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Prevalence of the different lumbar back pain etiologies in Spain: results from a large observational study in 306 centers (the SMILE study)

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European Orthopaedics and Traumatology

Abstract

Background

Identification of causes involved in low back pain (LBP) should contribute to improving the clinical management.

Methods

A large multicenter observational study assessing the prevalence of LBP causes in Spain. Patient-reported pain, dysfunctionality, and health-related quality of life (HQoL) outcomes after 3 months were registered by the Brief Pain Inventory Short Form (BPI-SF), Oswestry Disability Index (ODI), European Quality of Life-5 Dimensions (EQ-5D), and the Patient’s Global Impression of Change (PGIC). Data analysis was also stratified by the different disciplines of care.

Results

Overall, 6436 patients were recruited mainly in traumatology, rehabilitation, rheumatology, and pain units. Mechanical pain was identified in 92.8 % of patients. Although only 30.7 % of specialists reported use of any chronic LBP characterization system on their daily practice, all patients in the study had any diagnostic test. After 3 months, significant benefits were observed in pain outcomes and functional disability, given the decrease in BPI-SF scores (6.3 vs. 3.4; P < 0.001) and ODI values (51.1 vs. 28.8 % P < 0.001), also in terms of improved HQoL (10.0 vs. 7.7; P < 0.001) and independently of the discipline of care.

Conclusions

Despite of specialist, the study indicate a low rate of characterization system utilization and an overuse of complementary imaging in common practice but improvement in pain, patients’ functionality, and HQoL.

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Acknowledgments

We would like to thank the participating patients and the study Principal Investigators and Collaborators, listed by States as follows:

A Coruña (Dr. Alhendi, Dr. Barca, Dr. Blanco, Dr. Diaz, Dra. Diaz-Vieito, Dr. Fernández, Dr. Figueroa, Dra. López, Dr. Pérez, Dra. Rivas, Dra. Seoane); Álava (Dra. Ayala, Dra. Cabello, Dra. Fernández); Albacete (Dr. Berrocal, Dr. García, Dr. Jiménez, Dr. Judez, Dr. Nalldi, Dra. Sánchez, Dr. Trespalacios); Alicante (Dr. Castillo, Dr. Del Villar, Dr. Escuder, Dr. García, Dr. González, Dr. Hyun, Dr. Margarit, Dr. Moreno, Dr. Navarro, Dra. Peiro, Dr. Ramón, Dr. Santos, Dr. Tovar, Dra. Valls); Asturias (Dr. Abarrio, Dr. Acebal, Dr. Fernández, Dr. Fidalgo, Dr. Llavona, Dra. Mendoza, Dr. Sandoval); Ávila (Dra. Corteguera, Dra. Del Pino, Dr. Gil); Badajoz (Dr. Lozano, Dr. Llera); Barcelona (Dra. Acosta, Dra. Barcelo, Dr. Benalcazar, Dr. Calahorrano, Dr. Casanovas, Dr. Del Amo, Dr. García, Dra. García, Dra. Gómez, Dr. González, Dr. Lavado, Dr. Leiro, Dr. Maled, Dr. Mateo, Dr. Melero, Dr. Morera, Dr. Pellejero, Dr. Peret, Dra. Ridao, Dra. Roca, Dr. Rodríguez, Dr. Samper, Dra. Sánchez, Dra. Sánchez, Dra. Santo, Dra. Sintes, Dra. Sirvent, Dr. Suárez, Dra. Tejero, Dra. Ticó, Dr. Torrente, Dra. Unyó, Dr. Vélez); Cáceres (Dr. Abello, Dr. Leal); Cádiz (Dr. Alvarado, Dra. Álvarez, Dr. Benitez, Dr. Del Pino Algarrada, Dra. Del Pino Contreras, Dr. García, Dra. Grandal, Dr. Martínez Pardo, Dr. Martínez Vázquez, Dr. Martínez Villar, Dr. Rodríguez Haro, Dr. Rodríguez Miranda, Dr. Sánchez, Dra. Solís, Dr. Valenzuela, Dr. Ventura); Cantabria (Dr. Barquín, Dr. Fernández, Dra. Gómez, Dr. Maldonado, Dr. Narcis, Dr. Sarabia); Castellón (Dr. Gómez, Dr. Mercado, Dr. Pérez, Dr. Sabater, Dra. San Mateo, Dr. Tirado, Dr. Vicent, Dr. Vila, Dr. Villegas); Ceuta (Dr. El Hmindi, Dr. Gallego); Cuenca (Dr. Sancho); Girona (Dr. Beltrán, Dra. Mariñansky, Dr. Marull, Dr. Morales, Dra. Ruiz, Dr. Val, Dr. Vilaplana); Granada (Dr. Almazán, Dra. Pozuelo, Dr. Romero, Dr. Velázquez); Guipuzcoa (Dr. Barrera, Dra. Córdoba, Dr. Echavarría); Huelva (Dr. Balbontín, Dr. Camayd, Dr. Gallego, Dr. González); Huesca (Dr. Alarcón, Dra. Casas, Dr. Iglesias, Dr. Joven, Dr. Labad, Dra. Mur, Dr. Schinder, Dr. Vera); Illes Balears (Dr. Antich, Dr. Femenias, Dra. Jalón, Dr. Lacueva, Dra. Peláez, Dr. Rengel, Dr. Salazar); Jaén (Dr. Contreras, Dr. Esqueta, Dr. García, Dr. Gil, Dr. Moreno, Dr. Pérez-Artacho, Dr. Romero); La Rioja (Dr. Gracia, Dr. Malillos); Las Palmas (Dr. Jacinto, Dr. Jiménez, Dr. Machin, Dr. Sánchez Díaz, Dr. Sánchez Henríquez); León (Dr. Amador, Dra. Chico, Dra. Rodríguez); Lugo (Dr. Antolín, Dr. Colino, Dra. Fernández, Dra. García, Dr. López, Dra. Martín, Dr. Miguens, Dr. Montero, Dra. Portero, Dra. Revilla, Dra. Rodríguez, Dr. Solis, Dr. Vázquez); Lleida (Dr. Charlez, Dr. Gómez, Dr. Jove, Dr. Mas, Dr. Prim, Dr. Puertas); Madrid (Dra. Ahijado, Dra. Alonso, Dra. Balmisa, Dr. Cáceres, Dr. Carrillo, Dr. Chana, Dr. De Las Heras, Dra. De Miguel, Dr. Esparragoza, Dra. Fernández García, Dra. Fernández Izquierdo, Dra. Fernández Martín, Dr. Flores, Dr. García Coiradas, Dr. García De La Blanca, Dr. García Fernández, Dra. García Higuera, Dr. García Rodríguez, Dra. González, Dra. Infante, Dra. Madariaga, Dra. Martínez, Dr. Miranda, Dr. Molero, Dr. Molina, Dr. Morell, Dra. Ortega, Dra. Palomino, Dra. Patiño, Dr. Peralta, Dr. Pizones, Dr. Revenga, Dra. Riquelme, Dr. Saez-Arenillas, Dr. Salinero, Dr. Sanz, Dra. Sanz, Dr. Sotillo, Dra. Triviño, Dr. Veiga, Dr. Zubieta, Dr. Zúñiga); Málaga (Dr. Ballesteros, Dr. Cara, Dr. González, Dr. Jiménez, Dr. López, Dr. Narvaez, Dr. Ponce, Dr. Rico, Dr. Robles, Dr. Urbano); Murcia (Dr. Abellán, Dra. Bataller, Dr. Campos, Dr. Castaño, Dr. Fernández Fernández, Dr. Fernández Nicolás, Dr. González, Dr. Martínez, Dr. Puertas); Navarra (Dra. Garaikoetxea, Dr. Marques, Dr. Rotinen, Dr. Sainz); Ourense (Dr. Formigo, Dr. Perrotta, Dr. Ramos, Dr. Rión); Palencia (Dr. Cuenca, Dra. González, Dra. Maestro, Dra. Páez); Pontevedra (Dr. Buján, Dra. Gallego, Dra. González, Dra. Jorge, Dr. López, Dra. Pérez, Dra. Romo); Salamanca (Dr. Borobio, Dr. Borrego, Dr. De Cabo, Dr. García, Dr. López, Dr. Moreno, Dr. Santos); Santa Cruz De Tenerife (Dr. Álvarez, Dr. Arranz, Dr. Calvo, Dr. Cano, Dr. Cornejo, Dr. García-Pumarino); Segovia (Dr. Cermeño); Sevilla (Dr. Baturone, Dr. Bordas, Dra. Bravo, Dra. Fernández, Dra. González, Dr. Jiménez, Dr. Periañez, Dra. Pons, Dr. Prieto, Dr. Sánchez, Dra. Vazquez); Tarragona (Dra. Ferre, Dr. Fos, Dr. Fuentes, Dra. Gómez, Dra. Padrol, Dra. Roca); Teruel (Dr. Castro); Toledo (Dr. Cabañas, Dr. Cantalejo, Dr. Delgado, Dr. Díaz, Dra. García, Dra. Puentes); Valencia (Dra. Ayas, Dr. Baeza, Dr. Belenguer, Dr. Bellver, Dra. Blanes, Dr. Castillo, Dr. De La Cruz, Dr. Domenech, Dr. Escuder, Dr. Fabregat, Dr. Gómez, Dr. Gomis, Dr. Gorgues, Dr. Ibor, Dr. Llopis, Dr. Mañes, Dra. Mora, Dr. Moreno, Dr. Navarro, Dr. Nova, Dr. Orovitg, Dr. Pérez, Dr. Porcar, Dr. Robles, Dr. Segarra, Dr. Sogues, Dr. Tamayo, Dr. Tarazona, Dr. Vazquez, Dr. Villanueva); Valladolid (Dr. Carrera, Dra. Cebrián, Dra. Paredes, Dr. Tesedo, Dr. Vaca); Vizcaya (Dr. Alava, Dr. Duruelo, Dra. Fernández, Dra. Gómez, Dra. López, Dra. Muñoz, Dra. Ortiz, Dr. Reoyo, Dr. Saez, Dra. Torralba, Dr. Torre, Dr. Zugazabeitia); and Zaragoza (Dr. Aparicio, Dr. Arranz, Dr. Cobeta, Dr. Cuenca, Dr. Domingo, Dr. García, Dr. Gómez, Dr. Gorriz, Dra. Lambán, Dr. Martínez, Dr. Modrego, Dr. Navarro, Dr. Nicolau, Dr. Pons, Dr. Quero, Dra. Rodrigo, Dra. Seral, Dra. Serrano, Dr. Sola).

We would also like to acknowledge Irantzu Izco-Basurko for providing scientific editorial assistance.

This work has been funded by Mundipharma Pharmaceuticals S.L.

Conflict of interest

Susana Traseira Lugilde is employed by Mundipharma Pharmaceuticals S.L. The authors have no other relevant affiliations or financial involvement with any organization or entity with interest in or conflict with the subject matter discussed in the manuscript.

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Author notes

  1. David Abejón González

    Present address: Hospital Universitario Quirón, Madrid, Spain

Authors and Affiliations

  1. Pain Unit, Clínica Universitaria de Navarra, Navarra, Spain

    Juan Pérez-Cajaraville

  2. Pain Unit, Hospital Universitario Puerta del Hierro, Madrid, Spain

    David Abejón González

  3. Traumatology Unit, Fundació Privada Hospital de Mollet del Vallès, Barcelona, Spain

    Daniel Romero Esmerats

  4. Traumatology Unit, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Toledo, Spain

    Raul Parrón Cambero

  5. Anesthesiology Unit, Hospital de Especialidades de Puerto Real, Cádiz, Spain

    Fernando Neira Reina

  6. Rehabilitation Unit, Centro de Rehabilitación Ubarmin, Navarra, Spain

    Félix Ceberio Balda

  7. Medical Department, Mundipharma Pharmaceuticals S.L, Madrid, Spain

    Susana Traseira Lugilde

  8. Unidad del Dolor, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, España

    Juan Pérez-Cajaraville

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  1. Juan Pérez-Cajaraville
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Pérez-Cajaraville, J., Abejón González, D., Romero Esmerats, D. et al. Prevalence of the different lumbar back pain etiologies in Spain: results from a large observational study in 306 centers (the SMILE study). Eur Orthop Traumatol 6, 451–459 (2015). https://doi.org/10.1007/s12570-015-0316-0

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