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Study using twin registry cites factors associated with chronic back pain
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BOSTON — A presenter of an award-winning study at the North American Spine Society Annual Meeting said risk factors, such as severe obesity, depression and post-traumatic stress disorder should be taken into account during the planning of intervention strategies to reduce chronic back pain.
“The association between most lifestyle factors and lifetime chronic back pain (CBP) was explained by confounding to familial factors with the exception of severe obesity, a high BMI of 35 or greater,” Pradeep Suri, MD, said during his presentation of the research that won for Outstanding Paper: Medical/Interventional Science. “This indicates other factors aside from severe obesity are less likely to be important for chronic back pain (CBP) prevention.”
He added, “On the other hand, we found that psychological factors, such as [post-traumatic stress disorder] PTSD and depression, were strongly associated with CBP with or without adjusting for familiar factors. This suggests that these factors may be more important for CBP prevention.”
Suri and colleagues performed a cross-sectional co-twin control study of the Vietnam Era Twin Registry with about 7,000 participants, of which were 1,326 monozygotic (MZ) pairs. The primary outcome measure was patients self-report of CBP. Investigators looked at lifestyle factors, such as BMI, smoking history, alcohol consumption, physical activity and typical sleep duration. They also looked at psychological factors, such as depression and PTSD. Also, odd ratios were estimated for the correlation between risk factors and lifetime CBP for twins considered as individuals and within-pair co-twin analysis, which included both familial and genetic factors.
Results showed all lifestyle factors correlated with CBP at the individual level; however, only severe obesity significantly correlated with CBP in the within-pair analysis. Suri noted the magnitude of this correlation increased.
“There was a modest magnitude association between smoking and CBP at an individual-level analysis and this was diminished and practically non-existent after adjusting for familial factors,” He said. “When we looked at the obesity CBP association, that got larger after adjusting for familiar factors in the MZ-pair analyses.”
Suri said increased severity of PTSD and depression were strongly correlated with greater lifetime CBP at both the individual-level analysis and with the MZ-pair analysis. – by Monica Jaramillo
Reference:
Suri P, et al. Modifiable risk factors for chronic back pain: Insights using the co-twin control design. Presented at: North American Spine Society Annual Meeting; Oct. 26-29, 2016; Boston.
Disclosure: Suri reports no relevant financial disclosures.