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Are psychosocial factors associated with low back pain and work absence for low back pain in an occupational cohort?

Urquhart DM, Kelsall HL, Hoe VC, Cicuttini FM, Forbes AB, Sim MR

Clin J Pain, 2013 Dec;29(12):1015-20.
PMID: 23370089 DOI: 10.1097/AJP.0b013e31827ff0c0

OBJECTIVES: To examine the relationship between individual and work-related psychosocial factors and low back pain (LBP) and associated time off work in an occupational cohort.
METHODS: A self-administered questionnaire was completed by nurses working across 3 major public hospitals. Participants provided sociodemographic data and information on the occurrence of LBP, time off work, and psychosocial factors.
RESULTS: One thousand one hundred eleven participants (response rate 38.6%) were included in the study. Fifty-six percent of participants reported LBP in the previous year. When individual psychosocial factors were examined in the same model, the relationship between somatization and LBP persisted (OR 1.64; 95% confidence interval [CI], 1.35, 2.01). Low job security was also significantly associated with LBP independent of the other work-related factors (OR 0.82; 95% CI, 0.69, 0.98). Of those participants with LBP, 30% reported absence from work due to LBP. When absence from work was examined, negative beliefs (OR 0.97; 95% CI, 0.94, 1.00) and pain catastrophizing (OR 1.33; 95% CI, 1.04, 1.71) were independently associated with time off work, along with low job satisfaction (OR 0.71; 95% CI, 0.51, 0.97) and high job support (OR 1.35; 95% CI, 1.04, 1.75).
CONCLUSIONS: Somatization and low job security were found to be independently associated with occupational LBP, whereas negative beliefs, pain catastrophizing, reduced job satisfaction, and high job support were independently related to time off work. Longitudinal studies are needed to determine whether these individual and work-related psychosocial factors predict, or alternatively, are outcomes of pain and time off work associated with LBP.

Matched MeSH terms: Low Back Pain/psychology*
The effectiveness of patient education in improving pain, disability and quality of life among older people with low back pain: A systematic review

Zahari Z, Ishak A, Justine M

J Back Musculoskelet Rehabil, 2020;33(2):245-254.
PMID: 31356191 DOI: 10.3233/BMR-181305

OBJECTIVES: This study aimed to gain an overview of patient education and the effects of patient education for older people with low back pain (LBP).
METHODS: The search strategies were performed via EBSCO MEDLINE, EBSCO CINAHL, Science Direct, PubMed, and PEDro databases from 2006 to 2016. The keywords "patient education", "low back pain", "elderly", "older adults", "older persons" and "older people" were used during the literature search. Boolean operators were used to expand or limit the searching scope and manual exclusion was performed to choose articles eligible for this study.
RESULTS: A total of 2799 articles were retrieved but only five articles were related with patient education for older people with LBP. Findings suggest that patient education for older people may differ in terms of its contents such as health education, self-management, video education, and postural education. The high methodological quality of the studies revealed that patient education showed improvement in terms of pain, disability and quality of life among older people with LBP.
CONCLUSIONS: Patient education improved pain and had positive effects on disability and quality of life among older people with LBP. However, due to the limited number of RCTs more studies are needed to provide evidence for its effectiveness.

Matched MeSH terms: Low Back Pain/psychology
Fulltext Predictors of low back pain among secondary school teachers in Malaysia: a longitudinal study

Zamri EN, Hoe VCW, Moy FM

Ind Health, 2020 Jun 09;58(3):254-264.
PMID: 31666460 DOI: 10.2486/indhealth.2019-0106

Low back pain (LBP) is prevalent among workers both in developed and developing countries. School teachers represent a high proportion of the working population in Malaysia. However, there is a lack of longitudinal study on predictors and course of LBP among teachers. Therefore, this study aimed to determine the predictors and course of LBP among secondary school teachers. Longitudinal data of 701 teachers in Selangor, Malaysia were collected from May 2015 to October 2016. Associations between predictors and LBP were analysed using logistic regression and reported as odds ratio (OR) and 95% confidence interval (CI). At 12-month of follow-up, 44% (95%CI: 40.6%, 48.0%) of the participants reported having LBP. In the regression model that included all risk factors, only LBP at baseline (OR 10.43, 95%CI: 6.19, 17.58) was associated with LBP at 12-month follow-up. When LBP at baseline was removed from the model, anxiety symptom (OR 2.51, 95%CI: 1.19, 5.30) and lifting heavy weights (OR 4.16, 95%CI: 1.40, 12.30) were found to be significantly associated with LBP at 12-month follow-up. In conclusion, issues on anxiety and lifting heavy weights should be addressed to reduce the occurrence of LBP despite the presence of health condition itself (LBP at baseline).

Matched MeSH terms: Low Back Pain/psychology
Prevalence and associations of neuropathic pain in a cohort of multi-ethnic Asian low back pain patients

Kew Y, Tan CY, Ng CJ, Thang SS, Tan LH, Khoo YK, et al.

Rheumatol Int, 2017 Apr;37(4):633-639.
PMID: 28013358 DOI: 10.1007/s00296-016-3633-x

The prevalence of neuropathic low back pain differs in different ethnic populations. The aims of the study are to determine its frequency and associations in a multi-ethnic cohort of Asian low back pain patients. This was a cross-sectional study of low back patients seen at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Neuropathic low back pain patients were identified using the painDETECT questionnaire and compared with non-neuropathic (unclear or nociceptive) low back pain patients, in terms of socio-demographic and clinical factors, pain severity (numerical pain rating scale, NPRS), disability (Roland Morris Disability Questionnaire, RMDQ), as well as anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Of 210 patients, 26 (12.4%) have neuropathic low back pain. Neuropathic pain is associated with non-Chinese ethnicity, higher body mass index and pain radiation below the knee. Patients with neuropathic pain have significantly higher NPRS and RMDQ scores, and there are more subjects with anxiety on HADS. However, there are no differences between the groups in age, gender, pain duration or underlying diagnosis of low back pain. The prevalence of neuropathic low back pain in a multi-ethnic Malaysian cohort is lower than previously reported in other populations with possible differences between ethnic groups. It is associated with greater pain severity, disability and anxiety.
Study site: Spine Clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Low Back Pain/psychology
Fulltext Psycho-behavioural risks of low back pain in railway workers

Ganasegeran K, Perianayagam W, Nagaraj P, Al-Dubai SA

Occup Med (Lond), 2014 Jul;64(5):372-5.
PMID: 24727561 DOI: 10.1093/occmed/kqu039

BACKGROUND:
Low back pain (LBP) is the most costly ailment in the work force. Risky work behaviour and psychological stress are established risk factors.

AIMS:
To explore the associations between workplace risk factors, psychological stress and LBP among Malaysian railway workers.

METHODS:
A cross-sectional study was carried out on railway workers in Malaysia. Socio-demographics, workplace risk factors for LBP, perceived psychological stress and history of LBP over the previous month were obtained by direct interviews using a structured closed-ended questionnaire. Descriptive, bivariate and logistic regression analyses were conducted.

RESULTS:
There were 513 study participants (70% response rate). The prevalence of LBP in the previous month was 69%. Multivariate analysis yielded four significant predictors of LBP: employment of ≥ 10 years, lifting and lowering heavy loads, prolonged standing posture and psychological stress.

CONCLUSIONS:
The high prevalence of LBP and its significant associations with physical and psychological stress factors in railway workers points to an urgent need for preventive measures, particularly among workers in high-risk occupations.

Matched MeSH terms: Low Back Pain/psychology
The Association between risk factors and low back pain among commercial vehicle drivers in peninsular Malaysia: a preliminary result

Tamrin SB, Yokoyama K, Jalaludin J, Aziz NA, Jemoin N, Nordin R, et al.

Ind Health, 2007 Apr;45(2):268-78.
PMID: 17485871

To determine the risk factors associated with complain of low back pain. A cross sectional study was done from June 2004 until August 2005. Seven hundred and sixty commercial vehicle drivers from 11 bus companies in central, northern and eastern regions in Malaysia participated in this study. Modified Nordic questionnaire was used to determine the prevalence of low back pain; Maestro human vibration meter was used to measure the personal R.M.S values of lateral, anterior-posterior and vertical axes. Modified Owas was used to assess the awkward posture of the driver torso namely, bending forward movement, leaning, sitting straight and twisting. Profile of Mood States (POMS) was used to evaluate the mood states of bus drivers with complain of low back pain. A high prevalence of low back pain (60.4%) among Malaysian commercial vehicle drivers was found. Logistic regression analysis controlling for age, income, education level and non occupational activities revealed that the following factors were related to low back pain: Tension-anxiety [1.080, 95% CI 1.041-1.121], depression dejection [1.047, 95% CI 1.023-1.072], anger-hostility [1.053, 95% CI 1.027-1.081], fatigue [1.132, 95% CI 1.089-1.177] and confusion [1.114, 95% CI 1.061-1.169] of POMS, length of employment [1.001, 95% CI 1.0-1.003], steering wheel adjustment [1.521, 95% CI 1.101-2.101], perception of exposing to vibration [1.943, 95% CI 1.389-2.719]. In conclusion, combinations of risks lead to high increase of low back pain complain among Malaysian bus drivers.

Matched MeSH terms: Low Back Pain/psychology
Differences in psychological factors, disability and fatigue according to the grade of chronification in non-specific low back pain patients: A cross-sectional study

Adnan R, Van Oosterwijck J, Danneels L, Willems T, Meeus M, Crombez G, et al.

J Back Musculoskelet Rehabil, 2020;33(6):919-930.
PMID: 33016899 DOI: 10.3233/BMR-191548

BACKGROUND: Differences in pain processing, muscle structure and function have been reported in patients with low back pain (LBP) with different grades of pain chronicity.
OBJECTIVE: The present study aims to examine differences in psychological factors, disability and subjective fatigue between subgroups of LBP based on their chronification grade.
METHODS: Twenty-one healthy controls (HC) and 54 LBP patients (categorized based on the grades of chronicity into recurrent LBP (RLBP), non-continuous chronic LBP (CLBP), or continuous (CLBP)) filled out a set of self-reporting questionnaires.
RESULTS: The Hospital Anxiety and Depression Scale (HADS) and Multidimensional Pain Inventory (MPI) scores indicated that anxiety, pain severity, pain interference and affective distress were lower in HC and RLBP compared to non-continuous CLBP. Anxiety scores were higher in non-continuous CLBP compared to RLBP, continuous CLBP and HC. The Pain Catastrophizing Scale for Helplessness (PSCH) was higher in non-continuous CLBP compared to HC. The Survey of Pain Attitudes (SOPA) showed no differences in adaptive and maladaptive behaviors across the groups. The Pain Disability Index (PDI) measured a higher disability in both CLBP groups compared to HC. Moreover, the Rolland Morris Disability Questionnaire (RMDQ) showed higher levels of disability in continuous CLBP compared to non-continuous CLBP, RLBP and HC. The Checklist Individual Strength (CIS) revealed that patients with non-continuous CLBP were affected to a higher extent by severe fatigue compared to continuous CLBP, RLBP and HC (subjective fatigue, concentration and physical activity). For all tests, a significance level of 0.05 was used.
CONCLUSIONS: RLBP patients are more disabled than HC, but have a tendency towards a general positive psychological state of mind. Non-continuous CLBP patients would most likely present a negative psychological mindset, become more disabled and have prolonged fatigue complaints. Finally, the continuous CLBP patients are characterized by more negative attitudes and believes on pain, enhanced disability and interference of pain in their daily lives.

Matched MeSH terms: Low Back Pain/psychology