An update on the understanding article: 68th Annual Meeting
of the American Academy of Orthopaedic Surgeons. The question is
whether the found relation is/was very substantial (RR=1.25 for self
reported LBP and RR=1.85 for "spondylosis"), but still the conclusion of the
understanding article has been contradicted now.
To: "PHYSIO - for physiotherapists in education and practice" <[log in to unmask]>
Sent: donderdag 10 mei 2001 16:31
Subject: Re: Re: Low back pain and smoking
Dear Pete,
This is the abstract of the article Paul
mentioned:
______________________________________
A Review of the
Association Between Cigarette Smoking and the Development of Nonspecific Back
Pain and Related Outcomes
Mark S. Goldberg, PhD; Susan C. Scott, MSc;
Nancy E. Mayo, PhD
From the *Epidemiology and Biostatistics Unit,
Research Centre on Human Health, INRS-Institut Armand-Frappier, University of
Quebec, Laval, Quebec; the ?Department of Epidemiology, Biostatistics and
Occupational Health and the §Department of Medicine, McGill University,
Montreal, Quebec; and the ?Department of Clinical Epidemiology, Division of
Medicine, The Royal Victoria Hospital, McGill University Montreal, Quebec,
Canada.
Study
Design. A structured review of the epidemiologic literature was performed.
Thirty-eight studies published in peer-reviewed journals were reviewed. The
methodologic strengths and weaknesses of the studies were described and
assessed qualitatively. Four studies were excluded because of difficulties in
design or interpretation.
Objectives. To provide a systematic analysis of
the literature to assess the evidence as to whether smoking is associated
with the prevalence and incidence of nonspecific back pain and related
outcomes.
Summary of Background Data. Evidence has been gathering
regarding the association of smoking with nonspecific back pain and other
back disorders, but a comprehensive summary and evaluation of the data have
not been published.
Results. Positive associations between current
smoking and nonspecific back pain were found in 18 of 26 studies in men and
18 of 20 studies in women. For sciatica and herniated discs, there were four
of eight and one of five positive studies in men and women, respectively. The
majority of these studies were cross-sectional (18 in men and 16 in women),
with only a handful of prospective studies. Positive associations between
past smoking and nonspecific back pain were reported in five of nine studies
in men and five of six studies in women. In addition, increases in the
prevalence and/or incidence of nonspecific back pain were found in the
majority of studies in which level of consumption was analyzed and reported.
An attempt was made to assess whether these results could be artifactual
arising from selection bias, confounding bias, publication bias, or errors
in measurement. As well, the biologic mechanisms were summarized that have
been suggested by various investigators.
Conclusions. The available
data are consistent with the notion that smoking is associated with the
incidence and prevalence of nonspecific back pain, but there are too few
studies to make any conclusions for the other end points (e.g., sciatica,
herniated discs). It cannot be ruled out that the association is a
statistical artefact arising from either selection or confounding factors,
because the evidence for nonspecific low back pain derives mostly from
cross-sectional studies. In addition, it cannot be stated unequivocally that
smoking preceded back pain. Long-term follow-up studies are needed to
eliminate the possibility that chronic back pain preceded smoking, to better
estimate dose-response correlations, and to perform biologic measurements to
elucidate possible
mechanisms.
___________________________________
R., Frank
Conijn
----- Original Message ----- From: "pauen" <[log in to unmask]> To: <[log in to unmask]> Sent:
donderdag 10 mei 2001 15:51 Subject: Re: Low back pain and
smoking
Goldberg et al published a review on the association of low
back pain and smoking in Spine 2000, vol 25, no 8, pp995-1014. Hope this will
be of some interest for you.
I have another question: I have heard
that physical measures, e.g. range of motion in neck or low back patients,
can be a (partial) measure for compensation/insurance rates in the USA. Is
this (still) true?
sincerely
Paul Enthoven Department of
Neuroscience and Locomotion: Div of
Physiotherapy, HU-kansliet Faculty of Health Sciences, Linköpings
Universitet SE-581 85 Linköping tel +46 13 221792 fax +46 13
221706
