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2015 ; 16
(ä): 374
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Back pain was less explained than leg pain: a cross-sectional study using
magnetic resonance imaging in low back pain patients with and without
radiculopathy
#MMPMID26635015
Jensen OK
; Nielsen CV
; Sørensen JS
; Stengaard-Pedersen K
BMC Musculoskelet Disord
2015[Dec]; 16
(ä): 374
PMID26635015
show ga
BACKGROUND: Cross-sectional studies have shown associations between lumbar
degenerative manifestations on magnetic resonance imaging (MRI) and low back pain
(LBP). Disc herniations and other degenerative manifestations, however,
frequently occur in asymptomatic individuals. The purpose of this cross-sectional
study was to analyze for associations between pain intensity and degenerative
manifestations and other pain variables in patients for whom prognostic factors
have been published previously. METHODS: Included were 141 consecutive patients
with and without radiculopathy, all sick-listed 1-4 months due to low back pain
and subsequently examined by MRI of the lumbar spine. Using different methods of
grouping the degenerative manifestations, linear regression analyses were
performed with the intensity of back + leg pain, back pain and leg pain as
dependent variables covering actual pain and pain the preceding 2 weeks. The
clinical classification into +/- radiculopathy was established before and
independently of the standardised description of MRI findings. RESULTS:
Radiculopathy was present in 43 % of the patients. Pain was best explained using
rank-ordered degenerative manifestations on MRI. Back pain and leg pain were
differently associated, and back pain was less explained than leg pain in the
multivariate analyses (15 % vs. 31 % of the variation). Back pain intensity was
higher in patients with type 1 Modic changes and in some patients with nerve root
touch, but was not associated with disc herniations. Leg pain intensity was well
explained by disc herniations causing MRI nerve root compromise and
radiculopathy. In patients with radiculopathy, nerve root touch caused as much
leg pain as nerve root displacement or compression. High intensity zones and
osteophytes were not associated with back pain, but only associated with leg pain
in patients with radiculopathy. Tender points explained some of the back pain,
and widespread pain explained leg pain in some of the patients without
radiculopathy. CONCLUSIONS: Back pain was associated with type 1 Modic changes,
nerve root touch and tender points, whereas leg pain was associated with
osteophytes, HIZ, disc herniation, all sorts of MRI nerve root compromise,
radiculopathy and widespread pain.
|Adult
[MESH]
|Cross-Sectional Studies
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Low Back Pain/*pathology
[MESH]
|Lumbar Vertebrae/*pathology
[MESH]
|Magnetic Resonance Imaging/*statistics & numerical data
[MESH]