title: Do incontinence, breathing difficulties, and gastrointestinal symptoms increase the risk of future back pain?
abstract: Cross-sectional studies have suggested a relationship between respiratory disorders, incontinence, gastrointestinal symptoms, and back pain. However, longitudinal data are lacking. This study aimed to evaluate whether these disorders increase risk for the development of back pain. A total of 2943 younger, 2298 mid-age, and 2258 older women from the Australian Longitudinal Study on Women's Health who reported no back pain during the preceding 12 months were followed for 4, 2, and 3 years, respectively. Crude and adjusted associations between the development of back pain and changes in the presence of incontinence, breathing difficulty, and gastrointestinal symptoms were assessed with logistic regression. Women with preexisting incontinence (prevalence ratios [PR]: 1.26 to 1.46) and gastrointestinal symptoms (PR: 1.24 to 1.44) and women who developed breathing problems (PR: 1.63 to 2.11) were more likely to develop back pain than women without such problems. Menstrual pain and allergy were also associated with back pain development. Consistent with predictions from physiological data, this study provides novel evidence that the presence and/or development of incontinence, respiratory problems, and gastrointestinal symptoms are associated with the development of back pain. This highlights the importance of comorbidities and suggests opportunities for future preventative interventions.
  
  
  CONCLUSIONS
  This study demonstrates that women with incontinence, respiratory disorders, and gastrointestinal symptoms have increased risk for the development of back pain. Evidence of compromised control of the spine in people with incontinence and respiratory disorders and the potential for viscerosomatic hyperalgesia in people with gastrointestinal symptoms may provide physiological explanations for these findings.
authors.affiliation: Clinical Centre of Research Excellence, Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia. m.smith5@uq.edu.au
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Smith
authors.forename: Anne
authors.initials: A
authors.lastname: Russell
authors.forename: Paul W
authors.initials: PW
authors.lastname: Hodges
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000368:Aged; D001416:Back Pain / Q000453:epidemiology*; D004412:Dysmenorrhea / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D015995:Prevalence; D012120:Respiration Disorders / Q000453:epidemiology*; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology*; D055815:Young Adult