University of Warwick, Coventry, UK.
University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
J Headache Pain. 2019 Jul 15;20(1):82. doi: 10.1186/s10194-019-1031-y.
To systematically review studies quantifying the association between primary chronic headaches and persistent low back pain (LBP).
We searched five electronic databases. We included case-control, cross-sectional and cohort studies that included a headache and back pain free group, reporting on any association between persistent LBP and primary headache disorders. Methodological quality was assessed using Newcastle-Ottawa Scale. Our primary outcome was the association between primary headache disorders and persistent LBP. Our secondary outcomes were any associations between severity of LBP and severity of headache, and the relationship between specific headache sub-types classified as per International Classification of Headache Disorders (ICHD) criteria and persistent LBP. We included 14 studies. The sizes of the studies ranged from 88 participants to a large international study with 404, 206 participants. Odds ratios for the association were between 1.55 (95% confidence interval (CI) 1.13-2.11) and 8.00 (95% CI 5.3-12.1). Study heterogeneity meant statistical pooling was not possible. Only two studies presented data investigating persistent LBP and chronic headache disorders in accordance with ICDH criteria.
We identified a positive association between persistent LBP and primary headache disorders. The quality of the review findings is limited by diversity of populations, study designs and uncertainly about headache and LBP definitions.
PROSPERO 2018 CRD42018086557 .
系统回顾定量研究原发性慢性头痛与持续性腰痛（LBP）之间关联的研究。
我们检索了五个电子数据库。我们纳入了病例对照、横断面和队列研究，这些研究包括头痛和无腰痛组，报告了原发性 LBP 和原发性头痛障碍之间的任何关联。使用纽卡斯尔-渥太华量表评估方法学质量。我们的主要结局是原发性头痛障碍与持续性 LBP 之间的关联。我们的次要结局是 LBP 严重程度与头痛严重程度之间的任何关联，以及根据国际头痛疾病分类（ICHD）标准分类的特定头痛亚型与持续性 LBP 的关系。我们纳入了 14 项研究。研究规模从 88 名参与者到一项大型国际研究（404，206 名参与者）不等。关联的优势比在 1.55（95%置信区间（CI）1.13-2.11）和 8.00（95%CI 5.3-12.1）之间。研究异质性意味着不可能进行统计学合并。只有两项研究按照 ICHD 标准提供了关于持续性 LBP 和慢性头痛障碍的研究数据。
我们发现持续性 LBP 与原发性头痛障碍之间存在正相关。综述结果的质量受到人群、研究设计的多样性以及对头痛和 LBP 定义的不确定性的限制。
PROSPERO 2018 CRD42018086557。
