Care seek behavior for low back pain in southern Brazil during the COVID-19 pandemic: a panel data analysis.

BACKGROUND: During the COVID-19 pandemic, people with low back pain (LBP) might have avoided seeking care for their pain. We aimed to investigate how the COVID-19 pandemic has affected LBP care seeking behavior among adults. METHODS: Data from four assessments of the PAMPA cohort were analyzed. Participants who reported experiencing LBP during wave one both before and during social restrictions (n = 1,753 and n = 1,712, respectively), wave two (n = 2,009), and wave three (n = 2,482) were included. We asked participants about sociodemographic, behavioral, and health factors and outcomes related to LBP. Poisson regression analyses were conducted, and data are presented as prevalence ratios (PR) and respective 95% confidence interval (95%CI). RESULTS: Overall, care seeking behavior decreased by half in the first months of restrictions, from 51.5% to 25.2%. Although there was an increase in care seeking behavior observed in the other two assessments (nearly 10 and 16 months after restrictions), it was insufficient to reach pre-pandemic levels. In the first months of restrictions, a similar scenario was observed for specific care, such as general practitioner and exercise professional care, with proportions of pre-pandemic levels reached after 10 and 16 months. Women were more likely to seek care for LBP 10 and 16 months after restrictions (PR 1.30 95%CI 1.11; 1.52, PR 1.22 95%CI 1.06; 1.39, respectively). Also, those participants who worked, were physically active, and reported pain-related disability and high pain levels were more likely to seek care at all time points assessed. CONCLUSION: Overall, care-seeking behavior for LBP significantly decreased in the first months of restrictions and increased in the following months; however, this behavior remained lower than pre-pandemic levels.

Low Back Pain Prevalence among Distance Learning Students.

Background: Low back pain as a symptom affects many individuals around the globe regardless of their economic status or sociodemographic characteristics. During the 2019 COVID-19 pandemic, students found themselves obligated to sit down for long periods of time. The aim of this current study is to investigate the impact of these prolonged periods of sitting down in front of computers on developing a new episode of low back pain. Methods and Materials: This research adopted an observational cross-section study design. Students who are currently enrolled or had experienced distance learning classes in the last 6 months were eligible to participate. An online-based questionnaire was developed by the investigators through reviewing the literature with relevant objectives. McNemar's test was used to compare certain variables between two periods before and during online distance learning. We used paired t-tests to compare pain intensity before, during, and after online learning, while a chi-square test was used to investigate correlations between factors influencing low back pain. Results: A total of 84 students participated in the study­46 (54.8%) females and 38 (45.2%) males. Before online distance learning, only 42.9% of participants reported low back pain, while only 20% had a back injury. The mean pain scores before, during, and after online distance learning were (2.85 ± 2.16, 4.79 ± 2.6, and 4.76 ± 2.7), respectively. The pain scores before online learning were significantly lower than pain scores during and after online distance learning (p < 0.05), respectively. Conclusion: The study findings suggested that low back pain prevalence increased among students during the COVID-19 pandemic. Future research should study participants' behavior during the online learning and assess the long-run impact of distance learning among high-school and undergraduate students.

Remote work and back pain during the COVID-19 pandemic in adults and older population in South Brazil.

This article aims to investigate the association between remote work and Back Pain during the COVID-19 pandemic, and to analyze this relationship according to the body mass index. Population-based, cross-sectional study carried in two cities in southern Brazil, in individuals aged 18 years and over. Data were collected through household interviews from October to January 2020/21. Outcomes: back pain (cervical, thoracic, lumbar/acute, chronic) and pain intensity. Exposure variable: remote work. For the analyses, Poisson regression with robust adjustment for variance was used, stratified by BMI (eutrophic vs overweight/obese), and restricted to those who had worked in the past month. 1,016 had worked during the pandemic, average 42 years old (SD = 14), varying from 18 to 93 years. Remote work was performed by 7.7% of the individuals. Prevalence of back pain: 25.6% (95%CI: 19.5 to 31.7%). Overweight/obese remote workers felt pain acute cervical pain PR = 2.82 (95%CI: 1.15 to 6.92); chronic low back PR = 1.85 (95%CI: 1.04 to 3.29); acute thoracic PR = 1.81(95%CI: 3.76 to 8.68) compared to those who did not work. About one in four remote workers reported back pain during of the COVID-19 pandemic. BMI proved to be an important moderator between outcomes and exposure variable.

Occupational low back pain prevention capacity of nurses in China: A multicenter cross-sectional study.

Introduction: Nurses have a high prevalence of occupational low back pain, especially since the outbreak of the COVID-19 pandemic, which has increased the nurses' workloads. It has brought a huge burden on nurses and their professional development. Nurses' occupational low back pain prevention capacity is the logical starting point and core of interventions to prevent its occurrence. To date, there is no study investigating it with a scientific scale. Therefore, a multicenter cross-sectional study was conducted to explore the current status of nurses' capacity in occupational low back pain prevention and its influencing factors in China. Methods: Using a two-stage, purposive and convenience mixed sampling method, 1331 nurses from 8 hospitals across 5 provinces (Hubei, Zhejiang, Shandong, Henan, and Sichuan) in the southern, western, northern, and central areas of mainland China were involved in this study. The demographic questionnaire and occupational low back pain prevention behavior questionnaire were used for data collection. The descriptive analysis, univariate analysis, and multiple stepwise linear regression were used for data analysis. Results: The results showed that the occupational low back pain prevention behavior questionnaire score was 89.00 (80.00, 103.00) [M (Q1, Q3)], which indicated that nurses' ability was at a moderate level. Participation in prevention training before, perceived stress at work, and working hours per week were predictors for nurses' occupational low back pain prevention capacity. Discussion: To improve nurses' prevention ability, nursing managers should organize various training programs, strengthen regulations to reduce nurses' workload and stress, provide a healthy workplace, and offer incentives to motivate nurses.

Short-term impact of COVID-19 pandemic on low back pain: data from the PAMPA Cohort, Brazil.

BACKGROUND: To evaluate the short-term impact of COVID-19 pandemic on low back pain (LBP) outcomes in southern Brazil. METHODS: Data from the PAMPA Cohort were analyzed. Adults were recruited between June and July 2020 in the Rio Grande do Sul state using online-based strategies. Participants responded a self-reported, online questionnaire on LBP with two timepoints: before (retrospectively) and during COVID-19 pandemic. We assessed LBP experience, LBP-related activity limitation (no/yes), and LBP intensity (0 to 10 [strongest pain]). RESULTS: From a total sample of 2,321 respondents (mean age: 37.6 ± 13.5; 75.4% women), the prevalence of LBP did not change significantly from before (74.7% [95%CI 72.3; 76.9]) to the first months of pandemic (74.2% [95%CI 71.9; 76.3]). However, an increased pain levels (ß: 0.40; 95%CI 0.22; 0.58) and a higher likelihood for activity limitation due to LBP was observed (PR 1.14; 95%CI 1.01; 1.29). Longitudinal analyzes showed that age, gender, BMI, chronic diseases, physical activity, and anxiety and depression symptoms, were associated with LBP in the first pandemic months. CONCLUSION: Although the prevalence of LBP did not change at the first months of COVID-19 pandemic, LBP-induced impairment in daily activities and pain intensity was higher when compared to before the pandemic.

Low Back Pain in People With Lower Limb Amputation: A Cross-Sectional Study.

STUDY DESIGN: A cross-sectional study based on an online questionnaire. OBJECTIVE: The aim was to investigate the prevalence and intensity of low back pain (LBP) in people with lower limb amputation (LLA) and to analyze the association factors that can influence the genesis of LBP. SUMMARY OF BACKGROUND DATA: It is still unclear whether LBP is more prevalent in the amputated population than in its nonamputated counterpart. Given the multifactorial nature of LBP, it is necessary to explore possible factors that can influence its presence and intensity, to build a solid background to define a better rehabilitation pathway for the management of these people. METHODS: The online questionnaire included six sections: informed consent of the study, demographic information, comorbid conditions, history of LLA, history of LBP, and acceptance of the amputation. RESULTS: Between March and June 2021, 239 participants [mean age (SD): 49.2 (11.5); female 11%] completed the survey (response rate: 32%). From the results of this study, LBP in LLA showed a prevalence of 82% postamputation and 70% in the last year. A logistic regression with a backward method showed that participants who had problems in the not affected leg presented 1.58 (95% confidence interval: 0.70; 2.45) times higher odds to have LBP after the amputation. CONCLUSION: This study shows that the prevalence of LBP in lower limb amputees appears to be higher than in the general population, with similar levels of pain intensity and frequency. The highest percentage of people with a sedentary lifestyle not practicing any kind of sports emphasizes the importance of educating this population on the importance of physical activity. New strategies to invest in the education of this population in terms of physical activity are needed. LEVEL OF EVIDENCE: Level 4.

Relationships Between the Physical Work Environment, Postures and Musculoskeletal Pain During COVID-19: A Survey of Frequent Computer Users.

OBJECTIVE: To understand the flexible work practices during the COVID-19 pandemic and their impact on work-related musculoskeletal disorders (MSDs) and depression in frequent computer users. METHODS: An e-survey determined the extent of workplace changes and MSD, and the relationships between them using descriptive-statistics and chi-squared tests. RESULTS: Of 700 who commenced the survey, 511 were analyzed. Since the pandemic commenced, 80% of respondents reported they were working more from home; and 89% reported some musculoskeletal pain. Compared with prepandemic, more people worked in nonergonomic environments, computer configurations and body postures. Work location was associated with upper back pain ( P = 0.011); body posture with headache ( P = 0.027) and low back pain ( P = 0.003). CONCLUSION: Nonergonomic work environments of frequent computer users during COVID-19 are related to having upper back pain, whereas nonergonomic postures are related to having headache and low back pain.

Optimizing chronic pain management through patient engagement with quality of life measures: a randomized controlled trial.

CONTEXT: Health-related quality of life (HRQOL) represents a new approach for guiding chronic pain management because it is patient-centered and more likely to be understood and accepted by patients. OBJECTIVES: To assess the value and utility of an eHealth intervention for patients with chronic low back pain (CLBP) that was primarily based on HRQOL measures and to measure the clinical outcomes associated with its use. METHODS: A randomized controlled trial was conducted within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION Pain Research Registry) using participants screened from November 2019 through February 2021. A total of 331 registry participants within the 48 contiguous states and the District of Columbia met the eligibility criteria, which included having CLBP and HRQOL deficits. Almost three-fourths of the participants were enrolled after onset of the COVID-19 pandemic. The participants were randomized to an eHealth intervention for HRQOL or wait list control. The primary outcome measures involved HRQOL based on the Patient-Reported Outcomes Measurement Information System (PROMIS), including the SPADE cluster (Sleep disturbance, Pain interference with activities, Anxiety, Depression, and low Energy/fatigue) and each of its five component scales. Secondary outcome measures involved low back pain intensity and back-related functioning. Changes over time for each outcome measure reported by participants in each treatment group were compared utilizing the student's t-test for statistical significance and Cohen's d statistic for clinical importance. Outcomes were reported as between-group differences in change scores and the d statistic, with positive values favoring the experimental treatment group. RESULTS: There were no significant differences between the experimental and control treatment groups for changes over time in any primary outcome measure. The d statistic (95% confidence interval) for the difference between the experimental and control treatment groups on the SPADE cluster was 0.04 (-0.18-0.25). The corresponding d statistics for the SPADE scales ranged from -0.06 (-0.27 to 0.16) for anxiety to 0.11 (-0.10 to 0.33) for sleep disturbance. There were also no significant or clinically important differences between the experimental and control treatment groups on the secondary outcome measures. Additionally, in subgroup analyses involving participants treated by osteopathic vs allopathic physicians, no significant interaction effects were observed. CONCLUSIONS: The eHealth intervention studied herein did not achieve statistically significant or clinically important improvements in any of the primary or secondary outcome measures. However, the validity and generalizability of the findings may have been limited by the unforeseen onset and impact of the COVID-19 pandemic shortly after beginning the trial.

SARS-CoV-2 infection is associated with low back pain: findings from a community-based case-control study.

OBJECTIVES: Pain is a significant complaint of patients with postacute COVID-19 syndrome; however, little is known about the association between SARS-CoV-2 infection and pain. This study aimed to (1) examine the association between SARS-CoV-2 infection and low back pain (LBP) and (2) identify independent predictors of LBP among survivors of COVID-19. METHODS: This case-control study involved 878 participants aged ≥18 years. Data were collected from February 24 to April 7, 2022, in Bangladesh. LBP was measured using the musculoskeletal subscale of subjective health complaints produced by Eriksen et al. Descriptive analysis was performed to compute LBP prevalence and compare the prevalence across groups. Multiple logistic analyses helped to identify the predictors of LBP for survivors of COVID-19. RESULTS: Overall, 20% of participants reported LBP; however, the prevalence of LBP was significantly high among patients with postacute COVID-19 compared with their counterparts (24.4% vs 15.7%, P = 0.001). Regression analysis for all participants suggested that SARS-CoV-2 infection was independently associated with LBP (adjusted odds ratio 1.837, 95% confidence interval 1.253-2.692). However, moderate COVID-19 symptom (adjusted odds ratio 1.754, 95% confidence interval 0.984-3.126) was the only statistically significant predictor of LBP among postacute COVID-19 patients. CONCLUSION: SARS-CoV-2 infection was associated with LBP, and moderate COVID-19 symptom was an independently associated factor of LBP. The health care facilities must be prepared to deal with the burden of LBP among patients with postacute COVID-19.

Low back pain and telecommuting in Japan: Influence of work environment quality.

OBJECTIVES: This study examined the relationship between frequency of working from home and low back pain (LBP), considering the quality of work environment. METHODS: The study was based on a cross-sectional internet-based survey. Of 33 302 respondents, data from 12 774 desk workers were retained for analysis. We used a 0-10 numerical rating scale to assess LBP. Work environment was assessed using five subjective questions. Mixed-effects logistic regression nested by city level was used to analyze the relationship between frequency of working from home and LBP, stratified by work environment condition. RESULTS: The prevalence of LBP was 21.0%. Among those reporting a poor work environment, as opposed to almost never working from home, the multivariate odds ratio (OR) of LBP were as follows: working from home less than 1 day per week: OR = 1.25, 95% CI: 0.89-1.76, p = .190; 2-3 days per week: OR = 1.58, 95% CI: 1.16-2.16, p = .004; and 4 or more days per week: OR = 1.82, 95% CI: 1.38-2.40, p < .001. By contrast, among those reporting a good work environment, the OR of LBP did not increase as the frequency of working from home increased. CONCLUSIONS: The relationship between LBP and frequency of working from home was found to vary with the quality of the work environment; more specifically, LBP was associated with frequency of teleworking in a poor work environment. This study suggests that employers should give more support to their employees in promoting a good work environment to prevent LBP. (Words: 240/250).

COVID-19 Pandemic Increases the Impact of Low Back Pain: A Systematic Review and Metanalysis.

In March 2019, the World Health Organization (WHO) recognized the COVID-19 pandemic as a global issue. To reduce the spread of this disease, health safety pathways were implemented worldwide. These extraordinary measures changed people's lifestyles, e.g., by being forced to isolate, and in many cases, to work remotely from home. Low back pain (LBP), the most common cause of disability worldwide, is often a symptom of COVID-19. Moreover, it is often associated with different lifestyle features (type of job, physical activity, body weight). Therefore, the purpose of this systematic review and meta-analysis was to estimate the effect of the COVID-19 lockdown on LBP intensity and prevalence compared with LBP rates before the pandemic. A systematic search was performed on Scopus, PubMed, and Cochrane Central. Overall, eight studies with 2365 patients were included in the analysis. We used the Joanna Briggs Institute (JBI) critical appraisal tool to evaluate the risk of bias: six studies (75%) were at moderate risk of bias and two studies (25%) were at low risk of bias. These studies showed an increase in both the prevalence and intensity of LBP during the COVID-19 lockdown.

Prevalence and Potential Risk Factors for Occupational Low Back Pain Among Male Military Pilots: A Study Based on Questionnaire and Physical Function Assessment.

Objectives: Low back pain (LBP) has negative implications for the military's combat effectiveness. This study was conducted to determine the prevalence and risk factors of LBP among pilots through a questionnaire and physical function assessments. Methods: Data on the demographic and occupational characteristics, health habits, physical activity, and musculoskeletal injuries of 217 male pilots (114 fighter, 48 helicopter, and 55 transport pilots) were collected using a self-reported questionnaire and physical function assessments. Results: LBP prevalence was 37.8% in the total cohort and 36.0, 45.8, and 34.5% among fighter, helicopter, and transport pilots, respectively. Multivariate regression analysis revealed that the risk factors significantly associated with LBP were neck pain [odds ratio (OR): 3.559, 95% confidence interval (CI): 1.827-6.934], transversus abdominis activation (OR: 0.346, 95% CI: 0.172-0.698), and hip external rotator strength (OR: 0.001, 95% CI: 0.000-0.563) in the total cohort; neck pain (OR: 3.586, 95% CI: 1.365-9.418), transversus abdominis activation (OR: 0.268, 95% CI: 0.094-0.765), hip external rotator strength (OR: 0.000, 95% CI: 0.000-0.949), and weekly flying hours (OR: 3.889, 95% CI: 1.490-10.149) in fighter pilots; irregular strength training (OR: 0.036, 95% CI: 0.003-0.507) and hip external rotator strength (OR: 0.000, 95% CI: 0.000-0.042) in helicopter pilots; and neck pain (OR: 6.417, 95% CI: 1.424-28.909) in transport pilots. Conclusions: High volume flight schedules and weak core muscle functions have significant negative effects on pilots' back health. LBP is commonly associated with high weekly flying hours, worsening neck pain, transversus abdominis insufficient activation, and reduced hip extensor/rotator strength. Risk factors vary among pilots of different aircraft. Thus, specific core muscle training would be especially important for military pilots.

A Scoping Review on the Epidemiology of Chronic Low Back Pain among Adults in Sub-Saharan Africa.

BACKGROUND: The global burden of chronic low back pain (CLBP) is a major concern in public health. Several CLBP epidemiological studies have been conducted in high-income-countries (HICs) with little known in low-and-middle-income-countries (LMICs) due to other competing priorities of communicable diseases. The extrapolation of results of studies from HICs for use in LMICs is difficult due to differences in social norms, healthcare systems, and legislations, yet there is urgent need to address this growing burden. It is against this backdrop that we conducted this review to map the current evidence on the distribution of CLBP in Sub-Saharan Africa (SSA). METHODS: A comprehensive literature search was conducted from the following databases: PubMed, Google Scholar, Science Direct databases, World Health Organizations library databases, EMBASE, EBSCOhost by searching the following databases within the platform; academic search complete, CINAHL with full text, health sources: nursing/academic and MEDLINE. The title, abstract and the full text screening phases were performed by two independent reviewers with the third reviewer employed to adjudicate discrepancies. The reference list of all included articles was also searched for eligible articles. This scoping review was reported in accordance with the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation, as well as guided by Arksey and O'Malley's scoping review framework. A thematic content analysis was used to give a narrative account of the review. RESULTS: The electronic search strategy retrieved 21,189 articles. Title/abstract and full text screening only identified 11 articles, which were included in this review. The prevalence of CLBP among the general population ranged from 18.1% to 28.2% and from 22.2% to 59.1% among LBP patients. The prevalence of occupation based CLBP ranged from 30.1% to 55.5%. Identified risk factors for CLBP are multifactorial and included biomechanical, psychological, socioeconomic and lifestyle factors, with psychosocial factors playing a significant role. Hypertension, diabetes mellitus, peptic ulcer disease were the most common comorbidities identified. CLBP disability was significantly associated with psychosocial factors. The management of CLBP in primary care follows the traditional biomedical paradigm and primarily involves pain medication and inconsistent with guidelines. CONCLUSIONS: There are limited epidemiological data on CLBP in SSA, however, this study concluded that the prevalence and risk factors of CLBP in SSA are comparable to reports in HICs. Considering the projected increase in the burden of CLBP in LMICs extensive research effort is needed to close this knowledge gap.

Association of Sleep Quality Status With Worsening Low Back or Knee Pain During The COVID-19 State of Emergency Among Old-Old Adults.

BACKGROUND: Poor sleep quality has a negative effect on pain among older adults. During the coronavirus disease 2019 (COVID-19) state of emergency, lifestyle changes can cause psychologic stressors and lead to poor sleep quality. AIM: This study examined whether sleep quality status was associated with low back or knee pain changes during the COVID-19 state of emergency among community-dwelling Japanese old-old adults. DESIGN: Cross-sectional investigation. METHODS: In July 2020, during the COVID-19 epidemic, we conducted a postal survey for old-old adults aged ≥77 years and collected data on 597 participants. For those who had low back or knee pain at the time of the survey (in July), characteristics such as low back pain, knee pain, changes in pain status, and sleep quality status during the COVID-19 state of emergency (in March) were assessed. RESULTS: Data from 597 participants showed the prevalence of low back pain (50.6%) and knee pain (40.7%) in July. Of those with low back or knee pain, 374 had pain changes during the state of emergency, with 12.3% worsening. Of these, 23.9% had poor sleep quality in March compared to non-change (p = .008). In a multivariate logistic regression model adjusted for potential confounders, poor sleep quality was significantly associated with pain worsening (odds ratio 2.80, 95% confidence interval 1.26-6.22). CONCLUSIONS: During the COVID-19 state of emergency, poor sleep quality was associated with worsening low back or knee pain. This may indicate the need to pay attention to poor sleep quality to prevent the exacerbation of pain among old-old adults.

Musculoskeletal and Neurological Pain Symptoms Among Hospitalized COVID-19 Patients.

OBJECTIVE: As the coronavirus disease 2019 pandemic continues to grow, its clinical manifestations are still emerging and are being widely investigated. However, the pain symptoms, including neurological and musculoskeletal pain symptoms, are still poorly understood. DESIGN: In this cross-sectional study, we investigated the prevalence of musculoskeletal and neurological pain symptoms among hospitalized coronavirus disease 2019 patients. Furthermore, the association of clinical and demographic factors with the prevalence of pain symptoms was also investigated. RESULT: We included 182 hospitalized coronavirus disease 2019 patients with a mean age of 48.86 ± 13.98 yrs. Pain symptoms were reported by 61.54% patients (n = 112). Most common symptoms reported were generalized myalgia (n = 60, 32.96%), headache (n = 50, 27.47%), and low back pain (n = 41, 22.53%). Interestingly, neuropathic pain was present in 14 participants (7.69%). Logistic regression analysis revealed an association of pain symptoms with coronavirus disease 2019 severity, male sex, higher body mass index, and a history of addiction. CONCLUSIONS: Pain symptoms are common manifestation of coronavirus disease 2019. Generalized myalgia, headache, and low back pain are the three most common new-onset pain symptoms in hospitalized coronavirus disease 2019 patients. Further investigation of pain symptoms and their predictive factors are recommended, which may guide healthcare workers and policymakers to plan in this direction. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand common musculoskeletal and neurological pain symptoms among hospitalized COVID-19 patients; (2) Understand the basic etiopathogenesis of COVID-19 associated pain; and (3) Identify factors associated with presence of COVID-19 pain symptoms. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Association Between Telecommuting Environment and Low Back Pain Among Japanese Telecommuting Workers: A Cross-Sectional Study.

OBJECTIVES: We evaluated the relationship between telecommuting environment and low back pain (LBP) among desk-based workers in Japan. METHODS: This cross-sectional study included 3663 desk-based, telecommuting workers. LBP was assessed using a 0 to 10 numerical rating scale. The telecommuting environment was evaluated using subjective questions. Mixed-effects logistic regression analysis was used to evaluate this association. RESULTS: The results of mixed-effects logistic model revealed that not having a place or room to concentrate on work, desk not well-lit enough for work, lack of space on the desk to work, not having enough legroom, and uncomfortable temperature and humidity conditions in the workspace were significantly associated with higher odds of LBP. CONCLUSIONS: Our findings suggest that telecommuting environment is associated with the prevalence of LBP.

Increased Work from Home and Low Back Pain among Japanese Desk Workers during the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study.

To prevent the spread of coronavirus disease 2019 (COVID-19), desk workers in Japan have been encouraged to work from home. Due to rapidly increased working from home, working in environments that are not properly designed and working with poor posture can affect low back pain (LBP). This study aimed to examine the relationship between increased work from home during the COVID-19 pandemic and LBP among Japanese desk workers. Using study data from the Japan COVID-19 and Society Internet Survey 2020 conducted from August to September 2020, 4227 desk workers who did not have LBP before the COVID-19 pandemic were analyzed out of 25,482 total respondents. Odds ratios (ORs) and 95% confidence intervals (CIs) for LBP were calculated by multivariable logistic regression, adjusting for covariates such as socioeconomic factors. During the COVID-19 pandemic, 31.3% of desk workers with an increased chance of working from home, and 4.1% had LBP. Desk workers with increased working from home were more likely to have LBP (OR: 2.00 (95% CI, 1.36-2.93)). In this large-scale study, increased work from home was associated with LBP among desk workers during the COVID-19 pandemic. Therefore, preparing an appropriate work environment for desk workers working from home can improve productivity, leading to positive effects.

The prevalence and risk factors of chronic low back pain among adults in KwaZulu-Natal, South Africa: an observational cross-sectional hospital-based study.

BACKGROUND: Globally, chronic low back pain (CLBP) is the leading cause of disability associated with economic costs. However, it has received little attention in low-and-middle-income countries. This study estimated the prevalence and risk factors of CLBP among adults presenting at selected hospitals in KwaZulu-Natal. METHODOLOGY: This cross-sectional study was conducted among adults aged ≥18 years who attended the selected hospitals in KwaZulu-Natal during the study period. A self-administered questionnaire was used to collect data on socio-demographic, work-related factors, and information about CLBP. The SPSS version 24.0 (IBM SPSS Inc) was used for data analysis. Descriptive statistics were used for demographic characteristics of participants. CLBP risk factors were assessed using multivariate logistic regression analysis. A p-value of ≤0.05 was deemed statistically significant. RESULTS: A total of 678 adults participated in this study. The overall prevalence of CLBP was 18.1% (95% CI: 15.3 - 21.3) with females having a higher prevalence than males, 19.8% (95% CI: 16.0 - 24.1) and 15.85% (95% CI: 11.8 - 20.6), respectively. Using multivariate regression analysis, the following risk factors were identified: overweight (aOR: 3.7, 95% CI: 1.1 - 12.3, p = 0.032), no formal education (aOR: 6.1, 95% CI: 2.1 - 18.1, p = 0.001), lack of regular physical exercises (aOR: 2.2, 95% CI: 1.0 - 4.8, p = 0.044), smoking 1 to 10 (aOR: 4.5, 95% CI: 2.0 - 10.2, p < 0.001) and more than 11 cigarettes per day (aOR: 25.3, 95% CI: 10.4 - 61.2, p < 0.001), occasional and frequent consumption of alcohol, aOR: 2.5, 95% CI: 1.1 - 5.9, p < 0.001 and aOR: 11.3, 95% CI: 4.9 - 25.8, p < 0.001, respectively, a sedentary lifestyle (aOR: 31.8, 95% CI: 11.2 - 90.2, p < 0.001), manual work (aOR: 26.2, 95% CI: 10.1 - 68.4, p < 0.001) and a stooped sitting posture (aOR: 6.0, 95% CI: 2.0 - 17.6, p = 0.001). CONCLUSION: This study concluded that the prevalence of CLBP in KwaZulu-Natal is higher than in other regions, and that it is predicted by a lack of formal education, overweight, lack of regular physical exercises, smoking, alcohol consumption, sedentary lifestyle, manual work, and a stooped posture.

Chronic low back pain during COVID-19 lockdown: is there a paradox effect?

PURPOSE: The coronavirus 2019 (COVID-19) pandemic led to a compulsory lockdown of 3 months with strict restrictions. The impact of the COVID-19 pandemic has shown broad repercussions on patients with chronic pain; especially for conditions that present a significant emotional participation such as chronic low back pain (cLBP). METHODS: We performed a prospective study on 50 patients. Pre- and 1-month post-lockdown questionnaires such as: the Impact of Event Scale (IES), the Oswestry Disability Index (ODI), the Roland-Morris questionnaire (RMQ) and the visual analogue scale (VAS) for back and leg pain intensity were collected. RESULTS: The mean time of the evolution of cLBP was 33.04 months (range 5-120 months). Eighteen (36%) patients improved their cLBP (i-cLBP), whereas for 14 (28%) it was worse (w-cLBP). Cox multivariate proportional hazard model identified that MODIC 1 disc disease [OR 19.93, IC95% (2.81-102.13), p = 0.015] and at-home workouts [OR 18.854, IC95% (1.151-204.9), p = 0.040] were good prognosis factors of the improvement of cLBP while subclinical/mild Covid-19 anxiety (IES score < 26) was a poor prognosis factor in improving cLBP [OR 0.21, IC95% (0.001-0.384), p = 0.009]. Furthermore, pre-lockdown benzodiazepine medication [OR 2.554, IC95% (1.20-9.9), p = 0.002] was a prognosis factor of worse cLBP. In contrast, patients with severe Covid-19 anxiety (IES score > 26) significantly improved their cLBP [OR 0.58, IC95% (0.025-0.834), p = 0.01]. CONCLUSION: Lockdown affected the somatic component of cLBP by decreasing activities and physical measures, whereas the SARS-CoV-2 pandemic spectrum paradoxically improved the psychic and emotional component of cLBP.