What Triggers an LBP Flare? A Content Analysis of Individuals' Perspectives
What Triggers an LBP Flare? A Content Analysis of Individuals' Perspectives
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DOI：
10.1093/pm/pnz021
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发表时间：
2020-01-01
期刊：
影响因子：
3.1
通讯作者：
Setchell, Jenny
中科院分区：
文献类型：
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作者：
Costa, Nathalia;Hodges, Paul W.;Setchell, Jenny
Objective.对于许多人来说，腰痛（LBP）是一种终身疾病，症状随时间而变化。以前的研究已经调查了LBP发病的长期风险因素和触发因素。没有研究检查症状不太明显的波动的原因，例如“耀斑”，LBP患者认为这是LBP的重要和令人担忧的部分。由于对触发这种波动的原因知之甚少，我们的目的是调查个人对LBP爆发触发因素的看法。方法.我们对130名LBP患者进行了一项在线调查，询问他们认为是什么引发了他们的耀斑。使用内容分析对数据进行定性检查。结果大多数参与者确定了生物医学（84.8%）触发因素，赞同物理/生物因素来解释耀斑的发生。主题包括主动运动（35%的参与者），静态姿势（28.1%），过度执行任务（5.3%），生物力学功能障碍（4.4%），合并症（4%），缺乏运动（3.3%），工作（1.8%）和药物（1.5%）。15.2%的人报告了非生物医学触发因素，包括心理社会和背景因素，包括心理状态（6%），天气（5%），睡眠（2%），饮食（1.2%）和疲劳（1%）。这些结果表明，个人认为生物医学因素是LBP耀斑的主要触发因素，但也有人承认非生物医学触发因素。结论.研究结果与当前的疼痛理论形成对比，这表明需要减少对LBP疼痛的生物医学原因的重视，特别是当持续时。识别患者对LBP发作原因的看法对于更好地指导临床实践和进一步研究至关重要。腰痛患者确定的触发因素的有效性需要进一步调查。
Objective. For many, low back pain (LBP) is a lifelong condition with symptoms varying over time. Previous studies have investigated long-term risk factors and triggers for onset of LBP. No study has examined causes for less distinct fluctuations of symptoms, such as "flares," which individuals with LBP identify as a significant and worrisome part of LBP. As little is known about what triggers this type of fluctuation, we aimed to investigate individuals' perspectives on LBP flare triggers. Methods. We conducted an online survey of 130 people with LBP, asking what they think triggers their flares. Data were qualitatively examined using content analysis. Results. Most participants identified biomedical (84.8%) triggers, endorsing physical/biological factors to explain the flare occurrence. Themes included active movements (35% of participants), static postures (28.1%), over doi ng a task (5.3%), biomechanical dysfunction (4.4%), comorbidities (4%), lack of exercise (3.3%), work (1.8%), and medications (1.5%). Nonbiomedical triggers were reported by 15.2% and included psychosocial and contextual factors, including psychological state (6%), weather (5%), sleep (2%), diet (1.2%), and fatigue (1%). These results indicate that individuals consider biomedical factors to be the main triggers of LBP flares, but some acknowledge nonbiomedical triggers. Conclusions. Study findings contrast with current pain theories, which suggest that there is a need for a reduced emphasis on biomedical causes of LBP pain, especially when persistent. Recognition of patients' views on causes of LBP flares is crucial to better guide clinical practice and inform further research. The validity of triggers identified by LBP patients requires further investigation.