Smith Michelle D, Russell Anne, Hodges Paul W
Clinical Centre of Research Excellence, Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia.
J Pain. 2009 Aug;10(8):876-86. doi: 10.1016/j.jpain.2009.03.003. Epub 2009 May 5.
Cross-sectional studies have suggested a relationship between respiratory disorders, incontinence, gastrointestinal symptoms, and back pain. However, longitudinal data are lacking. This study aimed to evaluate whether these disorders increase risk for the development of back pain. A total of 2943 younger, 2298 mid-age, and 2258 older women from the Australian Longitudinal Study on Women's Health who reported no back pain during the preceding 12 months were followed for 4, 2, and 3 years, respectively. Crude and adjusted associations between the development of back pain and changes in the presence of incontinence, breathing difficulty, and gastrointestinal symptoms were assessed with logistic regression. Women with preexisting incontinence (prevalence ratios [PR]: 1.26 to 1.46) and gastrointestinal symptoms (PR: 1.24 to 1.44) and women who developed breathing problems (PR: 1.63 to 2.11) were more likely to develop back pain than women without such problems. Menstrual pain and allergy were also associated with back pain development. Consistent with predictions from physiological data, this study provides novel evidence that the presence and/or development of incontinence, respiratory problems, and gastrointestinal symptoms are associated with the development of back pain. This highlights the importance of comorbidities and suggests opportunities for future preventative interventions.
This study demonstrates that women with incontinence, respiratory disorders, and gastrointestinal symptoms have increased risk for the development of back pain. Evidence of compromised control of the spine in people with incontinence and respiratory disorders and the potential for viscerosomatic hyperalgesia in people with gastrointestinal symptoms may provide physiological explanations for these findings.
横断面研究表明呼吸系统疾病、尿失禁、胃肠道症状和背痛之间存在关联。然而，缺乏纵向数据。本研究旨在评估这些疾病是否会增加背痛发生的风险。对来自澳大利亚女性健康纵向研究的2943名年轻女性、2298名中年女性和2258名老年女性进行了随访，这些女性在之前12个月内均无背痛，随访时间分别为4年、2年和3年。采用逻辑回归评估背痛发生与尿失禁、呼吸困难和胃肠道症状变化之间的粗关联和调整后关联。与没有这些问题的女性相比，已有尿失禁（患病率比[PR]：1.26至1.46）和胃肠道症状（PR：1.24至1.44）的女性以及出现呼吸问题的女性（PR：1.63至2.11）更有可能发生背痛。痛经和过敏也与背痛的发生有关。与生理数据的预测一致，本研究提供了新的证据，即尿失禁、呼吸问题和胃肠道症状的存在和/或发展与背痛的发生有关。这突出了合并症的重要性，并为未来的预防性干预提供了机会。
本研究表明，患有尿失禁、呼吸系统疾病和胃肠道症状的女性发生背痛的风险增加。尿失禁和呼吸系统疾病患者脊柱控制受损的证据以及胃肠道症状患者内脏性痛觉过敏的可能性可能为这些发现提供生理学解释。
