Sex differences in predicting chronicity of low-back pain after acute trauma using lumbar muscle area

Am J Phys Med Rehabil. 2015 Feb;94(2):123-30. doi: 10.1097/PHM.0000000000000149.

Abstract

Objective: The aim of this study was to investigate sex differences in predicting chronicity of low-back pain after acute trauma using cross-sectional areas of paraspinal (multifidus and erector spinae) and psoas muscles.

Design: Between January 2006 and December 2010, a total of 54 patients were interviewed at least 6 mos after the trauma event. The subjects were classified into chronic low-back pain group and improved low-back pain group according to the presence of low-back pain for more than 6 mos. The cross-sectional area of the multifidus, erector spinae, and psoas muscles was measured at the level of the lower margin of the L3 and L5 vertebrae using magnetic resonance imaging.

Results: The cross-sectional area of the multifidus and erector spinae muscles at L5 in the chronic low-back pain group was significantly smaller than that of the improved low-back pain group (P < 0.05) in the men. There were no significant differences in the other parameters between the groups in the men. There were no significant differences in any parameters in the women.

Conclusions: In the men, the cross-sectional area of the multifidus and erector spinae muscles at the lower lumbar level can be considered to be prognostic factors for the chronic low-back pain after acute trauma. The authors thus suggest that strengthening of lumbar paraspinal muscles could be helpful for preventing chronicity of low-back pain.

MeSH terms

  • Adult
  • Back Injuries / complications
  • Back Injuries / pathology*
  • Chronic Pain / etiology*
  • Chronic Pain / pathology*
  • Female
  • Humans
  • Low Back Pain / etiology
  • Low Back Pain / pathology*
  • Lumbar Vertebrae
  • Magnetic Resonance Imaging
  • Male
  • Paraspinal Muscles / pathology*
  • Predictive Value of Tests
  • Psoas Muscles / pathology*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors*
  • Young Adult