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BMC Musculoskelet Disord. 2019 Apr 9;20(1):158. doi: 10.1186/s12891-019-2523-2.

Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis.

Author information

1
Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA. Adam.goode@duke.edu.
2
Duke Clinical Research Institute, Duke University, Durham, NC, USA. Adam.goode@duke.edu.
3
Duke Department of Population Health Sciences, Durham, NC, USA. Adam.goode@duke.edu.
4
Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
5
Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
6
Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA.
7
Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
8
Hospital for Special Surgery, New York, NY, USA.
9
Institute for Aging Research, Hebrew Senior Life, and Harvard Medical School, Boston, MA, USA.
10
Department of Radiology, University of North Carolina, Chapel Hill, NC, USA.
11
Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA.
12
Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
13
Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA.

Abstract

BACKGROUND:

Chronic low back pain (cLBP) affects millions of Americans and costs billions. Studies suggest a link between cLBP and joint hypermobility.

METHODS:

We conducted cross-sectional primary analyses of joint hypermobility and cLBP, lumbar spine osteoarthritis (OA), and lumbar facet joint OA (FOA) in 3 large studies-the Generalized Osteoarthritis Study, Genetics of Generalized Osteoarthritis Study, and Johnston County Osteoarthritis Project (total n = 5072). Associations of joint hypermobility and Beighton trunk flexion with cLBP and lumbar OA were estimated using separate adjusted logistic regression models. Adjusted pooled odds ratios (pORs) and 95% confidence intervals (CIs) were then summarized-using random effect univariate, multivariate crude, and adjusted models-and heterogeneity was determined (I2 statistic).

RESULTS:

In univariate models, hypermobility was associated with symptomatic FOA (pOR = 0.64 [95% CI 0.44, 0.93]) but this result was not found in the multivariate models. In multivariate adjusted models, hypermobility was not significantly associated with cLBP and lumbar OA, but trunk flexion was inversely associated with cLBP (pOR = 0.40 [95% 0.26, 0.62]), spine OA (pOR = 0.66 [95% CI 0.50, 0.87]), symptomatic spine OA (pOR = 0.39 [95% CI 0.28, 0.53]), and symptomatic FOA (pOR = 0.53 [95% CI 0.37, 0.77]). Generally, between-study heterogeneity was moderate-high.

CONCLUSIONS:

Hypermobility was not associated with cLBP or lumbar OA. The inverse association of trunk flexion with cLBP and lumbar OA may indicate a role for a flexible spine in avoiding or managing these conditions.

KEYWORDS:

Facet joint; Hypermobility; Intervertebral disc; Low back pain; Lumbar spine; Osteoarthritis

PMID:
30967130
DOI:
10.1186/s12891-019-2523-2
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