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Second Edition: Low Back Pain (LBP)

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 30 June 2024 | Viewed by 24372

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Prof. Dr. Vincenzo Denaro

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Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, 00128 Rome, Italy
Interests: spine; orthopedic and trauma surgery; sports medicine; joint replacement
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Prof. Dr. Sergio Iavicoli

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Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL—Italian Workers’ Compensation Authority, Monte Porzio Catone, 00078 Rome, Italy
Interests: occupational health and safety; public health; occupational risks; risk assessment; evaluation of interventions; work-related stress
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Dr. Fabrizio Russo

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Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Roma, Italy
Interests: spine; spine surgery; musculoskeletal system; orthopedic and trauma surgery; cartilage; osteoarthritis; joint reconstruction and replacement; tissue regeneration; stem cells
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Dr. Gianluca Vadalà

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Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of Rome, 00128 Rome, Italy
Interests: spine biomechanics; intervertebral disc; sport medicine; knee; tissue regeneration; mesenchymal stem cells
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Special Issue Information

Dear Colleagues,

Following the excellent results obtained from the previous Special Issue “Low Back Pain”, and in consideration of the continued relevance of this topic and the ongoing development of new technologies and treatments, we are pleased to announce the Special Issue “Second Edition: Low Back Pain (LBP)”. Low back pain (LBP) is a common worldwide disorder that significantly impacts productivity, ability to work, and quality of life. As it primarily affects individuals of working age, it is among the leading causes of sick leave and early retirement, with associated economic losses that may reach up to 2% of the gross domestic product in some countries. In addition, LBP treatment usually requires a multidisciplinary approach in which the concept of precision medicine and the adoption of innovative technologies, both related to conservative and surgical strategies, are profoundly revolutionizing the field.

In the new era of personalized medical care, the interest in patient-tailored LBP treatment continues to increase. According to the latest reports, LBP care cannot be based solely on generalized guidelines and protocols but must carefully consider all contributing factors, including occupational, psychosocial, and systemic determinants. Furthermore, the forced sedentary lifestyle and change in work conditions imposed by the COVID-19 pandemic have further reshaped this condition's treatment while also proposing new methods to deliver continuous care (e.g., telemedicine). Therefore, a personalized, multidimensional, and precision medicine approach is urgently needed to improve the care and outcomes of patients with LBP. In this framework, novel tools (including artificial intelligence and biosensors) may support the identification of previously unknown factors which may be key players in the definition of specific LBP phenotypes. At the same time, as the number of surgical procedures to the lumbar spine is increasing worldwide, innovative technologies such as robotic and navigated surgery are gradually emerging to improve safety and accuracy while reducing operation time and optimizing surgical outcomes following lumbar spine surgery.

The present Special Issue offers a unique opportunity to update many of the recent advances and perspectives of this critical health problem. We kindly renew the invitation to submit high-quality research papers on the following topics: prevalence and epidemiological data, etiology, prevention, assessment and treatment approaches, and health promotion strategies for LBP. We particularly welcome new insights into the use of innovative technologies, including artificial intelligence, telemedicine, robotic and navigated surgery, and biosensors in lumbar spine disorders.

We are glad to present the Second Edition of this Special Issue by the International Journal of Environmental Research and Public Health. We invite all experts in the field—both clinicians and researchers—to submit their manuscript for consideration in this Special Issue. Papers may differ from literature reviews (systematic reviews and meta-analyses) to original research (clinical trials, cohort studies, experimental lab work, case-control studies). We warmly welcome multidisciplinary projects, and papers with substantial implications for practice and high translational potential.

Prof. Dr. Vincenzo Denaro
Prof. Dr. Sergio Iavicoli
Dr. Fabrizio Russo
Dr. Gianluca Vadalà
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

low back pain
robot
navigation
sensors
precision medicine
COVID-19
conservative treatment

Related Special Issue

Low Back Pain (LBP) in International Journal of Environmental Research and Public Health (20 articles)

Published Papers (7 papers)

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Research

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15 pages, 1922 KiB

Open AccessArticle

Biomechanical Consequences of Using Passive and Active Back-Support Exoskeletons during Different Manual Handling Tasks

by Mathilde Schwartz, Kévin Desbrosses, Jean Theurel and Guillaume Mornieux

Int. J. Environ. Res. Public Health 2023, 20(15), 6468; https://doi.org/10.3390/ijerph20156468 - 28 Jul 2023

Viewed by 1354

Abstract

The aim of this study was to assess, for both men and women, the consequences of using different back-support exoskeletons during various manual material tasks (MMH) on the activity of back muscles and trunk kinematics. Fifteen men and fourteen women performed MMH involving a 15 kg load (a static task, a symmetric lifting task, and an asymmetric lifting task). Four exoskeleton conditions were tested: without equipment (CON) and with three exoskeletons passive (P-EXO), and active (A-EXO1 and A-EXO2)). The electromyographic activity of the lower trapezius (TZ), latissimus dorsi (LD), erector spinae (ES), gluteus maximus (GM), and biceps femoris (BF) muscles was recorded. Trunk kinematics were evaluated to provide average thoracic, lumbar, and hip angles. The use of the P-EXO decreased the activity of LD, GM, and BF from −12 to −27% (p < 0.01) compared to CON, mostly during the static task. The A-EXO1 and A-EXO2 reduced the muscle activity of all studied muscles from −7 to −62% (p < 0.01) compared to CON and from −10 to −52% (p < 0.005) compared to the P-EXO, independently of the modalities of the experimental tasks. A statistical interaction between the sex and exoskeleton was only observed in a few rare conditions. Occupational back-support exoskeletons can reduce trunk extensor muscle activity compared to no equipment being used. However, these reductions were modulated by the exoskeleton technology (passive vs. active), design (weight and anthropomorphism), and the modalities of the task performed (static vs. dynamic). Our results also showed that the active exoskeletons could modify the trunk kinematics. Full article

(This article belongs to the Special Issue Second Edition: Low Back Pain (LBP))

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11 pages, 375 KiB

Open AccessArticle

Quality of Life and Mental Distress in Patients with Chronic Low Back Pain: A Cross-Sectional Study

by Dijana Hnatešen, Roman Pavić, Ivan Radoš, Iva Dimitrijević, Dino Budrovac, Maja Čebohin and Ivana Gusar

Int. J. Environ. Res. Public Health 2022, 19(17), 10657; https://doi.org/10.3390/ijerph191710657 - 26 Aug 2022

Cited by 6 | Viewed by 2548

Abstract

The aim of this study was to examine the levels of health-related quality of life (HRQoL), pain intensity, and mental distress in participants with chronic low back pain (CLBP), and to examine the differences in the HRQoL of participants with respect to mental distress and the correlations of the examined variables. Data were collected from 148 patients using the SF-36 Health Status Questionnaire (SF-36), the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) questionnaire, and the visual-analog pain scale (VAS). The results indicate poorer self-assessment of physical health (M_e = 28.1) compared to mental health (M_e = 39.4). Participants with higher levels of mental distress reported significant emotional limitations (p = 0.003), lower energy (p < 0.001), poorer psychological health (p < 0.001) and social functioning (p < 0.001), more pain (p = 0.007), and, ultimately, poorer general health (p < 0.001). The level of mental distress was related to the level of HRQoL, while a correlation with the level of pain of the participants was not found. The study results indicate a connection between the presence of mental distress and almost all aspects of HRQoL in participants with CLBP. Full article

(This article belongs to the Special Issue Second Edition: Low Back Pain (LBP))

13 pages, 1140 KiB

Open AccessArticle

Predictors of Low Back Pain Risk among Rubber Harvesters

by Parnchon Chokprasit, Supabhorn Yimthiang and Siriluk Veerasakul

Int. J. Environ. Res. Public Health 2022, 19(17), 10492; https://doi.org/10.3390/ijerph191710492 - 23 Aug 2022

Cited by 5 | Viewed by 1878

Abstract

Low back pain (LBP) is a significant work-related musculoskeletal disorder among rubber farmers. This major occupational health problem was highly reported in the agricultural sector. While rubber farming is a profession with high risk of LBP, predictors for LBP remain unclear. This study was designed to investigate the risk predictors of LBP among rubber farmers during the harvesting process. A cross-sectional study was conducted between January and March 2021, in which an interviewer administered a pretested structured questionnaire. Bivariate and multivariate binary logistic regression analyses were performed. A total of 317 rubber farmers were recruited with a 100% response rate. The prevalence of LBP was 71.2% with 95% confidence interval (CI) of (0.716–1.900). Significant risk predictors were working experience (adjusted odds ratio (AOR): 1.743, 95% CI (1.034–2.937)), agricultural registration (AOR: 2.022, 95% CI (1.078–3.792)), work without training (AOR: 2.037, 95% CI (1.083–3.832)), heavy workload (AOR: 2.120, 95% CI (1.242–3.621)), and prolonged standing (AOR: 2.944, 95% CI (1.586–5.465)). Intriguingly, those with sufficient income had a reduced risk of LBP than those with insufficient income. This study confirmed that LBP is a major work-related musculoskeletal disorder among rubber farmers. The result here suggests that the five predictors reported above should be prioritized for further disease prevention. Full article

(This article belongs to the Special Issue Second Edition: Low Back Pain (LBP))

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Review

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20 pages, 663 KiB

Open AccessReview

Artificial Intelligence and Computer Aided Diagnosis in Chronic Low Back Pain: A Systematic Review

by Federico D’Antoni, Fabrizio Russo, Luca Ambrosio, Luca Bacco, Luca Vollero, Gianluca Vadalà, Mario Merone, Rocco Papalia and Vincenzo Denaro

Int. J. Environ. Res. Public Health 2022, 19(10), 5971; https://doi.org/10.3390/ijerph19105971 - 14 May 2022

Cited by 23 | Viewed by 5097

Abstract

Low Back Pain (LBP) is currently the first cause of disability in the world, with a significant socioeconomic burden. Diagnosis and treatment of LBP often involve a multidisciplinary, individualized approach consisting of several outcome measures and imaging data along with emerging technologies. The increased amount of data generated in this process has led to the development of methods related to artificial intelligence (AI), and to computer-aided diagnosis (CAD) in particular, which aim to assist and improve the diagnosis and treatment of LBP. In this manuscript, we have systematically reviewed the available literature on the use of CAD in the diagnosis and treatment of chronic LBP. A systematic research of PubMed, Scopus, and Web of Science electronic databases was performed. The search strategy was set as the combinations of the following keywords: “Artificial Intelligence”, “Machine Learning”, “Deep Learning”, “Neural Network”, “Computer Aided Diagnosis”, “Low Back Pain”, “Lumbar”, “Intervertebral Disc Degeneration”, “Spine Surgery”, etc. The search returned a total of 1536 articles. After duplication removal and evaluation of the abstracts, 1386 were excluded, whereas 93 papers were excluded after full-text examination, taking the number of eligible articles to 57. The main applications of CAD in LBP included classification and regression. Classification is used to identify or categorize a disease, whereas regression is used to produce a numerical output as a quantitative evaluation of some measure. The best performing systems were developed to diagnose degenerative changes of the spine from imaging data, with average accuracy rates >80%. However, notable outcomes were also reported for CAD tools executing different tasks including analysis of clinical, biomechanical, electrophysiological, and functional imaging data. Further studies are needed to better define the role of CAD in LBP care. Full article

(This article belongs to the Special Issue Second Edition: Low Back Pain (LBP))

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20 pages, 7256 KiB

Open AccessSystematic Review

Association of Low Back Pain with Shift Work: A Meta-Analysis

by Ho-Ming Chen, Po-Yao Huang, Hung-Yi Chuang, Chao-Ling Wang, Chen-Cheng Yang, Peng-Ju Huang and Chi-Kung Ho

Int. J. Environ. Res. Public Health 2023, 20(2), 918; https://doi.org/10.3390/ijerph20020918 - 04 Jan 2023

Cited by 1 | Viewed by 2427

Abstract

Shift work (SW) is the main working schedule worldwide, and it may cause sleep disorders, breast cancer, and cardiovascular disease. Low back pain (LBP) is a common problem in the workplace; however, the association between LBP and SW remains unclear. Therefore, we conducted a meta-analysis to determine the association between SW and LBP. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and Web of Science databases using a set of associated keywords were queried. The inclusion criteria were as follows: (1) adult employees hired by a company or organization; (2) SW exposure; and (3) the outcome of LBP according to examination or assessment. A total of 40 studies were included that met the inclusion criteria for the meta-analysis. SW was significantly associated with LBP (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.18–1.47, p < 0.00001). Furthermore, it was observed that LBP was significantly associated with night shift (NS) (OR: 1.49, 95% CI: 1.24–1.82, p < 0.0001) but not with rotating shift (RS) (OR: 0.96, 95% CI: 0.76–1.22, p = 0.49). Moreover, LBP was significantly associated with SW in health care workers (HCWs) (OR: 1.40, 95% CI: 1.20–1.63, p < 0.0001) but not in non-HCWs (OR: 1.19, 95% CI: 0.94–1.50, p = 0.14). SW was significantly associated with LBP. Furthermore, the subgroup analysis showed that NS, but not RS, was associated with LBP. Compared with SW in non-HCWs, SW in HCWs was significantly associated with LBP. Full article

(This article belongs to the Special Issue Second Edition: Low Back Pain (LBP))

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9 pages, 1207 KiB

Open AccessPerspective

Non-Specific Low Back Pain, Dietary Salt Intake, and Posterior Lumbar Subcutaneous Edema

by Ronald B. Brown

Int. J. Environ. Res. Public Health 2022, 19(15), 9158; https://doi.org/10.3390/ijerph19159158 - 27 Jul 2022

Cited by 5 | Viewed by 5264

Abstract

Low back pain is the world’s leading disability, but the etiology of the majority of low back pain is non-specific with no known cause. Moreover, overuse of opioids to treat low back pain is a widespread problem. This paper proposes that non-specific low back pain may be associated with excessive intake of dietary salt, potentially mediated by posterior lumbar subcutaneous edema. In addition to pain, symptoms of edema include swelling, tightness, and stiff joints, which are common complaints of people with low back pain, along with restricted lumbar range of motion and impaired mobility. Many global populations consume excess sodium chloride, which can lead to fluid overload in hypervolemia, and cause swelling and temporary weight gain associated with low back pain. Numerous conditions comorbid with low back pain are also potentially mediated by excessive salt intake, including migraine headache, hypertension, cardiovascular disease, venous thromboembolism, liver disease, respiratory disorders, chronic kidney disease, pregnancy complications, and multiple sclerosis. Novel approaches to identify and prevent the cause of non-specific low back pain have potential to reduce disability worldwide by reducing low back pain prevalence. More research is needed to confirm the involvement of dietary salt and posterior lumbar subcutaneous edema in non-specific low back pain. Full article

(This article belongs to the Special Issue Second Edition: Low Back Pain (LBP))

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11 pages, 2082 KiB

Open AccessSystematic Review

COVID-19 Pandemic Increases the Impact of Low Back Pain: A Systematic Review and Metanalysis

by Giuseppe Francesco Papalia, Giorgia Petrucci, Fabrizio Russo, Luca Ambrosio, Gianluca Vadalà, Sergio Iavicoli, Rocco Papalia and Vincenzo Denaro

Int. J. Environ. Res. Public Health 2022, 19(8), 4599; https://doi.org/10.3390/ijerph19084599 - 11 Apr 2022

Cited by 32 | Viewed by 4477

Abstract

In March 2019, the World Health Organization (WHO) recognized the COVID-19 pandemic as a global issue. To reduce the spread of this disease, health safety pathways were implemented worldwide. These extraordinary measures changed people’s lifestyles, e.g., by being forced to isolate, and in many cases, to work remotely from home. Low back pain (LBP), the most common cause of disability worldwide, is often a symptom of COVID-19. Moreover, it is often associated with different lifestyle features (type of job, physical activity, body weight). Therefore, the purpose of this systematic review and meta-analysis was to estimate the effect of the COVID-19 lockdown on LBP intensity and prevalence compared with LBP rates before the pandemic. A systematic search was performed on Scopus, PubMed, and Cochrane Central. Overall, eight studies with 2365 patients were included in the analysis. We used the Joanna Briggs Institute (JBI) critical appraisal tool to evaluate the risk of bias: six studies (75%) were at moderate risk of bias and two studies (25%) were at low risk of bias. These studies showed an increase in both the prevalence and intensity of LBP during the COVID-19 lockdown. Full article

(This article belongs to the Special Issue Second Edition: Low Back Pain (LBP))

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