While the majority of our clients make their way to our clinic as a result of chronic, long term conditions, we also see many patients who are suffering from pain caused by a direct, or indirect injury to the spine. Among these, low back pain is by far the most common issue.
With so many of us spending a lot of time on the road today, it’s no surprise that a substantial number of these cases are related to road traffic accidents (workplace injuries from lifting are the other most common story!). Low back pain is common in car crash victims, and can usually be resolved with chiropractic care, assuming there is no underlying serious trauma. Most often, patients are able to quickly recover and go back to their normal lives – but a new study has suggested that those involved in road accidents may actually be at a higher risk for low back pain going forward, even after they have recovered from their initial injury. This week, let’s look at the study.
Low back pain – a common problem!
Globally, low back pain (LBP) is the leading cause of years lived with disability[1] and represents a substantial economic burden with both direct and indirect costs[2]. Low back pain is, without doubt, one of the conditions chiropractors are most commonly associated with since many patients find excellent relief from the condition. Despite this, rates of low back pain seem to be increasing – could a link to road traffic accidents be yet another cause?
Road traffic accidents and low back pain
LBP is a common symptom after being involved in a road traffic accident. In patients reporting to emergency departments after a crash, 37% reported moderate to severe low back pain persisting 6 weeks later.[3] In another study of accident victims in candy, respondents reported being injured in a traffic accident, where they were treated or filed an auto insurance claim within 30 days – 60.4% reported LBP[4].
Given these figures are so high, the association between accidents and LBP has actually been an area of some interest for insurers and governments, meaning there has already been some research. Two studies in 2011 and 2013 found a positive association between a prior low back injury and current LBP [5] whereas a study of insured drivers by Berglund et al.[6] found an increased risk of low back pain up to 7 years later in subjects with an injury in a rear-end collision.
New research
The latest research on this topic utilised data from the Saskatchewan Health and Back Pain Survey (SHBPS), a population-based 21-page mailed survey, on the distribution, determinants and risks of spinal disorders[7].
The Canadian province of Saskatchewan, during the time of the survey, had approximately one million inhabitants with universal health care coverage. Eligible for the study were Saskatchewan residents between the ages of 20 and 69 with a valid Health Services card on August 31, 1995. Excluded from the survey were inmates of correctional facilities, residents under the Office of the Public Trustee, foreign students and workers holding employment or immigration visas, and residents of special care homes[8].
Within a sample of the data, investigators identified 789 individuals at risk from low back pain – of these, 48 had suffered a road traffic accident in the past, and of these 45 reported troublesome low back pains at 6 months from the start of the study – 39 reported LBP at 12 months.
In analysing the data, the study investigators were able to look for an association between those patients reporting a problem with LBP, and those who had previously suffered a road accident. The study investigators confirmed that there was a positive correlation between road accidents, and low back pain – although it was noted that the correlation became less strong once adjustments were made for ongoing conditions such as arthritis.
How to reduce the risk
While specific research is needed to determine the best way you can try to reduce your risk of reoccurring low back pain after an accident, it has already been established that chiropractic maintenance care can be highly effective in reducing the reoccurrence of low back pain in particular – you can read more about that here.
If you have been involved in an accident and are seeking relief from short or long term back pain, why not get in touch today!
[1] Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M et al (2012) Years Lived with Disability (YLDs) for 1160 Sequelae of 289 Diseases and Injuries 1990-2010: A Systematic Analysis for the Global Burden of Disease Study 2010 Lancet. 2012 (Dec 15); 380 (9859): 2163–2196
[2] Hoy D, March L, Brooks P, Woolf A, Blyth F et al (2010) Measuring the global burden of low back pain.Best Pract Res Clin Rheumatol 24:155–165
[4] Hincapie´ C, Cassidy JD, Carroll LJ, Coˆte´ P, Guzma´n J (2010) Whiplash injury is more than neck pain: a population-study of pain localization after traffic injury. J Occup Environ Med 52(4):434–440
[5] Fujii T, Matsudaira K (2013) Prevalence of low back pain and factors associated with chronic disabling back pain in Japan. Eur Spine J 22:432–438
Myran R, Hagen K, Swebak S, Nygaard O, Zwart JA (2011) Headache and musculoskeletal complaints among subjects with self-reported whiplash injury: the HUNT-2 study. BMC Musculoskelet Disord 12:129
[6] Berglund A, Alfredsson L, Jensen I, Cassidy JD, Nygren A ° (2001)
The association between exposure to a rear-end collision and future health complaints. J Clin Epidemiol 54:851–856
[7] Nolet PS, Coˆte´ P, Cassidy JD, Carroll LJ (2011)
The association between a lifetime history of a work-related neck injury and future neck pain: a population based cohort study. J Manip Physiol Ther 34(6):348–355
[8] Carroll LJ, Cassidy JD, Coˆte´ P (2000)
The Saskatchewan Health and Back Pain Survey: the prevalence and factors associated with depressive symptomatology in Saskatchewan adults.
Can J Public Health 91:459–464
