METHODS: Participants (N=142) in this randomized controlled trial were office workers aged 20-50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention.
RESULTS: There was significant differences in pain scores for neck (MD -10.55; 95%CI -14.36 to -6.74), right shoulder (MD -12.17; 95%CI -16.87 to -7.47), left shoulder (MD -11.1; 95%CI -15.1 to -7.09) and lower back (MD -7.8; 95%CI -11.08 to -4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD -9.99; 95%CI -13.63 to -6.36), right shoulder (MD -11.12; 95%CI -15.59 to -6.65), left shoulder (MD -10.67; 95%CI -14.49 to -6.85) and lower back (MD -6.87; 95%CI -10 to -3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p<0.05).
CONCLUSION: To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification.
CLINICAL TRIAL ID: NCT02874950 - https://www.clinicaltrials.gov/ct2/show/NCT02874950.
METHODS: A within-subject, repeated-measures, crossover randomized controlled design was conducted among 25 participants (7 males and 18 females) with chronic nonspecific low back pain. All the participants received 3 different types of experimental interventions, which included LPST, the passive automated cycling intervention, and the control intervention randomly, with 48 hours between the sessions. The pressure pain threshold (PPT), hot-cold pain threshold, and pain intensity were estimated before and after the interventions.
RESULTS: Repeated-measures analysis of variance showed that LPST provided therapeutic effects as it improved the PPT beyond the placebo and control interventions (P < 0.01). The pain intensity under the LPST condition was significantly better than that under the passive automated cycling intervention and controlled intervention (P < 0.001). Heat pain threshold under the LPST condition also showed a significant trend of improvement beyond the control (P < 0.05), but no significant effects on cold pain threshold were evident.
CONCLUSIONS: Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain.
OBJECTIVES: The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites SUMMARY OF BACKGROUND DATA.: Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain.
METHODS: We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries.
RESULTS: Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group.
CONCLUSION: Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations.
LEVEL OF EVIDENCE: 2.