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Cardiovascular and lifestyle risk factors in lumbar radicular pain or clinically defined sciatica: a systematic review

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Abstract

Lumbar radicular pain is a fairly common health problem, yet its risk factors are far from clear. There are no published systematic reviews on associations between cardiovascular or lifestyle risk factors and lumbar radicular pain or sciatica. The aim of this systematic literature review was to assess associations between these risk factors and lumbar radicular pain or sciatica. We conducted a systematic search of the Medline database for all original articles on lumbar radicular pain or sciatica published until August 2006. Twenty-two papers from 19 studies were included in the review. Overweight or obesity was associated with sciatica in most of the case-control and cohort studies. Some studies showed an increased risk of lumbar radicular pain in smokers with a long smoking history or in those with high levels of physical activity. A few case-control studies showed an association between serum C-reactive protein and sciatica. No consistent associations were found for serum lipids levels or high blood pressure. In summary, the associations of overweight, long smoking history, high physical activity and a high serum C-reactive protein level with lumbar radicular pain or sciatica were substantiated by the present review. However, more prospective studies are needed in order to further clarify these associations and the mechanisms of action.

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References

  1. An HS, Silveri CP, Simpson JM, File P, Simmons C, Simeone FA, Balderston RA (1994) Comparison of smoking habits between patients with surgically confirmed herniated lumbar and cervical disc disease and controls. J Spinal Disord 7:369–373

    Article  PubMed  CAS  Google Scholar 

  2. Battie MC, Haynor DR, Fisher LD, Gill K, Gibbons LE, Videman T (1995) Similarities in degenerative findings on magnetic resonance images of the lumbar spines of identical twins. J Bone Joint Surg Am 77:1662–1670

    PubMed  CAS  Google Scholar 

  3. Battie MC, Videman T, Gill K, Moneta GB, Nyman R, Kaprio J, Koskenvuo M (1991) Volvo Award in clinical sciences. Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins. Spine 16:1015–1021

    Article  PubMed  CAS  Google Scholar 

  4. Berg AH, Scherer PE (2005) Adipose tissue, inflammation, and cardiovascular disease. Circ Res 96:939–949

    Article  PubMed  CAS  Google Scholar 

  5. Biering-Sorensen F, Hansen FR, Schroll M, Runeborg O (1985) The relation of spinal X-ray to low-back pain and physical activity among 60-year-old men and women. Spine 10:445–451

    Article  PubMed  CAS  Google Scholar 

  6. Bostman OM (1993) Body mass index and height in patients requiring surgery for lumbar intervertebral disc herniation. Spine 18:851–854

    Article  PubMed  CAS  Google Scholar 

  7. Ernst E (1993) Smoking, a cause of back trouble? Br J Rheumatol 32:239–242

    Article  PubMed  CAS  Google Scholar 

  8. Fogelholm M, Kukkonen-Harjula K (2000) Does physical activity prevent weight gain-a systematic review. Obes Rev 1:95–111

    Article  PubMed  CAS  Google Scholar 

  9. Gebhardt K, Brenner H, Sturmer T, Raum E, Richter W, Schiltenwolf M, Buchner M (2006) The course of high-sensitive C-reactive protein in correlation with pain and clinical function in patients with acute lumbosciatic pain and chronic low back pain—a 6 months prospective longitudinal study. Eur J Pain 10(8):711–719

    Article  PubMed  CAS  Google Scholar 

  10. Geffken DF, Cushman M, Burke GL, Polak JF, Sakkinen PA, Tracy RP (2001) Association between physical activity and markers of inflammation in a healthy elderly population. Am J Epidemiol 153:242–250

    Article  PubMed  CAS  Google Scholar 

  11. Han TS, Schouten JS, Lean ME, Seidell JC (1997) The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord 21:600–607

    Article  PubMed  CAS  Google Scholar 

  12. Heliövaara M (1987) Body height, obesity, and risk of herniated lumbar intervertebral disc. Spine 12:469–472

    Article  PubMed  Google Scholar 

  13. Heliövaara M, Impivaara O, Sievers K, Melkas T, Knekt P, Korpi J, Aromaa A (1987) Lumbar disc syndrome in Finland. J Epidemiol Community Health 41:251–258

    PubMed  Google Scholar 

  14. Heliövaara M, Knekt P, Aromaa A (1987) Incidence and risk factors of herniated lumbar intervertebral disc or sciatica leading to hospitalization. J Chronic Dis 40:251–258

    Article  PubMed  Google Scholar 

  15. Heliövaara M, Mäkelã M, Knekt P, Impivaara O, Aromaa A (1991) Determinants of sciatica and low-back pain. Spine 16:608–614

    Article  PubMed  Google Scholar 

  16. Higgins J, Green S (eds) (2005) http://www.cochrane.org/resources/handbook/hbook.htm Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 (updated May 2005). Wiley, Chichester

  17. Hurri H, Karppinen J (2004) Discogenic pain. Pain 112:225–228

    Article  PubMed  Google Scholar 

  18. Iwahashi M, Matsuzaki H, Tokuhashi Y, Wakabayashi K, Uematsu Y (2002) Mechanism of intervertebral disc degeneration caused by nicotine in rabbits to explicate intervertebral disc disorders caused by smoking. Spine 27:1396–1401

    Article  PubMed  Google Scholar 

  19. Kaila-Kangas L, Leino-Arjas P, Riihimäki H, Luukkonen R, Kirjonen J (2003) Smoking and overweight as predictors of hospitalization for back disorders. Spine 28:1860–1868

    Article  PubMed  Google Scholar 

  20. Karvonen MJ, Viitasalo JT, Komi PV, Nummi J, Järvinen T (1980) Back and leg complaints in relation to muscle strength in young men. Scand J Rehabil Med 12:53–59

    PubMed  CAS  Google Scholar 

  21. Kauppila LI, McAlindon T, Evans S, Wilson PW, Kiel D, Felson DT (1997) Disc degeneration/back pain and calcification of the abdominal aorta. A 25-year follow-up study in Framingham. Spine 22:1642–1647, discussion 1648–1649

    Google Scholar 

  22. Kauppila LI, Mikkonen R, Mankinen P, Pelto-Vasenius K, Mãenpãã I (2004) MR aortography and serum cholesterol levels in patients with long-term nonspecific lower back pain. Spine 29:2147–2152

    Article  PubMed  Google Scholar 

  23. Kelsey JL (1975) An epidemiological study of acute herniated lumbar intervertebral discs. Rheumatol Rehabil 14:144–159

    PubMed  CAS  Google Scholar 

  24. Kelsey JL, Githens PB, O’Conner T, Weil U, Calogero JA, Holford TR, White AA 3rd, Walter SD, Ostfeld AM, Southwick WO (1984) Acute prolapsed lumbar intervertebral disc. An epidemiologic study with special reference to driving automobiles and cigarette smoking. Spine 9:608–613

    Article  PubMed  CAS  Google Scholar 

  25. Kostova V, Koleva M (2001) Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors. J Neurol Sci 192:17–25

    Article  PubMed  CAS  Google Scholar 

  26. Le Gars L, Borderie D, Kaplan G, Berenbaum F (2000) Systemic inflammatory response with plasma C-reactive protein elevation in disk-related lumbosciatic syndrome. Joint Bone Spine 67:452–455

    PubMed  CAS  Google Scholar 

  27. Lean ME, Han TS, Seidell JC (1998) Impairment of health and quality of life in people with large waist circumference. Lancet 351:853–856

    Article  PubMed  CAS  Google Scholar 

  28. Leino-Arjas P, Kaila-Kangas L, Solovieva S, Riihimäki H, Kirjonen J, Reunanen A (2006a) Serum lipids and low back pain: an association? A follow-up study of a working population sample. Spine 31:1032–1037

    Article  PubMed  Google Scholar 

  29. Leino-Arjas P, Solovieva S, Kirjonen J, Reunanen A, Riihimäki H (2006b) Cardiovascular risk factors and low-back pain in a long-term follow-up of industrial employees. Scand J Work Environ Health 32:12–19

    PubMed  Google Scholar 

  30. Liuke M, Solovieva S, Lamminen A, Luoma K, Leino-Arjas P, Luukkonen R, Riihimäki H (2005) Disc degeneration of the lumbar spine in relation to overweight. Int J Obes (Lond) 29:903–908

    Article  CAS  Google Scholar 

  31. Luoma K, Riihimäki H, Raininko R, Luukkonen R, Lamminen A, Viikari-Juntura E (1998) Lumbar disc degeneration in relation to occupation. Scand J Work Environ Health 24:358–366

    PubMed  CAS  Google Scholar 

  32. Manninen P, Riihimäk H, Heliövaara M (1995) Incidence and risk factors of low-back pain in middle-aged farmers. Occup Med (Lond) 45:141–146

    Article  CAS  Google Scholar 

  33. Miranda H, Viikari-Juntura E, Martikainen R, Takala EP, Riihimäki H (2001) Physical exercise and musculoskeletal pain among forest industry workers. Scand J Med Sci Sports 11:239–246

    Article  PubMed  CAS  Google Scholar 

  34. Miranda H, Viikari-Juntura E, Martikainen R, Takala EP, Riihimäki H (2002) Individual factors, occupational loading, and physical exercise as predictors of sciatic pain. Spine 27:1102–1109

    Article  PubMed  Google Scholar 

  35. Pietila TA, Stendel R, Kombos T, Ramsbacher J, Schulte T, Brock M (2001) Lumbar disc herniation in patients up to 25 years of age. Neurol Med Chir (Tokyo) 41:340–344

    Article  CAS  Google Scholar 

  36. Riihimäki H, Wickstrom G, Hanninen K, Luopajarvi T (1989) Predictors of sciatic pain among concrete reinforcement workers and house painters-a five-year follow-up. Scand J Work Environ Health 15:415–423

    PubMed  Google Scholar 

  37. Riihimäki H, Viikari-Juntura E, Moneta G, Kuha J, Videman T, Tola S (1994) Incidence of sciatic pain among men in machine operating, dynamic physical work, and sedentary work. A three-year follow-up. Spine 19:138–142

    Article  PubMed  Google Scholar 

  38. Riihimäki H, Viikari-Juntura E, Takala EP, Rauas S, Leppänen A, Malmivaara A, Grönqvist R, Härmä M, Martikainen R, Saarenmaa K, Kuosma E (1993) Factors predicting pain in the low back and lower limbs in forestry work. Työ ja Ihminen (People and Work Research Reports) 7:344–350

    Google Scholar 

  39. Saito M, Ishimitsu T, Minami J, Ono H, Ohrui M, Matsuoka H (2003) Relations of plasma high-sensitivity C-reactive protein to traditional cardiovascular risk factors. Atherosclerosis 167:73–79

    Article  PubMed  CAS  Google Scholar 

  40. Salminen JJ, Erkintalo M, Laine M, Pentti J (1995) Low back pain in the young. A prospective three-year follow-up study of subjects with and without low back pain. Spine 20:2101–2107, discussion 2108

    Google Scholar 

  41. Salminen JJ, Erkintalo-Tertti MO, Paajanen HE (1993) Magnetic resonance imaging findings of lumbar spine in the young: correlation with leisure time physical activity, spinal mobility, and trunk muscle strength in 15-year-old pupils with or without low-back pain. J Spinal Disord 6:386–391

    Article  PubMed  CAS  Google Scholar 

  42. Solovieva S, Lohiniva J, Leino-Arjas P, Raininko R, Luoma K, Ala-Kokko L, Riihimäki H (2002) COL9A3 gene polymorphism and obesity in intervertebral disc degeneration of the lumbar spine: evidence of gene-environment interaction. Spine 27:2691–2696

    Article  PubMed  Google Scholar 

  43. Specchia N, Pagnotta A, Toesca A, Greco F (2002) Cytokines and growth factors in the protruded intervertebral disc of the lumbar spine. Eur Spine J 11:145–151

    Article  PubMed  Google Scholar 

  44. Sturmer T, Raum E, Buchner M, Gebhardt K, Schiltenwolf M, Richter W, Brenner H (2005) Pain and high sensitivity C reactive protein in patients with chronic low back pain and acute sciatic pain. Ann Rheum Dis 64:921–925

    Article  PubMed  CAS  Google Scholar 

  45. Sugimori K, Kawaguchi Y, Morita M, Kitajima I, Kimura T (2003) High-sensitivity analysis of serum C-reactive protein in young patients with lumbar disc herniation. J Bone Joint Surg Br 85:1151–1154

    Article  PubMed  CAS  Google Scholar 

  46. Takahashi H, Suguro T, Okazima Y, Motegi M, Okada Y, Kakiuchi T (1996) Inflammatory cytokines in the herniated disc of the lumbar spine. Spine 21:218–224

    Article  PubMed  CAS  Google Scholar 

  47. Toda Y, Segal N, Toda T, Morimoto T, Ogawa R (2000) Lean body mass and body fat distribution in participants with chronic low back pain. Arch Intern Med 160:3265–3269

    Article  PubMed  CAS  Google Scholar 

  48. Tracy RP, Psaty BM, Macy E, Bovill EG, Cushman M, Cornell ES, Kuller LH (1997) Lifetime smoking exposure affects the association of C-reactive protein with cardiovascular disease risk factors and subclinical disease in healthy elderly subjects. Arterioscler Thromb Vasc Biol 17:2167–2176

    PubMed  CAS  Google Scholar 

  49. Vessey M, Painter R, Mant J (1999) Oral contraception and other factors in relation to back disorders in women: findings in a large cohort study. Contraception 60:331–335

    Article  PubMed  CAS  Google Scholar 

  50. Videman T, Battie MC, Gibbons LE, Manninen H, Gill K, Fisher LD, Koskenvuo M (1997) Lifetime exercise and disk degeneration: an MRI study of monozygotic twins. Med Sci Sports Exerc 29:1350–1356

    PubMed  CAS  Google Scholar 

  51. Videman T, Sarna S, Battie MC, Koskinen S, Gill K, Paananen H, Gibbons L (1995) The long-term effects of physical loading and exercise lifestyles on back-related symptoms, disability, and spinal pathology among men. Spine 20:699–709

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Musculoskeletal Disorders, Finnish Institute of Occupational Health, Topeliuksenkatu 41a A, 00250, Helsinki, Finland

    Rahman Shiri, Jaro Karppinen, Päivi Leino-Arjas, Svetlana Solovieva, Helena Varonen & Eira Viikari-Juntura

  2. Department of Physical Medicine and Rehabilitation, Oulu University Hospital, Oulu, Finland

    Jaro Karppinen

  3. Pain Clinic, Helsinki University Central Hospital, Helsinki, Finland

    Eija Kalso

  4. Department of Internal Medicine, Oulu University, Oulu, Finland

    Olavi Ukkola

Authors
  1. Rahman Shiri
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  2. Jaro Karppinen
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  3. Päivi Leino-Arjas
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  4. Svetlana Solovieva
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Correspondence to Rahman Shiri.

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Shiri, R., Karppinen, J., Leino-Arjas, P. et al. Cardiovascular and lifestyle risk factors in lumbar radicular pain or clinically defined sciatica: a systematic review. Eur Spine J 16, 2043–2054 (2007). https://doi.org/10.1007/s00586-007-0362-6

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  • DOI: https://doi.org/10.1007/s00586-007-0362-6

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