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      The association between physical activity and neck and low back pain: a systematic review

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          Abstract

          The effect of physical activity on neck and low back pain is still controversial. No systematic review has been conducted on the association between daily physical activity and neck and low back pain. The objective of this study was to evaluate the association between physical activity and the incidence/prevalence of neck and low back pain. Publications were systematically searched from 1980 to June 2009 in several databases. The following key words were used: neck pain, back pain, physical activity, leisure time activity, daily activity, everyday activity, lifestyle activity, sedentary, and physical inactivity. A hand search of relevant journals was also carried out. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. The strength of the evidence was based on methodological quality and consistency of the results. Seventeen studies were included in this review, of which 13 were rated as high-quality studies. Of high-quality studies, there was limited evidence for no association between physical activity and neck pain in workers and strong evidence for no association in school children. Conflicting evidence was found for the association between physical activity and low back pain in both general population and school children. Literature with respect to the effect of physical activity on neck and low back pain was too heterogeneous and more research is needed before any final conclusion can be reached.

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          Most cited references 46

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          The economic burden of back pain in the UK.

          This paper reports the results of a 'cost-of-illness' study of the socio-economic costs of back pain in the UK. It estimates the direct health care cost of back pain in 1998 to be pound1632 million. Approximately 35% of this cost relates to services provided in the private sector and thus is most likely paid for directly by patients and their families. With respect to the distribution of cost across different providers, 37% relates to care provided by physiotherapists and allied specialists, 31% is incurred in the hospital sector, 14% relates to primary care, 7% to medication, 6% to community care and 5% to radiology and imaging used for investigation purposes. However, the direct cost of back pain is insignificant compared to the cost of informal care and the production losses related to it, which total pound10668 million. Overall, back pain is one of the most costly conditions for which an economic analysis has been carried out in the UK and this is in line with findings in other countries. Further research is needed to establish the cost-effectiveness of alternative back pain treatments, so as to minimise cost and maximise the health benefit from the resources used in this area.
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            Lumbar disc disorders and low-back pain: socioeconomic factors and consequences.

             Jeffrey Katz (2006)
            Socioeconomic factors are important risk factors for lumbar pain and disability. The total costs of low-back pain in the United States exceed $100 billion per year. Two-thirds of these costs are indirect, due to lost wages and reduced productivity. Each year, the fewer than 5% of the patients who have an episode of low-back pain account for 75% of the total costs. Because indirect costs rely heavily on changes in work status, total costs are difficult to calculate for many women and students as well as elderly and disabled patients. These methodologic challenges notwithstanding, the toll of lumbar disc disorders is enormous, underscoring the critical importance of identifying strategies to prevent these disorders and their consequences.
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              The prevalence of low back pain: a systematic review of the literature from 1966 to 1998.

               Bruce Walker (2000)
              A systematic literature review of population prevalence studies of low back pain between 1966 and 1998 was conducted to investigate data homogeneity and appropriateness for pooling. Fifty-six studies were analyzed using methodologic criteria that examined sample representativeness, data quality, and pain definition. Acceptable studies were assessed for homogeneity and appropriateness for pooling. Thirty were methodologically acceptable. Of these there were significant differences in study design, patient age, mode of data collection, potential temporal effects, and prevalence results. Point prevalence ranged from 12% to 33%, 1-year prevalence ranged from 22% to 65%, and lifetime prevalence ranged from 11% to 84%. A limited number of studies were left for analysis, making the pooling of data difficult. A model using uniform best-practice methods is proposed.
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                Author and article information

                Contributors
                +66-2-2183767 , +66-2-2183766 , prawit.j@chula.ac.th
                Journal
                Eur Spine J
                European Spine Journal
                Springer-Verlag (Berlin/Heidelberg )
                0940-6719
                1432-0932
                27 November 2010
                27 November 2010
                May 2011
                : 20
                : 5
                : 677-689
                Affiliations
                [1 ]Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
                [2 ]Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
                [3 ]Body@Work, Research Center on Physical Activity, Work and Health, TNO-VUmc, Amsterdam, The Netherlands
                1630
                10.1007/s00586-010-1630-4
                3082686
                21113635
                © The Author(s) 2010
                Categories
                Review Article
                Custom metadata
                © Springer-Verlag 2011

                Orthopedics

                systematic review, lifestyle, daily activity, spinal pain

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