Prevalence of Chronic Nonspecific Low Back Pain and Its Associated Factors among Middle-Aged and Elderly People: An Analysis Based on Data from a Musculoskeletal Examination in Japan

Study DesignA cross-sectional study.PurposeTo clarify the prevalence of chronic nonspecific low back pain (CNSLBP) and its associated factors among middle-aged and elderly Japanese individuals using data from a musculoskeletal examination conducted in general Japanese populations.Overview of LiteratureMost studies evaluating low back pain-associated factors have been conducted in Western countries, but they have not always evaluated CNSLBP.MethodsWe obtained data on 213 subjects aged >50 years who responded to a survey regarding age, gender, body mass index, lifestyle-related diseases (diabetes mellitus, hypertension, and hyperlipidemia), glucocorticoid use, smoking and alcohol-drinking habits, labor intensity, and chronic low back pain (CLBP) and underwent screening for lumbar spinal stenosis, evaluation for quality of life (QOL), and evaluation for specific spinal pathology via thoracolumbar spine X-rays. We investigated the prevalence of CNSLBP and association between CNSLBP and measured variables.ResultsThe prevalence of CNSLBP and chronic specific low back pain (CSLBP) was 15.4% and 9.3%, respectively. Among the subjects with CLBP, 62.2% had CNSLBP. In age-adjusted logistic models, smoking habits (p=0.049, odds ratio [OR]=2.594), low back pain (p<0.001, OR=0.974), lumbar function (p=0.001, OR=0.967), and social function (p=0.023, OR=0.976) in the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were significantly associated with CNSLBP, whereas EQ-5D utility score (p=0.024, OR=0.068), low back pain (p=0.007, OR=0.981), lumbar function (p=0.001, OR=0.963), walking ability (p=0.001, OR=0.968), and social function (p=0.002, OR=0.966) in JOABPEQ were significantly associated with CSLBP.ConclusionsCNSLBP among middle-aged and elderly individuals was associated with smoking habits and decreased QOL; however, CSLBP was considered to be more multilaterally associated decreased QOL

Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle-Aged and Elderly Asian Individuals

Study DesignCross-sectional study.PurposeThe purpose of this study was to evaluate the correlation between pelvic tilt (PT) and the sacro-femoral-pubic (SFP) angle, which is easier to identify than PT, in middle-aged and elderly Asian subjects from the general population.Overview of LiteratureMeasuring PT is important in the diagnosis and treatment of adult spinal deformity. However, identifying femoral heads, which are necessary to determine PT, using sagittal radiographs is often difficult.MethodsStanding coronal and sagittal pelvic radiographs of individuals aged more than 50 years were taken during a local medical examination. The subjects were divided into female, male, and total groups at the time of evaluation. Linear regression analysis was performed to investigate the relationship between PT and the SFP angle, which were obtained from the X-rays.ResultsThe present study included 291 subjects. There were no statistically significant differences between the left and right SFP angles, and there was gender difference regarding the SFP angle. However, a gender difference was observed regarding PT. The correlation between PT and the SFP angle was substantiated in each group. Pearson's correlation coefficients between PT and the SFP angle in the total, female, and male groups were 0.696, 0.853, and 0.619, respectively. In the linear regression analysis, PT was calculated as follows: PT=60.1−0.77×(SFP angle) in the total group, PT=62.8−0.80×(SFP angle) in the female group, and PT=51.5−0.64×(SFP angle) in the male group.ConclusionsA significant correlation between PT and the SFP angle was observed in middle-aged and elderly Asian subjects from the general population

Shoulder and elbow pain in elementary school baseball players : The results from a nation-wide survey in Japan

Background: Despite recommendations on how to prevent baseball injuries in youths by the Japanese Society of Clinical Sports Medicine, shoulder and elbow pain still frequently occurs in young baseball players. We conducted a questionnaire survey among baseball players at elementary schools across the country to understand the practice conditions of players, examining the risk factors of shoulder and elbow pain in baseball players. Methods: The questionnaire survey was conducted among elementary school baseball players as members of the Baseball Federation of Japan in September 2015. Results: A total of 8354 players belonging to 412 teams (average age: 8.9) responded to the survey. Among 7894 players who did not have any shoulder and/or elbow pain in September 2014, elbow pain was experienced in 12.3% of them, shoulder pain in 8.0% and shoulder and/or elbow pain in 17.4% during the previous one year. A total of 2835 (39.9% of the total) practiced four days or more per week and 97.6% practiced 3 h or more per day on Saturdays and Sundays. The risk factors associated shoulder and elbow pain included a male sex, older age, pitchers and catchers, and players throwing more than 50 balls per day. Conclusions: It has been revealed that Japanese elementary school baseball players train too much. Coaches should pay attention to older players, male players, pitchers and catchers in order to prevent shoulder and elbow pain. Furthermore, elementary school baseball players should not be allowed to throw more than 50 balls per day. Study design: Retrospective cohort study

Reliability of Measuring the Proximal Humeral Bone Mineral Density Using Dual-Energy X-ray Absorptiometry

We established a protocol for assessing the areal bone mineral density (BMD) of the proximal humerus using dual-energy X-ray absorptiometry (DXA). We also investigated the correlation between the BMD of the proximal humerus and that of the lumbar spine and proximal femur to predict the BMD of the proximal humerus. We included female patients aged >60 years who underwent bone density evaluation using DXA. The BMD of the proximal humerus was calculated at seven regions of interest (ROIs): the head of the humerus, lesser tubercle, greater tubercle in two locations, and proximal metaphysis in three locations. The intra- and inter-examiner reliabilities in the setting of the ROIs were examined using intraclass correlation coefficients (ICCs) (1.1) and (2.1), respectively, and the intra-examiner reliability in DXA was examined using ICCs (1.1). The intra- and inter-examiner reliabilities in the setting of ROIs and the intra-examiner reliability in DXA were high in all regions. The BMD of the lumbar spine and proximal femur correlated weakly with that of the humeral head and diaphysis. Our method for measuring the BMD of the proximal humerus was found to be reliable and may be applied in future studies

Digital flexion contracture caused by tophaceous gout in flexor tendon

Gouty tophus is an unusual cause of digital flexion contracture. Awareness of this pathophysiology will lead to more confidence in proper treatment and surgical management of this rare condition. This report describes a case of digital flexion contracture by tophaceous gout distinguished between trigger finger and locking of the metacarpophalangeal joint. We found the flexor tendon with a deposited chalky white substance suggestive of gouty tophus intraoperatively. We performed tenosynovectomy and removed the chalky white substance to the greatest degree possible. Histological findings confirmed the diagnosis of gout. Postoperatively, the patient recovered nearly to a full range of motion of the affected digits. When meeting with the patient who has had hyperuricemia and who is unable to extend the affected digits suddenly, one must keep in mind digital flexion contracture caused by tophaceous gout

Prevalence of de Quervain’s Disease in the General Population and Risk Factors

Background & Aims : De Quervain’s disease is known as a representative disease that causes wrist pain, however, its epidemiology remains unclear. The purpose of this study was to elucidate the prevalence of de Quervain’s disease among the general population and to identify its risk factors. M ethods : The subjects participated in the examinations consisted of 402 people(total of 804 hands),including 157 males and 245 females with mean age of 64.1 years. We recorded the subjects’background and medical history and then performed physical examinations. We determined the prevalence of de Quervain’s disease and conducted a statistical analysis to investigate their background factors. Results : De Quervain’s disease was present in 3.7％ (15/402 people) and the prevalence by age group was 9.8％ in their forties,3.6％ in their fifties,1.8％ in their sixties,3.9％ in their seventies,and 3.7％ in their eighties. The prevalence was significantly higher in females than in males. No difference was found in terms of the mean age, hand dominance, height,weight, heaviness of labor activity and presence of medical complication. Conclusions : In the general population, 3.7％ of 402 people had de Quervain’s disease, and its risk factor was identified to be females