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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2019

Open Access 01-12-2019 | Chronic Pain Syndrome | Review article

The association between headache and low back pain: a systematic review

Authors: Arani Vivekanantham, Claire Edwin, Tamar Pincus, Manjit Matharu, Helen Parsons, Martin Underwood

Published in: The Journal of Headache and Pain | Issue 1/2019

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Abstract

Background

To systematically review studies quantifying the association between primary chronic headaches and persistent low back pain (LBP).

Main text

We searched five electronic databases. We included case-control, cross-sectional and cohort studies that included a headache and back pain free group, reporting on any association between persistent LBP and primary headache disorders. Methodological quality was assessed using Newcastle-Ottawa Scale. Our primary outcome was the association between primary headache disorders and persistent LBP. Our secondary outcomes were any associations between severity of LBP and severity of headache, and the relationship between specific headache sub-types classified as per International Classification of Headache Disorders (ICHD) criteria and persistent LBP.
We included 14 studies. The sizes of the studies ranged from 88 participants to a large international study with 404, 206 participants. Odds ratios for the association were between 1.55 (95% confidence interval (CI) 1.13–2.11) and 8.00 (95% CI 5.3–12.1). Study heterogeneity meant statistical pooling was not possible. Only two studies presented data investigating persistent LBP and chronic headache disorders in accordance with ICDH criteria.

Conclusions

We identified a positive association between persistent LBP and primary headache disorders. The quality of the review findings is limited by diversity of populations, study designs and uncertainly about headache and LBP definitions.

Trial registration

PROSPERO 2018 CRD42018086557.
Appendix
Available only for authorised users
Literature
1.
GBD 2015 Disease and Injury Incidence and Prevalance Collaborators (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1474–547X (Electronic)
2.
Hartvigsen J, Hancock MJ, Kongsted A et al (2018) What low back pain is and why we need to pay attention. Lancet 391(10137):2356–2367PubMedCrossRef
3.
International Headache Society (2018) The international classification of headache disorders, 3rd edition. Cephalalgia 38:1–211
4.
Nichols VP, Ellard DR, Griffiths FE et al (2017) The lived experience of chronic headache: a systematic review and synthesis of the qualitative literature. BMJ Open 7(12):e019929PubMedPubMedCentralCrossRef
5.
Stovner LJ, Hagen K, Jensen R et al (2007) The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 27(3):193–210PubMedCrossRef
6.
Dunn KM, Croft PR (2004) Epidemiology and natural history of low back pain. Europa Medicophysica 40:0014–2573 (Print)
7.
Dionne CE, Dunn KM, Croft PR et al (2008) A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 33(1):95–103PubMedCrossRef
8.
9.
National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management. United Kingdom National Institute for Clinical Excellence. 2016
10.
Yoon MS, Manack A, Schramm S et al (2013) Chronic migraine and chronic tension-type headache are associated with concomitant low back pain: results of the German headache consortium study. Pain. 154:484–492PubMedCrossRef
11.
Dunn KM, Jordan K, Croft PR (2006) Characterizing the course of low back pain: a latent class analysis. Am J Epidemiol 163:754–761PubMedCrossRef
12.
LA Moher D, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7):e1000097PubMedPubMedCentralCrossRef
13.
Wells G, Shea B, O’Connell D, et al. Newcastle-Ottawa Quality Assessment Scale, Cohort Studies. 2014
14.
GA Wells, B Shea, D O’Connell, et al. The Newcastle–Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2012
15.
Hartvigsen J, Christensen K, Frederiksen H (2003) Back pain remains a common symptom in old age. A population-based study of 4486 Danish twins aged 70-102. Eur Spine J 12:528–534PubMedPubMedCentralCrossRef
16.
Hartvigsen J, Christensen K, Frederiksen H (2004) Back and neck pain exhibit many common features in old age: a population-based study of 4,486 Danish twins 70-102 years of age. Spine. 29:576–580PubMedCrossRef
17.
Jones GT, Watson KD, Silman AJ et al (2003) Predictors of low back pain in British schoolchildren: a population-based prospective cohort study. Pediatrics. 111:822–828PubMedCrossRef
18.
Ghandour RM, Overpeck MD, Huang ZHJ et al (2004) Headache, stomachache, backache, and morning fatigue among adolescent girls in the United States - Associations with behavioral, sociodemographic, and. environmental factors. Arch Pediatr Adolesc Med 158:797–803PubMedCrossRef
19.
20.
21.
Angst F, Angst J, Ajdacic-Gross V et al (2017) Epidemiology of Back pain in young and middle-aged adults: a longitudinal population cohort survey from age 27-50 years. Psychosomatics. 58:604–613PubMedCrossRef
22.
Ashina S, Lipton RB, Bendtsen L et al (2018) Increased pain sensitivity in migraine and tension-type headache coexistent with low back pain: a cross-sectional population study. Eur J Pain 22(5):904–914PubMedCrossRef
23.
Bejia I, Younes M, Jamila HB et al (2005) Prevalence and factors associated to low back pain among hospital staff. Joint Bone Spine 72:254–259PubMedCrossRef
24.
Bener A, Dafeeah EE, Salem MO (2015) Determinants of depression and somatisation symptoms in low back pain patients and its treatment: global burden of diseases. JPMA J Pak Med Assoc 65:473–479PubMed
25.
Ahangar AA, Hossini SR, Kheirkhah F et al (2016) Associated factors of headache in an unstudied cohort of elderly subjects. Caspian J Intern Med 7:120–125
26.
Hestbaek L, Leboeuf-Yde C, Kyvik KO (2006) Is comorbidity in adolescence a predictor for adult low back pain? A prospective study of a young population. BMC Musculoskelet Disord 7:29PubMedPubMedCentralCrossRef
27.
Hestbaek L, Leboeuf-Yde C, Kyvik KO et al (2004) Comorbidity with low back pain: a cross-sectional population-based survey of 12- to 22-year-olds. Spine. 29:1483–1491 discussion 92PubMedCrossRef
28.
Schur EA, Afari N, Furberg H et al (2007) Feeling bad in more ways than one: comorbidity patterns of medically unexplained and psychiatric conditions. J Gen Intern Med 22:818–821PubMedPubMedCentralCrossRef
29.
Roland M, Fairbank J (2000) The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine. 25:3115–3124PubMedCrossRef
30.
Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24(Suppl 1):9–160.
31.
Yoon MS, Obermann M, Dommes P et al (2010) Chronic pain, use of mixed analgesics/opioids and medication overuse are associated with chronic daily headache: results: of german headache study. J Headache Pain 11:S63
32.
Derogatis LR. SCL-90-R. Administration, Scoring and Procedures Manual-II for the R(evised) Version and Other Instruments of the Psychopathology Rating Scale Series. Clinical Psychometric Research. 1983 2nd ed. Towson
33.
Breivik H, Collett B, Ventafridda V et al (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10:287–333PubMedCrossRef
34.
Vandenbroucke JP, von Elm E, Altman DG et al (2007) Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Epidemiology 18:805–835PubMedCrossRef
35.
Song F, Parekh S, Hooper L et al (2010) Dissemination and publication of research findings: an updated review of related biases. Health Technol Assess 14:2046–4924 (Electronic)CrossRef
36.
Foster NE, Anema JR, Cherkin D et al (2018) Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet 391:2368–2383PubMedCrossRef
37.
Carnes D, Homer KE, Miles CL et al (2012) Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: a systematic literature review. Clinic J Pain 28:344–354CrossRef
38.
Mao J (2017) Challenges of managing chronic pain. BMJ. 356
39.
40.
Froud R, Patterson S, Eldridge S, et al. A systematic review and meta-synthesis of the impact of low back pain on people’s lives. BMC Musculoskelet Disord. 2014; 21: 1471–2474 (Electronic)
41.
Simons LE, Elman I, Borsook D (2014) Psychological processing in chronic pain: a neural systems approach. Neurosci Biobehav Rev 39:61–78PubMedCrossRef
42.
Mehling WE, Krause N (2005) Are difficulties perceiving and expressing emotions associated with low-back pain? The relationship between lack of emotional awareness (alexithymia) and 12-month prevalence of low-back pain in 1180 urban public transit operators. J Psychosom Res 58
43.
Yang Y, Zhao H, Boomsma DI, et al. Molecular genetic overlap between migraine and major depressive disorder. Eur J Hum Genet 2018; 26: 1476–5438 (Electronic)PubMedCrossRefPubMedCentral
44.
Chou R, Deyo R, Friedly J et al (2017) Nonpharmacologic therapies for low Back pain: a systematic review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med 166:493–495PubMedCrossRef
45.
Penzien DB, Taylor FR (2014) Behavioral and other nonpharmacologic treatments for headache. Headache 54:955–956PubMedCrossRef
46.
Ferreira PH, Beckenkamp P, Maher CG et al (2013) Nature or nurture in low back pain? Results of a systematic review of studies based on twin samples. European Journal of Pain 17:1532–2149 (Electronic)CrossRef
47.
Sutherland HG, LRA-Ohoo G (2017) Genetics of Migraine: Insights into the Molecular Basis of Migraine Disorders. Headache 57:1526–4610 (Electronic)CrossRef
48.
Hou M, Xing H, Cai Y et al (2017) The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis. J Headache Pain 18:42PubMedPubMedCentralCrossRef
49.
50.
Ozawa T, Ohtori S, Inoue G et al (2006) The degenerated lumbar intervertebral disc is innervated primarily by peptide-containing sensory nerve fibers in humans. SPINE 31:2418–2422PubMedCrossRef
51.
Metadata
Title
The association between headache and low back pain: a systematic review
Authors
Arani Vivekanantham
Claire Edwin
Tamar Pincus
Manjit Matharu
Helen Parsons
Martin Underwood
Publication date
01-12-2019
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2019
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-019-1031-y

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