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Objective Both clinical and epidemiologic studies have shown an association between atherosclerotic changes in the aorta or lumbar arteries and lumbar disc degeneration. However, the association between atherosclerosis and sciatica remains unknown. The aim of this study was to investigate the association between carotid intima-media thickness and sciatica. Methods The target population consisted of people aged 45 to 74 years, who had participated in a Finnish nationwide population study during the period 2000 to 2001 and lived within 200 km of the 6 study clinics. Of the 1867 eligible subjects, 1386 (74%) were included in the study. We used high-resolution B-mode ultrasound imaging to measure intima-media thickness, and local or radiating low back pain was determined by a standard interview and clinical signs of sciatica through a physician’s clinical examination. Results Carotid intima-media thickness was associated with continuous radiating low back pain and with a positive unilateral clinical sign of sciatica among men only. After adjustment for potential confounders, each standard deviation (0.23 mm) increment in carotid intima-media thickness showed an odds ratio of 1.6 (95% confidence interval 1.1-2.3) for continuous radiating low back pain and 1.7 (95% confidence interval 1.3-2.1) for a positive unilateral clinical sign of sciatica. Carotid intima-media thickness was not associated with local low back pain. Conclusion Sciatica may be a manifestation of atherosclerosis, or both conditions may share common risk factors.

Objectives To evaluate the effects of work-related and individual factors as well as physical activity and sports on the incidence and persistence of knee pain among a working population. Design Employees of a large Finnish forestry company replied to a questionnaire (a modified version of the Nordic Questionnaire) on musculoskeletal pain and its possible risk factors at the baseline of this study. A cohort of 2122 workers free of knee pain and another cohort of 333 workers with severe knee pain were followed up for one year. The effects of the risk factors on the incidence and persistence of knee pain were studied using multivariable logistic regression models. Results A total of 214 (10%) workers developed knee pain during the follow-up. Significant predictors of incident knee pain in the multivariable model were higher age, overweight, smoking, and previous knee injuries. Also, working with the trunk forward flexed in kneeling or standing position and physically strenuous work were non-significant predictors of incident knee pain. Of those 333 workers with severe knee pain at baseline, 220 (66%) still reported severe knee pain after one year. Higher age and job dissatisfaction increased the risk of persistent symptoms. General physical exercise and different sports activities did not predict the incidence or persistence of knee pain. Conclusions In this large prospective study, the risk factors for self-reported knee pain seemed to be highly similar to the risk factors for knee osteoarthritis (OA) reported in other papers. Age, previous knee injuries, overweight, and knee-straining work were those risk factors, which contributed to the incidence of knee pain. Psychosocial elements of work were more involved in the persistence of the symptoms in the knee. Copyright 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved .

BACKGROUND: The purpose of this study is to assess the effects of lifestyle risk factors on the risk of hospitalization for sciatica and to determine whether overweight or obesity modifies the effect of leisure-time physical activity on hospitalization for sciatica. METHODS: We included 4 Finnish prospective cohort studies (Health 2000 Survey, Mobile Clinic Survey, Helsinki Health Study, and Young Finns Study) consisting of 34,589 participants and 1259 hospitalizations for sciatica during 12 to 30 years of follow-up. Sciatica was based on hospital discharge register data. We conducted a random-effects individual participant data meta-analysis. RESULTS: After adjustment for confounding factors, current smoking at baseline increased the risk of subsequent hospitalization for sciatica by 33% (95% confidence interval [CI], 13%-56%), whereas past smokers were no longer at increased risk. Obesity defined by body mass index increased the risk of hospitalization for sciatica by 36% (95% CI 7%-74%), and abdominal obesity defined by waist circumference increased the risk by 41% (95% CI 3%-93%). Walking or cycling to work reduced the risk of hospitalization for sciatica by 33% (95% CI 4%-53%), and the effect was independent of body weight and other leisure activities, while other types of leisure activities did not have a statistically significant effect. CONCLUSIONS: Smoking and obesity increase the risk of hospitalization for sciatica, whereas walking or cycling to work protects against hospitalization for sciatica. Walking and cycling can be recommended for the prevention of sciatica in the general population. (C) 2017 Elsevier Inc. All rights reserved.

A standardized examination protocol was developed for the assessment of neck and shoulder disorders in primary health care. We investigated to what extent the symptoms and signs can predict sick leave due to neck and shoulder disorders. Our study involved 474 patients seeking medical advice from an occupational health service. Most of the 20 symptoms and 15 signs of the protocol were associated with the number of sick leave days within the 60-day postexamination period, but only three symptoms (short duration, high pain intensity, and continuous pain) and two signs (pain in the upper limb during rotation of head and pain in the shoulder during abduction of arm) retained their significance in a multivariate model. No unambiguous subset of protocol items can be suggested for general use. The predictive validity should be tested in other populations and settings before a conclusion is drawn about the external validity of the results.

Objective. To investigate the day-to-day reproducibility and long-term (9 months) stability of variables of postural control, and the associations of these variables with low-back and lower-extremity pain in a working population. Design. Test-retest measurements of 18 healthy subjects. Cross-sectional study of 165 working women and 343 men. Background. Sudden loss of postural balance may result in microtraumas of back structures. Therefore workers with decreased postural control may run an increased risk of low-back pain. There are few reports describing the reproducibility of force-plate-based posturography. Methods. Amplitude and velocity of postural sway were measured with a force-plate in a two-feet stance with eyes open and closed, and in a one-foot stance with eyes open. A stepping response test was developed to measure the dynamic components of balance. Results. The mean differences between the repeated measurements were generally 5–10% and the standard deviations of these differences were up to a quarter or one third of the mean measurement values. Sway velocity showed the best overall reproducibility. Men had a larger sway than women independent of age and anthropometry. The group of non-symptomatic subjects showed wide variation and a slightly lower sway than the groups with low-back or lower-extremity pain. Conclusions. Postural sway has moderate stability, wide variation, and slight associations with low-back symptoms in a working population.

The purpose of this study was to investigate the frequency, intensity and causes of sudden movements occurring at work. Another aim was to find out whether the frequency and intensity of sudden movements show a correlation with self-assessed risk of accident. Eighteen workers in the forest industry, representing low, moderate and high self-assessed accident risk categories, were selected for the study. Occurrence of sudden trunk movement was assessed by a new method based on trunk acceleration measurement. A total of 297 sudden movements were registered. The most common causes of the sudden movements were jerking and climbing, and only two sudden movements were caused by slips. We found a correlation between self-assessed accident risk and occurrence of sudden movements at work. The present assessment method did not discriminate between different kinds of sudden movements. Methods to detect sudden movements should be further developed.

A static shoulder model including a novel muscular synergy principle for computing load sharing between the shoulder muscles is presented. This principle is feasible especially when analysing endurance-type activities. According to the principle, time elapsed from the start of the activity decreases the allowable muscle stress levels on the basis of the stress-endurance time curves of individual muscles. At low load levels the sum of the squared forces is minimized. At higher load levels the increase in the stress levels of individual muscles is counteracted in order to prevent fatigue. In the model the direction of the contact force in the glenohumeral joint is constrained. The stiffness of the shoulder can also be constrained to produce more muscular co-contraction in tasks with high precision demands.

The aim of this study was to investigate electromyographic (EMG) changes reflecting fatigue in different shoulder muscles and the relations between EMG changes and the holding time during the static holding test of the arm. Nine men and nine women held their arm flexed horizontally until exhaustion with a weight (4 kg for the men, 2.5 kg for the women) suspended on the wrist. EMG was recorded by surface electrodes over the upper trapezius (two locations), infraspinatus, and the anterior deltoid muscles. Reduction of the median frequency of the EMG signal was used as indicator of localized muscle fatigue. The times for detecting EMG changes in the deltoid and infraspinatus muscles were about half of that in the upper trapezius. Women and men had similar holding times, but the men showed more EMG changes reflecting fatigue than the women. The EMG changes did not predict the total holding time.

An experimental study was performed to investigate differences in shoulder muscle activity between subjects with and those without neck-shoulder pain. Ten female bank cashiers with frequent neck-shoulder pain (cases) and ten nonsymptomatic referents (matched by age, body size and work experience) with similar work performed a simulation of one of their ordinary main tasks. Surface electromyography (EMG) was recorded on the upper trapezius and rhomboideus/erector spinae muscles. The mean EMG activities were similar in both groups. The cases had a greater number of short rest periods (less than 2% of the maximal activity) for their trapezius muscles during the work cycles. Lowering the height of the service counter by 25 cm reduced the mean electromyographic activity and the duration of the work periods (over 2% of the maximal activity) in the right trapezius in both cases and referents.

The purpose of our investigation was to study the relations of neck-shoulder symptoms with muscle function and pressure pain sensitivity. Ten female bank cashiers with frequent neck-shoulder symptoms were compared with nonsymptomatic referents (matched by age, body size and work experience) in similar work. Isometric elevation and abduction forces of the shoulders, and endurance time of shoulder elevation against 30% of maximum force were measured. Signs of fatigue of the upper trapezius and rhomboideus muscles were recorded with surface electromyography (EMG). Pressure pain threshold was measured on eight muscles in the neck-shoulder region. No significant differences between the cases and referents were detected in muscle function. Signs of fatigue in EMG increased with static holding time in all subjects. The pressure pain threshold was lower for the cases than for the referents.