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The physical characteristics of postmenopausal women that are associated with upper back pain are not well-understood. The aim of this cross-sectional study was to identify the physical characteristics associated with presence and severity of upper back pain in healthy postmenopausal women. Self-reported upper back pain presence (within the previous month) and severity (numerical rating scale) were examined against the physical characteristics: height; weight; body mass index; breast size; breast ptosis; upper back extensor muscle endurance (isometric chest raise test); head, shoulder and upper back posture (photogrammetry); thoracic extension mobility (photogrammetry); bone mineral density (dual-energy x-ray absorptiometry (DXA)); body composition (DXA); and thoracic kyphosis, thoracic osteoarthritis and thoracic vertebral fracture (all radiography). A multivariable logistic regression model, adjusted for age, was built using physical characteristics with a significant univariate association with upper back pain. Censored Tobit regression, adjusted for age, was used to examine each physical characteristic against upper back pain severity. Postmenopausal women (n = 119) with a mean (SD) age of 61.4 (7.0) years participated in the study. After adjusting for age, the physical characteristics independently associated with upper back pain were: height (OR: 0.50, 95% CI: 0.31-0.79); and upper back extensor muscle endurance (OR: 0.46, 95%CI: 0.28-0.75). This model explained 31% of the variance in upper back pain (p<0.001). After adjusting for age, being taller and having better upper back extensor muscle endurance were associated with lower odds for upper back pain. After adjusting for age, differences in upper back pain severity were explained by upper back extensor muscle endurance (p = <0.001) and lean mass (p = 0.01). Conclusion: As a modifiable physical characteristic of postmenopausal women with upper back pain, upper back extensor muscle endurance is worth considering clinically., Competing Interests: The authors have declared that no competing interests exist.

Purpose: To investigate associations between anthropometric measures (birthweight, weight gain and current BMI) and back pain; and to determine whether these associations differ between those born with low or full birthweight., Methods: The cross-sectional associations between the lifetime prevalence of back pain and anthropometric measures (birthweight, weight gain and current BMI) among 2754 adult twins were investigated in three stages: total sample; within-pair case-control for monozygotic and dizygotic twins together; and within-pair case-control analysis separated by dizygotic and monozygotic. Results were expressed as odds ratios (OR) and 95% confidence intervals (CI)., Results: Birthweight was not associated with back pain (OR 0.99; 95% CI 0.99-1.00), but a weak association was found between weight gain (OR 1.01; CI 1.00-1.01) or current BMI (OR 1.02; 95% CI 1.00-1.05) and back pain in the total sample analysis. These associations did not remain significant after adjusting for genetics. The associations did not differ between those whose were born with low or full birthweight., Conclusion: Birthweight was not associated with prevalence of back pain in adulthood. Weight gain and current BMI were weakly associated with back pain prevalence in the total sample analysis but did not differ between those born with low or full birthweight. However, the small-magnitude association only just achieved significance and appeared to be confounded by genetics and the early shared environment. Our results suggest that a direct link between these predictors and back pain in adults is unlikely. These slides can be retrieved under Electronic Supplementary Material.

Back pain is common in older people and is associated with functional disability and poor self-rated health. Older persons are under-represented in back pain research, and research on back pain in older persons from ethnic minorities is particularly sparse. We investigated differences in back pain characteristics, effects and medication use in a population-based sample of 335 Italian-born immigrants and 849 Australian-born men aged 70 years and over. There were 189 (62%) Italian-born men and 507 (63%) Australian-born men who reported experiencing back pain in the past 12 months. Despite no difference in the reported prevalence of back pain between the two groups of men, Italian-born men were more likely to report that their pain was frequent, severe and chronic. Italian-born men were also more likely to report having other sites of pain and that they had limited their activities in the past 12 months due to back pain. Despite these differences, the use of analgesic medication was the same in both groups. Multivariate analyses showed that differences in pain characteristics and effects between the two groups of men were explained by socioeconomic factors such as years of education and occupation history., (Copyright © 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.)

Background: Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football., Methods: Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n = 29) or control group (n = 30), being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months). The main outcome measure was an injury surveillance with a missed match injury definition., Results: After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051) and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051). The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025). There was no significant difference for weeks missed due to hamstring injury (4 v 14, chi2:1.12, p = 0.29) and lower-limb muscle strains (4 v 21, chi2:2.66, p = 0.10). A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, chi2:6.70, p = 0.01)., Conclusions: This study demonstrated a trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries through the addition of a sports chiropractic intervention to the current best practice management.

Question: Is there an association between Caesarean section and back pain over the longer term?, Design: Secondary analysis of data from the Australian Longitudinal Study on Women's Health., Participants: The mid-aged cohort of women within the Australian Longitudinal Study on Women's Health aged 54 to 59 years (n = 9146)., Outcome Measures: Data were included from women who answered the question regarding back pain. Data were extracted on whether they had given birth and, if so, whether it was by Caesarean section. Then, data on confounding variables (such as arthritis, asthma, osteoporosis, hysterectomy, ovaries removed, and repair of prolapsed vagina, bladder or bowel, menopause, smoking) were also extracted., Results: After adjusting for confounding factors, women who delivered by Caesarean section had the same odds (OR 1.03, 95% CI 0.81 to 1.31) of having back pain as women who had not had a birth., Conclusion: Previous delivery by Caesarean section is not associated with increased back pain in mid-aged Australian women.

Objective: To illustrate quantitatively the effect of the aging of the population on the prevalence of chronic disorders by comparing the projected frequency of musculoskeletal (MSK) disorders in 3 comparatively "young" countries, Australia, Canada, and the United States, and 3 comparatively "old" countries, France, the United Kingdom, and Sweden., Methods: Age specific rates for MSK disability in Canada were applied to World Bank population estimates and projects to estimate prevalence rates and numbers of persons with MSK disability in the years 1985, 2000, 2010, and 2020., Results: The age structure of the populations affected baseline rates for MSK disability. Increases in both prevalence and numbers affected are expected for all countries between 1985 and 2020, up to a 34% increase in prevalence in Canada, and an 88% increase in numbers in Australia., Conclusion: The aging of the population is likely to result in a disproportionate increase in the number of people with chronic disabling disorders, which will be taking place against a background of a decreasing or static number of young adults, with implications for meeting needs for health care and community support.

This study compared 47 patients with chronic low back pain who were involved in personal injury litigation with 33 patients not seeking compensation who were also complaining of low back pain. Pain was assessed using a visual analogue scale and the adjectival check-list of the McGill Pain Questionnaire. Psychological state was assessed using the Zung Depression Scale, the State-Trait Anxiety Inventory, the Eysenck Personality Inventory and the Hostility and Direction of Hostility Questionnaire. The group involved in litigation contained significantly more males, and the duration of pain was significantly less. The mean age of the 'compensation' group was less than that of the 'no compensation' group, but this did not reach statistical significance at the 5% level. There was no difference between the two groups on ratings of pain severity or pain description, and no difference on measures of psychological disturbance. Both groups had significant elevations of mean depression, neuroticism, state anxiety and trait anxiety scores when compared with the normal population. It was concluded that there is no support for the claim that personal injury litigants describe their pain as more severe than do non-litigants, and that both groups show similar levels of psychological disturbance.