Special Issue "Low Back Pain (LBP)"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Occupational Safety and Health".

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editors

Prof. Dr. Vincenzo Denaro
E-Mail Website
Guest Editor
Orthopaedics and Traumatology Unit, Campus Bio-Medico University, Via Álvaro del Portillo, 21, 00128 Roma RM, Italy
Interests: spine; orthopedic and trauma surgery; sports medicine; joint replacement
Prof. Dr. Sergio Iavicoli
E-Mail Website
Guest Editor
Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL—Italian Workers’ Compensation Authority, Monte Porzio Catone, 00078 Rome, Italy
Interests: occupational health and safety; public health; occupational risks; risk assessment; evaluation of interventions; work-related stress
Special Issues and Collections in MDPI journals
Dr. Fabrizio Russo
E-Mail Website
Guest Editor
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy
Interests: spine; spine surgery; musculoskeletal system; orthopedic and trauma surgery; cartilage; osteoarthritis; joint reconstruction and replacement; tissue regeneration; stem cells
Dr. Gianluca Vadalà
E-Mail Website
Guest Editor
Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy
Interests: spine biomechanics; intervertebral disc; sport medicine; knee; tissue regeneration; mesenchymal stem cells

Special Issue Information

Dear Colleagues,

We are pleased to announce a new Special Issue on “Low Back Pain”, which we are editing on the International Journal of Environmental Research and Public Health.

Low back pain (LBP) is s a major public health problem, being the most commonly-reported musculoskeletal disorder (MSD) and the leading cause of compromised quality of life, work absenteeism, and chronic disability worldwide. Indeed, LBP is the leading worldwide cause of years lost to disability, and its burden is growing alongside the increasing and aging population. Moreover, LBP is reported by more patients and has a higher impact in the workforce than any other MSD and most other clinical conditions.

Despite the vast amount of research on the management of LBP, the etiology, pathogenesis, and occupational risk factors are still not fully understood. It is crucial to give a stronger focus to reducing the consequences of LBP, as well as preventing its onset. Primary prevention at the occupational level remains important for highly exposed groups. Therefore, it is essential to identify which treatment options and workplace-based intervention strategies are effective in increasing participation at work and encouraging early return-to-work to reduce personal and socioeconomic consequences of LBP. Moreover, the role of workers’ compensation on patient outcomes is not fully explored. 

The present Special Issue offers a unique opportunity to update many of the recent advances and perspectives of this health problem. A number of topics will be covered in order to attract high-quality research papers, including but not limited to the following major areas: prevalence and epidemiological data, etiology, prevention, assessment and treatment approaches, and health promotion strategies for LBP. We hope to receive a wide range of submissions, including research on the physical, psychosocial, environmental, and occupational perspectives, also focused on workplace interventions.

We are delighted with the initiative by the International Journal of Environmental Research and Public Health to launch this Special Issue. We invite all experts in the field—clinicians and researchers—around the world to submit their work for consideration in this Special Issue. Manuscript formats can vary from literature reviews (systematic literature reviews and meta-analyses or narrative reviews) to original research (clinical trials, cohort studies, experimental lab work, case-control studies). We particularly welcome multidisciplinary contributions, studies with strong implications for practice, and papers reporting occupational health interventions.

Prof. Dr. Vincenzo Denaro

Prof. Dr. Sergio Iavicoli

Dr. Fabrizio Russo

Dr. Gianluca Vadalà

Guest Editors

Published Papers (6 papers)

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Research

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Article
Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults
Int. J. Environ. Res. Public Health 2021, 18(14), 7246; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147246 - 06 Jul 2021
Viewed by 533
Abstract
Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of [...] Read more.
Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of chronic low back pain among a sample of underserved urban African American and Latino older adults. Controlling for age, gender, race/ethnicity, education, living arrangement, and number of major chronic conditions, associations between low back pain and the following outcome variables are examined: (1) healthcare utilization, (2) health-related quality of life (HR-QoL) and self-rated quality of health; and (3) physical and mental health outcomes. Methods: We recruited nine hundred and five (905) African American and Latino older adults from the South Los Angeles community using convenience and snowball sampling. In addition to standard items that measure demographic variables, our survey included validated instruments to document HR-QoL health status, the Short-Form McGill Pain Questionnaire-2, Geriatric Depression Scale, sleep disorder, and healthcare access. Data analysis includes bivariate and 17 independent multivariate models. Results: Almost 55% and 48% of the Latino and African American older adults who participated in our study reported chronic low back pain. Our data revealed that having low back pain was associated with three categories of outcomes including: (1) a higher level of healthcare utilization measured by (i) physician visits, (ii) emergency department visits, (iii) number of Rx used, (iv) a higher level of medication complexity, (v) a lower level of adherence to medication regimens, and (vi) a lower level of satisfaction with medical care; (2) a lower level of HR-QoL and self-assessment of health measured by (i) physical health QoL, (ii) mental health QoL, and (iii) a lower level of self-rated health; and (3) worse physical and mental health outcomes measured by (i) a higher number of depressive symptoms, (ii) a higher level of pain, (iii) falls, (iv) sleep disorders, (v) and being overweight/obese. Discussion: Low back pain remains a public health concern and significantly impacts the quality of life, health care utilization, and health outcomes of underserved minority older adults. Multi-faceted and culturally sensitive interventional studies are needed to ensure the timely diagnosis and treatment of low back pain among underserved minority older adults. Many barriers and challenges that affect underserved African American and Latino older adults with low back pain simply cannot be addressed in over-crowded EDs. Our study contributes to and raises the awareness of healthcare providers and health policymakers on the necessity for prevention, early diagnosis, proper medical management, and rehabilitation policies to minimize the burdens associated with chronic low back pain among underserved older African American and Latino patients in an under-resourced community such as South Los Angeles. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
Article
Influence of Stabilization Techniques Used in the Treatment of Low Back Pain on the Level of Kinesiophobia
Int. J. Environ. Res. Public Health 2021, 18(12), 6393; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126393 - 13 Jun 2021
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Abstract
The aim of this study was to try to compare the effectiveness of manual therapy techniques in combination with stabilization techniques: the so-called Australian method and the Neurac method in relation to pain sensations and the level of kinesiophobia. A total of 69 [...] Read more.
The aim of this study was to try to compare the effectiveness of manual therapy techniques in combination with stabilization techniques: the so-called Australian method and the Neurac method in relation to pain sensations and the level of kinesiophobia. A total of 69 people were examined, divided into three groups of 23 people each. The Visual Analogue Scale was used to assess the antalgic effect, and the Kinesiophobia Causes Scale questionnaire was used to assess the level of kinesiophobia. Patients improved over four weeks, during which they were assessed three times. The evaluation of the desired parameters was also performed over a 24-week period to assess long-term performance. Stabilization techniques are an effective extension of manual therapy techniques in patients with low back pain. People in the groups additionally improved in terms of stabilization techniques, which are characterized by a lower level of kinesiophobia. Its lowest level was found in the group additionally improved with the Neurac method. In the long-term study, the level of kinesiophobia in this group was still maintained at a reduced level. The use of stabilization techniques involving patients in action may significantly affect the level of kinesiophobia, and thus have a much wider effect than just pain reduction. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
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Article
Seasonality of Back Pain in Italy: An Infodemiology Study
Int. J. Environ. Res. Public Health 2021, 18(3), 1325; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031325 - 01 Feb 2021
Viewed by 825
Abstract
Background: E-health tools have been used to assess the temporal variations of different health problems. The aim of our infodemiology study was to investigate the seasonal pattern of search volumes for back pain in Italy. Methods: In Italian, back pain is indicated by [...] Read more.
Background: E-health tools have been used to assess the temporal variations of different health problems. The aim of our infodemiology study was to investigate the seasonal pattern of search volumes for back pain in Italy. Methods: In Italian, back pain is indicated by the medical word “lombalgia”. Using Google Trends, we selected the three search terms related to “lombalgia” with higher relative search volumes (RSV), (namely, “mal di schiena”, “dolore alla schiena” and “dolore lombare”), representing the semantic preferences of users when performing web queries for back pain in Italy. Wikipedia page view statistics were used to identify the number of visits to the page “lombalgia”. Strength and direction of secular trends were assessed using the Mann–Kendall test. Cosinor analysis was used to evaluate the potential seasonality of back pain-related RSV. Results: We found a significant upward secular trend from 2005 to 2020 for search terms “mal di schiena” (τ = 0.734, p < 0.0001), “dolore alla schiena” (τ = 0.713, p < 0.0001) and “dolore lombare” (τ = 0.628, p < 0.0001). Cosinor analysis on Google Trends RSV showed a significant seasonality for the terms “mal di schiena” (pcos < 0.001), “dolore alla schiena” (pcos < 0.0001), “dolore lombare” (pcos < 0.0001) and “lombalgia” (pcos = 0.017). Cosinor analysis performed on views for the page “lombalgia” in Wikipedia confirmed a significant seasonality (pcos < 0.0001). Both analyses demonstrated a peak of interest in winter months and decrease in spring/summer. Conclusions: Our infodemiology approach revealed significant seasonal fluctuations in search queries for back pain in Italy, with peaking volumes during the coldest months of the year. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
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Article
What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2020, 17(19), 7104; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197104 - 28 Sep 2020
Cited by 1 | Viewed by 939
Abstract
This study examines demographic, physical and psychosocial factors associated with an increase in low back pain (LBP) during a one-hour standing task. A cross-sectional survey with 40 office workers was conducted. The primary outcome was pain severity during a one-hour standing task recorded [...] Read more.
This study examines demographic, physical and psychosocial factors associated with an increase in low back pain (LBP) during a one-hour standing task. A cross-sectional survey with 40 office workers was conducted. The primary outcome was pain severity during a one-hour standing task recorded every 15 min using a 100 mm Visual Analogue Scale (VAS). Participants were defined as pain developers (PD), if they reported a change in pain of ≥10 mm from baseline, or non-pain developers (NPD). Physical outcomes included participant-rated and examiner-rated trunk and hip motor control and endurance. Self-report history of LBP, physical activity, psychosocial job characteristics, general health and pain catastrophising were collected. Fourteen participants were PD. Hip abduction, abdominal and spinal muscle endurance was lower for PD (p ≤ 0.05). PD had greater self-reported difficulty performing active hip abduction and active straight leg raise tests (p ≤ 0.04). Those reporting a lifetime, 12 month or 7-day history of LBP (p < 0.05) and lower self-reported physical function (p = 0.01) were more likely to develop LBP during the standing task. In conclusion, a history of LBP, reduced trunk and hip muscle endurance and deficits in lumbopelvic/hip motor control may be important to consider in office workers experiencing standing-induced LBP. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
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Review

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Review
Does Workers’ Compensation Status Affect Outcomes after Lumbar Spine Surgery? A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2021, 18(11), 6165; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116165 - 07 Jun 2021
Viewed by 681
Abstract
Low back pain (LBP) is currently the leading cause of disability worldwide and the most common reason for workers’ compensation (WC) claims. Studies have demonstrated that receiving WC is associated with a negative prognosis following treatment for a vast range of health conditions. [...] Read more.
Low back pain (LBP) is currently the leading cause of disability worldwide and the most common reason for workers’ compensation (WC) claims. Studies have demonstrated that receiving WC is associated with a negative prognosis following treatment for a vast range of health conditions. However, the impact of WC on outcomes after spine surgery is still controversial. The aim of this meta-analysis was to systematically review the literature and analyze the impact of compensation status on outcomes after lumbar spine surgery. A systematic search was performed on Medline, Scopus, CINAHL, EMBASE and CENTRAL databases. The review included studies of patients undergoing lumbar spine surgery in which compensation status was reported. Methodological quality was assessed through ROBINS-I and quality of evidence was estimated using the GRADE rating. A total of 26 studies with a total of 2668 patients were included in the analysis. WC patients had higher post-operative pain and disability, as well as lower satisfaction after surgery when compared to those without WC. Furthermore, WC patients demonstrated to have a delayed return to work. According to our results, compensation status is associated with poor outcomes after lumbar spine surgery. Contextualizing post-operative outcomes in clinical and work-related domains helps understand the multifactorial nature of the phenomenon. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
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Other

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Study Protocol
The Relationship between Reactive Balance Control and Back and Hamstring Strength in Physiotherapists with Non-Specific Back Pain: Protocol for a Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(11), 5578; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115578 - 23 May 2021
Viewed by 655
Abstract
Back pain is one of the most costly disorders among the worldwide working population. Within that population, healthcare workers are at a high risk of back pain. Though they often demonstrate awkward postures and impaired balance in comparison with healthy workers, there is [...] Read more.
Back pain is one of the most costly disorders among the worldwide working population. Within that population, healthcare workers are at a high risk of back pain. Though they often demonstrate awkward postures and impaired balance in comparison with healthy workers, there is no clear relationship between compensatory postural responses to unpredictable stimuli and the strength of related muscle groups, in particular in individuals with mild to moderate back pain. This paper presents a study protocol that aims to evaluate the relationship between peak anterior to peak posterior displacements of the center of pressure (CoP) and corresponding time from peak anterior to peak posterior displacements of the CoP after sudden external perturbations and peak force during a maximum voluntary isometric contraction of the back and hamstring muscles in physiotherapists with non-specific back pain in its early stages. Participants will complete the Oswestry Disability Questionnaire. Those that rate their back pain on the 0–10 Low Back Pain Scale in the ranges 1–3 (mild pain) and 4–6 (moderate pain) will be considered. They will undergo a perturbation-based balance test and a test of the maximal isometric strength of back muscles and hip extensors. We assume that by adding tests of reactive balance and strength of related muscle groups in the functional testing of physiotherapists, we would be able to identify back problems earlier and more efficiently and therefore address them well before chronic back disorders occur. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
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