Occupational Risks for Low Back Pain versus Risks for Specific Lumbar Disc Diseases: German Lumbar Spine Study (EPILIFT)

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Occupational Risks for Low Back Pain versus Risks for Specific Lumbar Disc Diseases: German Lumbar Spine Study (EPILIFT)
Key Take-Away: 

Low back pain is a painful condition that mainly affects the lower portion of the spine and is majorly induced by occupational factors. However, not all diseases which involve lower back pain such as Lumbar Disc Diseases are affected by the same kind of occupational factors. This study interpreted the differences in the physical workplace factors of structural lumbar disc diseases and low back pain.

Low back pain is a very common health problem worldwide and a major cause of disability, affecting performance at work and general well-being. 

ABSTRACT: 
Background: 

Low back pain is a very common health problem worldwide and a major cause of disability, affecting performance at work and general well-being.

Worldwide, 37% of LBP has been estimated to be caused by occupational factors. The present analysis aimed to clarify potential differences in the "occupational risk profiles" of structural lumbar disc diseases vs. low back pain (LBP). These physical workplace factors seem to play an important aetiological role.

Methods: 

This was a multicenter population-based case-control study. 901 patients with structural lumbar disc diseases (disc herniation or severe disc space narrowing) and 233 controls with low back pain were recruited. Both groups were compared with 422 low-back pain-free control patients.

Case history, pain data, neurological deficits and movement restrictions were documented. Low back pain was recorded by the Nordic questionnaire on musculoskeletal symptoms. All MRI, CT, and X-rays were inspected by an independent study radiologist. The calculation of cumulative physical workload was based on a computer-assisted interview and a biomechanical analysis by the 3D-dynamic simulation tool. Occupational exposures were documented for the whole working life.

Results: 

A positive dose-response relationship between cumulative lumbar load and low back pain among men was reported; however, the same was not the case among women.

Physical, occupational risks for structural lumbar disc diseases (OR 3.7; CI 2.3-6.0) are higher than for LBP (OR 1.9; 95% CI 1.0-3.5).

Conclusion: 

Study finding points to potentially different aetiological pathways in the heterogeneous disease group of LBP. Results suggest that not all of the structural disc damage arising from physical workload leads to LBP.

 

Source:

Spine (Phila Pa 1976). 2017 Jun 27

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28658034

The original title of the article:

Do occupational Risks for Low Back Pain Differ from Risks for Specific Lumbar Disc Diseases? Results of the German Lumbar Spine Study (EPILIFT)

Authors:

Bergmann A; et al.

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