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Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis

BACKGROUND: Chronic low back pain (cLBP) affects millions of Americans and costs billions. Studies suggest a link between cLBP and joint hypermobility. METHODS: We conducted cross-sectional primary analyses of joint hypermobility and cLBP, lumbar spine osteoarthritis (OA), and lumbar facet joint OA...

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Autores principales: Goode, Adam P., Cleveland, Rebecca J., Schwartz, Todd A., Nelson, Amanda E., Kraus, Virginia B., Hillstrom, Howard J., Hannan, Marian T., Flowers, Portia, Renner, Jordan B., Jordan, Joanne M., Golightly, Yvonne M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456963/
https://www.ncbi.nlm.nih.gov/pubmed/30967130
http://dx.doi.org/10.1186/s12891-019-2523-2
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author Goode, Adam P.
Cleveland, Rebecca J.
Schwartz, Todd A.
Nelson, Amanda E.
Kraus, Virginia B.
Hillstrom, Howard J.
Hannan, Marian T.
Flowers, Portia
Renner, Jordan B.
Jordan, Joanne M.
Golightly, Yvonne M.
author_facet Goode, Adam P.
Cleveland, Rebecca J.
Schwartz, Todd A.
Nelson, Amanda E.
Kraus, Virginia B.
Hillstrom, Howard J.
Hannan, Marian T.
Flowers, Portia
Renner, Jordan B.
Jordan, Joanne M.
Golightly, Yvonne M.
author_sort Goode, Adam P.
collection PubMed
description BACKGROUND: Chronic low back pain (cLBP) affects millions of Americans and costs billions. Studies suggest a link between cLBP and joint hypermobility. METHODS: We conducted cross-sectional primary analyses of joint hypermobility and cLBP, lumbar spine osteoarthritis (OA), and lumbar facet joint OA (FOA) in 3 large studies—the Generalized Osteoarthritis Study, Genetics of Generalized Osteoarthritis Study, and Johnston County Osteoarthritis Project (total n = 5072). Associations of joint hypermobility and Beighton trunk flexion with cLBP and lumbar OA were estimated using separate adjusted logistic regression models. Adjusted pooled odds ratios (pORs) and 95% confidence intervals (CIs) were then summarized—using random effect univariate, multivariate crude, and adjusted models—and heterogeneity was determined (I(2) statistic). RESULTS: In univariate models, hypermobility was associated with symptomatic FOA (pOR = 0.64 [95% CI 0.44, 0.93]) but this result was not found in the multivariate models. In multivariate adjusted models, hypermobility was not significantly associated with cLBP and lumbar OA, but trunk flexion was inversely associated with cLBP (pOR = 0.40 [95% 0.26, 0.62]), spine OA (pOR = 0.66 [95% CI 0.50, 0.87]), symptomatic spine OA (pOR = 0.39 [95% CI 0.28, 0.53]), and symptomatic FOA (pOR = 0.53 [95% CI 0.37, 0.77]). Generally, between-study heterogeneity was moderate-high. CONCLUSIONS: Hypermobility was not associated with cLBP or lumbar OA. The inverse association of trunk flexion with cLBP and lumbar OA may indicate a role for a flexible spine in avoiding or managing these conditions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2523-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-64569632019-04-19 Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis Goode, Adam P. Cleveland, Rebecca J. Schwartz, Todd A. Nelson, Amanda E. Kraus, Virginia B. Hillstrom, Howard J. Hannan, Marian T. Flowers, Portia Renner, Jordan B. Jordan, Joanne M. Golightly, Yvonne M. BMC Musculoskelet Disord Research Article BACKGROUND: Chronic low back pain (cLBP) affects millions of Americans and costs billions. Studies suggest a link between cLBP and joint hypermobility. METHODS: We conducted cross-sectional primary analyses of joint hypermobility and cLBP, lumbar spine osteoarthritis (OA), and lumbar facet joint OA (FOA) in 3 large studies—the Generalized Osteoarthritis Study, Genetics of Generalized Osteoarthritis Study, and Johnston County Osteoarthritis Project (total n = 5072). Associations of joint hypermobility and Beighton trunk flexion with cLBP and lumbar OA were estimated using separate adjusted logistic regression models. Adjusted pooled odds ratios (pORs) and 95% confidence intervals (CIs) were then summarized—using random effect univariate, multivariate crude, and adjusted models—and heterogeneity was determined (I(2) statistic). RESULTS: In univariate models, hypermobility was associated with symptomatic FOA (pOR = 0.64 [95% CI 0.44, 0.93]) but this result was not found in the multivariate models. In multivariate adjusted models, hypermobility was not significantly associated with cLBP and lumbar OA, but trunk flexion was inversely associated with cLBP (pOR = 0.40 [95% 0.26, 0.62]), spine OA (pOR = 0.66 [95% CI 0.50, 0.87]), symptomatic spine OA (pOR = 0.39 [95% CI 0.28, 0.53]), and symptomatic FOA (pOR = 0.53 [95% CI 0.37, 0.77]). Generally, between-study heterogeneity was moderate-high. CONCLUSIONS: Hypermobility was not associated with cLBP or lumbar OA. The inverse association of trunk flexion with cLBP and lumbar OA may indicate a role for a flexible spine in avoiding or managing these conditions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2523-2) contains supplementary material, which is available to authorized users. BioMed Central 2019-04-09 /pmc/articles/PMC6456963/ /pubmed/30967130 http://dx.doi.org/10.1186/s12891-019-2523-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Goode, Adam P.
Cleveland, Rebecca J.
Schwartz, Todd A.
Nelson, Amanda E.
Kraus, Virginia B.
Hillstrom, Howard J.
Hannan, Marian T.
Flowers, Portia
Renner, Jordan B.
Jordan, Joanne M.
Golightly, Yvonne M.
Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis
title Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis
title_full Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis
title_fullStr Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis
title_full_unstemmed Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis
title_short Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis
title_sort relationship of joint hypermobility with low back pain and lumbar spine osteoarthritis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456963/
https://www.ncbi.nlm.nih.gov/pubmed/30967130
http://dx.doi.org/10.1186/s12891-019-2523-2
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