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Open Access Highly Accessed Research article

Chronic low back pain is associated with reduced vertebral bone mineral measures in community-dwelling adults

Andrew M Briggs123*, Leon M Straker12, Angus F Burnett45 and John D Wark36

Author Affiliations

1 School of Physiotherapy, Curtin University, Perth, Australia

2 Curtin Health Innovation Research Institute (CHIRI), Curtin University, GPO Box U1978, 6845 Perth, Western Australia

3 University of Melbourne Department of Medicine, Royal Melbourne Hospital, Melbourne, Australia

4 Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, New Territories Hong Kong

5 School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia

6 Bone and Mineral Service, Royal Melbourne Hospital, Melbourne, Australia

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BMC Musculoskeletal Disorders 2012, 13:49  doi:10.1186/1471-2474-13-49

Published: 30 March 2012

Abstract

Background

Chronic low back pain (CLBP) experienced in middle-age may have important implications for vertebral bone health, although this issue has not been investigated as a primary aim previously. This study investigated the associations between CLBP and dual energy X-ray absorptiometry (DXA)-derived vertebral bone mineral measures acquired from postero-anterior and lateral-projections, among community-dwelling, middle-aged adults.

Methods

Twenty-nine adults with CLBP (11 male, 18 female) and 42 adults with no history of LBP in the preceding year (17 male, 25 female) were evaluated. Self-reported demographic and clinical data were collected via questionnaires. Areal bone mineral density (aBMD) was measured in the lumbar spine by DXA. Apparent volumetric (ap.v) BMD in the lumbar spine was also calculated. Multiple linear regression models were used to examine associations between study group (CLBP and control) and vertebral DXA variables by gender, adjusting for height, mass and age.

Results

There was no difference between groups by gender in anthropometrics or clinical characteristics. In the CLBP group, the mean (SD) duration of CLBP was 13.3 (10.4) years in males and 11.6 (9.9) years in females, with Oswestry Disability Index scores of 16.2 (8.7)% and 15.4 (9.1)%, respectively. Males with CLBP had significantly lower adjusted lateral-projection aBMD and lateral-projection ap.vBMD than controls at L3 with mean differences (standard error) of 0.09 (0.04) g/cm2 (p = 0.03) and 0.02 (0.01) g/cm3 (p = 0.04). These multivariate models accounted for 55% and 53% of the variance in lateral-projection L3 aBMD and lateral-projection L3 ap.vBMD.

Conclusions

CLBP in males is associated with some lumbar vertebral BMD measures, raising important questions about the mechanism and potential clinical impact of this association.