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Daily Archives: February 7, 2017

Individual Courses of Low Back Pain in Adult Danes

By |February 7, 2017|Low Back Pain|

Individual Courses of Low Back Pain in Adult Danes: A Cohort Study with 4-Year and 8-Year Follow-up

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SOURCE:   BMC Musculoskelet Disord. 2017 (Jan 21); 18 (1): 28

Per Kjaer, Lars Korsholm, Charlotte Leboeuf-Yde,
Lise Hestbaek and Tom Bendix

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
Campusvej 55, DK-5230,
Odense M, Denmark.


BACKGROUND: &nbsp Few longitudinal studies have described the variation in LBP and its impact over time at an individual level. The aims of this study were to:

1)   determine the prevalence of LBP in three surveys over a 9-year period in the Danish general population, using five different definitions of LBP,

2)   study their individual long-term courses, and

3)   determine the odds of reporting subsequent LBP when having reported previous LBP.

METHODS: &nbsp A cohort of 625 men and women aged 40 was sampled from the general population. Questions about LBP were asked at ages 41, 45 and 49, enabling individual courses to be tracked across five different definitions of LBP. Results were reported as percentages and the prognostic influence on future LBP was reported as odds ratios (OR).

RESULTS: &nbsp Questionnaires were completed by 412 (66%), 348 (56%) and 293 (47%) persons respectively at each survey. Of these, 293 (47%) completed all three surveys. The prevalence of LBP did not change significantly over time for any LBP past year: 69, 68, 70%; any LBP past month: 42, 48, 41%; >30 days LBP past year: 25, 27, 24%; seeking care for LBP past year: 28, 30, 36%; and non-trivial LBP, i.e. LBP >30 days past year including consequences: 18, 20, 20%. For LBP past year, 2/3 remained in this category, whereas four out of ten remained over the three time-points for the other definitions of LBP. Reporting LBP defined in any of these ways significantly increased the odds for the same type of LBP 4 years later. For those with the same definition of LBP at both 41 and 45 years, the risk of also reporting the same at 49 years was even higher, regardless of definition, and most strongly for seeking care and non-trivial LBP (OR 17.6 and 18.4) but less than 11% were in these groups.

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Australian study indicates common painkillers ineffective for back pain

By |February 7, 2017|NSAIDs|

Commonly used non-steroidal anti-inflammatory drugs used to treat back pain provide little benefit and may make things worse according to new research from The George Institute for Global Health.

The findings of the systematic review, published in the Annals of the Rheumatic Diseases, reveal only one in six patients treated with the pills, also known as NSAIDs, achieve any significant reduction in pain.

The study is the latest work from The George Institute questioning the effectiveness of existing medicines for treating back pain. Earlier research has already demonstrated paracetamol does not speed recovery or reduce pain for acute low back pain, and opioids provide minimal benefit over placebo.

Lead author Associate Professor Manuela Ferreira says the study highlights an urgent need to develop new therapies to treat back pain which affects 80 per cent of Australians during their lifetime.

A/Prof Ferreira, Senior Research Fellow at The George Institute and at the Institute of Bone and Joint Research, said: “Back pain is the leading cause of disability worldwide and is commonly managed by prescribing medicines such as anti-inflammatories. But our results show anti-inflammatory drugs actually only provide very limited short term pain relief. They do reduce the level of pain, but only very slightly, and arguably not of any clinical significance.”

A/Prof Ferreira added: “When you factor in the side effects which are very common, it becomes clear that these drugs are not the answer to providing pain relief to the many millions of Australians who suffer from this debilitating condition every year.”

The team at The George Institute, which examined 35 trials involving more than 6000 people, also found patients taking anti-inflammatories were 2.5 times more likely to suffer from gastro-intestinal problems such as stomach ulcers and bleeding.

Research Fellow Gustavo Machado, of The George Institute and the School of Medicine at the University of Sydney, said: “Millions of Australians are taking drugs that not only don’t work very well, they’re causing harm. We need treatments that will actually provide substantial relief of these people’s symptoms.

“Better still we need a stronger focus on preventing back pain in the first place. We know that education and exercise programs can substantially reduce the risk of developing low back pain.”

Most clinical guidelines currently recommend NSAIDs as the second line analgesics after paracetamol, with opioids coming at third choice.