Differences in Comorbidities on Low Back Pain and Low Back Related Leg Pain

  1. Adam Goode PT, DPT1,*,
  2. Chad Cook PT, PhD1,2,
  3. Christopher Brown MD1,
  4. Robert Isaacs MD2,
  5. Matthew Roman PT, MHS3,
  6. William Richardson MD2

Article first published online: 5 JUL 2010

DOI: 10.1111/j.1533-2500.2010.00391.x

Issue

Pain Practice

Pain Practice

Volume 11, Issue 1, pages 42–47, January/February 2011

Additional Information

How to Cite

Goode, A., Cook, C., Brown, C., Isaacs, R., Roman, M. and Richardson, W. (2011), Differences in Comorbidities on Low Back Pain and Low Back Related Leg Pain. Pain Practice, 11: 42–47. doi: 10.1111/j.1533-2500.2010.00391.x

Author Information

  1. 1

    Department of Community and Family Medicine;

  2. 2

    Department of Surgery;

  3. 3

    Department of Physical and Occupational Therapy, Duke University, Durham, North Carolina, U.S.A.

*Adam Goode, PT, DPT, Duke University Doctor of Physical Therapy, Durham, NC 919-681-6154, U.S.A. E-mail: adam.goode@duke.edu

  1. Funding Disclosures: Supported by the NIH Loan Repayment Award, National Institute of Arthritis and Musculoskeletal and Skin Diseases (1 L30 AR057661-01).

Publication History

  1. Issue published online: 11 JAN 2011
  2. Article first published online: 5 JUL 2010
  3. Submitted: December 30, 2009; Revision Accepted: February 28, 2010

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Keywords:

  • low back pain;
  • moderators;
  • low back related leg pain

Abstract

Objective:  Investigate the influence of external factors such as depression and BMI among subjects with primary severe low back pain (LBP) and low back related leg pain (LBLP).

Background:  The report of disability in patients with LBP may be significantly influenced by confounding and moderating variables. No similar studies have examined the influence of these factors on LBLP.

Methods:  This study included 1,448 consecutive subjects referred to a tertiary spine clinic. Unconditional binary logistic regression was used to determine the influence of comorbidities on the relationship between self-reported back and leg pain. A change in estimate formula was used to quantify this relationship.

Results:  Among those subjects with primary LBP the unadjusted odds ratio was 8.58 (95% CI 4.87, 15.10) and when adjusting for BMI, depression and smoking was 5.94 (95% CI 3.04, 11.60) resulting in a 36.7% change due to confounding by these comorbidities. Among those with primary LBLP, the unadjusted odds ratio was 4.49 (95% CI 2.78, 7.27) and when adjusting for BMI and depression was 4.60 (95% CI 2.58, 8.19) resulting in a 1.7% change due to confounding by these comorbidities.

Conclusion:  The disability statuses of the patients with primary LBP in this study were more significantly affected by comorbidities of BMI, depression and smoking than patients with report of LBLP. However, these comorbidities contribute little to the relationship of primary low back related leg pain and Oswestry scores ≥ 40.

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