| Clinical presentation of low back pain and association with risk factors according to findings on magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 21514999 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We hypothesised that the relative importance of physical and psychological risk factors for mechanical low back pain (LBP) might differ importantly according to whether there is underlying spinal pathology, psychological risk factors being more common in patients without demonstrable pathology. If so, epidemiological studies of LBP could benefit from tighter case definitions. To test the hypothesis, we used data from an earlier case-control study on patients with mechanical LBP who had undergone magnetic resonance imaging (MRI) of the lumbosacral spine. MRI scans were classified for the presence of high-intensity zone (HIZ), disc degeneration, disc herniation, and nerve root displacement/compression. Information about symptoms and risk factors was elicited by postal questionnaire. Logistic regression was used to assess associations of MRI abnormalities with symptoms and risk factors, which were characterised by odds ratios (ORs) and 95% confidence intervals (CIs). Among 354 patients (52% response), 306 (86.4%) had at least 1, and 63 (17.8%) had all 4 of the MRI abnormalities. Radiation of pain below the knee (280 patients) and weakness or numbness below the knee (257 patients) were both associated with nerve root deviation/compression (OR 2.5, 95% CI 1.4 to 4.5; and OR 1.8, 95% CI 1.1 to 3.1, respectively). However, we found no evidence for the hypothesised differences in risk factors between patients with and without demonstrable spinal pathology. This suggests that when researching the causes and primary prevention of mechanical LBP, there may be little value in distinguishing between cases according to the presence or absence of the more common forms of potentially underlying spinal pathology. In patients with low back pain investigated by magnetic resonance imaging, absence of demonstrable spinal pathology was not associated differentially with psychological risk factors. |
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Authors:
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James Shambrook; Philip McNee; E Clare Harris; Miranda Kim; Madeleine Sampson; Keith T Palmer; David Coggon |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-22 |
Journal Detail:
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Title: Pain Volume: - ISSN: 1872-6623 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7508686 Medline TA: Pain Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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Southampton University Hospitals NHS Trust, Southampton, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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