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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 277 - 277
1 May 2009
Shiri R Viikari-Juntura E Leino-Arjas P Vehmas T Varonen H Moilanen L Karppinen J Heliövaara M
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Aims: Both clinical and epidemiologic studies have shown an association between atherosclerotic changes in the aorta or lumbar arteries and lumbar disc degeneration. However, the association between atherosclerosis and sciatica is unknown. The aim of this study was to investigate the association between carotid intima-media thickness (IMT) and clinically defined sciatica in a representative population sample.

Methods: The target population consisted of people aged 45–74 years who had participated in a nationwide Finnish population study during 2000–2001 and lived within 200 kilometres from the six study clinics. Of the 1867 eligible subjects, 1386 (74%) were included in the study. High-resolution B-mode ultrasound imaging was used to measure IMT. Local or radiating low back pain (LBP) was determined by a standard interview and clinical signs of sciatica by physician’s clinical examination.

Results: Carotid IMT was associated with continuous radiating LBP and with a positive unilateral clinical sign of sciatica. The associations were seen only in men; after adjustment for potential confounders, each standard deviation (0.23 mm) increment in carotid IMT showed an odds ratio of 1.6 (95% confidence interval 1.1–2.3) for continuous radiating LBP and 1.7 (95% confidence interval 1.3–2.1) for a positive unilateral clinical sign of sciatica. This latter association was observed in subjects with and in those without exposure to physical work load factors. Carotid IMT was not associated with local LBP.

Conclusions: Sciatica may be a manifestation of atherosclerosis, or both conditions may share common risk factors.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 279 - 279
1 May 2009
Karppinen J Pienimäki T Remes J Taimela S Zitting P Leino-Arjas P
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Purpose: The aim of this study was to investigate whether distress alone or in combination with personality traits associates with low back pain (LBP) in adolescence.

Materials and methods: Oulu Back Study (OBS) is a sub-cohort of the Northern Finland 1986 Birth Cohort. Data was collected at 16 and 18 years. The response rate was 69% (1987/2969). Incident cases reported LBP at 18 but not at 16, whereas persistent cases reported back pain at both time points. Distress (GHQ-12) and personality traits (hostility, optimism-pessimism, trait anxiety) were inquired at 18. Logistic regression analysis, stratified for gender, with adjustment for BMI, physical activity, smoking, parents’ socioeconomic status, sedentary hours, and sleep disturbances at 16 years was used. Additionally, the psychological determinants were mutually adjusted in the final analysis.

Results: Distress was associated independently with incident LBP among boys (highest quartile vs. lowest: OR 2.47; 95% CI 1.17–5.21), whereas none of the psychological determinants were significant in incident pain among girls. Trait anxiety was associated with persistent LBP among girls (OR 2.27; 1.09–4.75), and of borderline significance with boys’ persistent pain (OR 2.40; 0.99–5.84). The combination of trait anxiety and distress (highest quartiles) associated significantly with both incident and persistent pain in both genders (OR range from 1.95 to 2.36), whereas of the other combinations of distress with personality traits only pessimism associated with persistent LBP among boys (OR 2.05).

Conclusions: Perceived distress and trait anxiety, alone and especially combined with each other, associate with self-reported LBP in adolescence.