽  
Yohannes Mulugeta Demmu ◽  
Addisu Alemu
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Boolean Logic ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Low Back ◽  
Working Population ◽  
Pooled Prevalence

Background: Back pain, such as upper and low back pain are among the most common musculoskeletal conditions that can cause major public health and socioeconomic problems. Back pain is one of the leading causes of disability that reduces worker performance and well-being and increases absence from work, which can cause an enormous economic burden. In developing countries, particularly in Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related upper and low back pain, and they remain less prioritized and empirically unrepresented. Therefore, this study aimed to determine the prevalence of occupational-related upper and low back pain among the working population of Ethiopia. Methods: This systematic review and meta-analysis considered studies conducted in Ethiopia, written in English, and published from 2017 to 2020. Articles were searched from 9 electronic databases (Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database, and Science Direct) using a combination of Boolean logic operators, Medical Subject Headings, and main keywords. The quality assessment of the articles was performed using the Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the articles to the study. A random effects model was used to estimate the pooled prevalence, the 95% confidence interval, and the degree of heterogeneity among the included studies. Sensitivity analyses were performed to identify the influence of outliers and to identify sources of heterogeneity. Results: Of the 1114 studies identified from the included databases, 20 studies were included in the systematic review and meta-analysis. The pooled prevalence of occupational-related upper and low back pain in the previous year was (27.1% [95% CI: 18.4, 37.9]) and (54.2% [95% CI: 48.2, 60.0]), respectively. Based on a subgroup analysis by publication year, study population, and regions where the studies were conducted, the prevalence of upper back pain was (43.8% [95% CI: 39.3, 47.7]), (34.7% [95% CI: 33.1, 36.2]), and (36.2% [95% CI: 33.6, 39.0]), respectively, while the prevalence of low back pain was (61.8% [95% CI: 58.9, 64.6], (52.8% [95% CI: 51.3, 54.3]), and (55.2% [95% CI: 51.4, 59.0]), respectively. Conclusions: This systematic review and meta-analysis found that 54.2% of the included study participants experienced low back pain in the previous year, while 27.1% experienced upper back pain. The highest prevalence was reported among pedestrian back-loading women.

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