The Spinal Column and Abdominal Pressure changes and their relationship with Pain severity in Patients with Low Back Pain

Abstract

Background: Low back pain (LBP) is a complex condition which is mainly associated with back (multifidi) and abdominal (transverses abdominis) muscles dysfunction. Though pain is one of the indicators of LBP, the literature data regarding relationship between pain and muscle dysfunction is lacking.

Objective: The objective of this study is to investigate the differences in spinal column pressure changes (SCPC) and abdominal pressure changes (APC) in male and female patients with LBP and evaluate their relationship with pain severity.

Methods: Thirty nine patients (28 male and 11 female) with sub-acute or chronic LBP participated in the study. Spinal and abdominal muscles pressure changes were measured by pressure measuring device (PMD) while pain severity (Pain) was assessed by Visual Analogue Scale (VAS). Eight physical characteristics such as Age, Weight, Height, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse rate (PR) were also taken while waist hip ratio (WHR) and body mass index (BMI) were estimated from WC and HC and Weight and Height respectively. Statistical analysis was done using independent Student's t-test, Spearman rank correlation and step wise multiple regression analysis.

Results: The mean Age, Weight, WC, HC, WHR, SBP, DBP, DUR and Pain ofmale and female were found to be similar (p> 0.05). The mean level of both SCPC and APC in male and female differed significantly (p< 0.01) and the levels ofboth were significantly (p< 0.05) high in male than female and for this, significant (p< 0.05) differences in Height, BMI and PR were found to be the responsible. Both spinal column and abdominal pressure changes showed inverse and significant (p< 0.01) correlation with the Pain severity. The WC (waist circumference), HC (hip circumference), BMI and PR were found to be significant risk factors for LBP as they correlate positively and significantly (p< 0.01) with the pain severity. Pain and DUR (duration of pain) were found to be significant predictors of SCPC which accounts for 73% variations of SCPC while Pain, Height and WC of APC which accounts for 61% variations of APC.

Conclusion: In LBP, spinal column and abdominal pressure changes have inverse and significant (p< 0.01) relation with the pain severity. Though, most of the physical characteristics ofmale and female were similar, their spinal and abdominal pressure changes differed significantly. The findings of this study may be helpful in the management of LBP and it is recommended that clinicians should adopt both the pressure changes for diagnostics and prognostics of LBP.