Epidemiological Differences Between Localized and Nonlocalized Low Back Pain.
METHODS
A cross-sectional survey with a longitudinal follow-up.


OBJECTIVE
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.


CONCLUSIONS
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.


METHODS
2.
Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
David
D
Coggon
Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Georgia
G
Ntani
Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Karen
K
Walker-Bone
Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Keith T
KT
Palmer
School of Nursing, University of São Paulo, São Paulo, Brazil.
Vanda E
VE
Felli
Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral - IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
Raul
R
Harari
Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia.
Lope H
LH
Barrero
Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX.|Center for Disease Control and Prevention/National Institute for Occupational Safety and Health, Atlanta, GA.
Sarah A
SA
Felknor
Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX.
David
D
Gimeno
North East London NHS Foundation Trust, Goodmayes Hospital, Ilford, Essex, UK.
Anna
A
Cattrell
Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
Sergio
S
Vargas-Prada
Epidemiology and Preventive Medicine Research Centre, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
Matteo
M
Bonzini
Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece.
Eleni
E
Solidaki
Institute of Technology, Estonian University of Life Sciences, Tartu, Estonia.
Eda
E
Merisalu
Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Rima R
RR
Habib
Department of Occupational Health, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
Farideh
F
Sadeghian
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
M Masood
MM
Kadir
Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayawardenepura, Gangodawila, Nugegoda, Sri Lanka.
Sudath Sp
SS
Warnakulasuriya
Department for Medical Research and Management for Musculoskeletal Pain, 22 Century Medical and Research Center, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Ko
K
Matsudaira
National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.|Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Busisiwe
B
Nyantumbu
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Malcolm R
MR
Sim
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Helen
H
Harcombe
Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Ken
K
Cox
Federal University of Paraná, Curitiba-PR, Brazil.
Leila M M
LMM
Sarquis
School of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Maria H
MH
Marziale
Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral - IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
Florencia
F
Harari
Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral - IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
Rocio
R
Freire
Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral - IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
Natalia
N
Harari
Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia.
Magda V
MV
Monroy
Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia.
Leonardo A
LA
Quintana
Program Health, Work and Environment in Central America, Institute for Studies on Toxic Substances (IRET), National University of Costa Rica, Heredia, Costa Rica.
Marianela
M
Rojas
Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Elizabeth Clare
EC
Harris
Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.|Occupational Health Service, Parc de Salut MAR, Barcelona, Spain.
Consol
C
Serra
Servicio de Investigación y Análisis IT/EP, Departamento de Investigación y Análisis de Prestaciones, MC Mutual, Barcelona, Spain.
José Miguel
JM
Martinez
Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX.|Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
George
G
Delclos
Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
Fernando G
FG
Benavides
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Michele
M
Carugno
Epidemiology and Preventive Medicine Research Centre, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
Marco M
MM
Ferrario
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.|Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Angela C
AC
Pesatori
Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece.
Leda
L
Chatzi
Department of Psychiatry, Medical School, University of Crete, Heraklion, Greece.
Panos
P
Bitsios
CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.|Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Manolis
M
Kogevinas
North Estonia Medical Centre, Tallinn, Estonia.
Kristel
K
Oha
Tartu University Hospital, Tartu, Estonia.
Tiina
T
Freimann
Klinikum Leverkusen, Leverkusen, Germany.
Ali
A
Sadeghian
Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.|Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Roshini J
RJ
Peiris-John
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
Nalini
N
Sathiakumar
Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
A Rajitha
AR
Wickremasinghe
Department of Joint Disease Research, 22 Century Medical and Research Center, University of Tokyo, Tokyo, Japan.
Noriko
N
Yoshimura
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Helen L
HL
Kelsall
Centre for Occupational and Environmental Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Victor C W
VCW
Hoe
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Donna M
DM
Urquhart
Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Sarah
S
Derrett
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
David
D
McBride
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Peter
P
Herbison
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Andrew
A
Gray
Health Safety and Environment Department, AkzoNobel, Houston, TX.
Eduardo J
EJ
Salazar Vega
D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012727:Sex Characteristics; D011795:Surveys and Questionnaires