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Is there an association between diabetes and neck pain and lower back pain? Results of a population-based study

Authors Jimenez-Garcia R, del Barrio JL, Hernandez-Barrera V, de Miguel-Díez J, Jimenez-Trujillo I, Martinez-Huedo MA, Lopez-de-Andres A

Received 4 December 2017

Accepted for publication 27 March 2018

Published 24 May 2018 Volume 2018:11 Pages 1005—1015

DOI https://doi.org/10.2147/JPR.S158877

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Erica Wegrzyn

Rodrigo Jimenez-Garcia,1 José Luis del Barrio,1 Valentín Hernandez-Barrera,1 Javier de Miguel-Díez,2 Isabel Jimenez-Trujillo,1 María Angeles Martinez-Huedo,3 Ana Lopez-de-Andres1

1Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; 2Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; 3Preventive Medicine and Public Health, Unidad de Docencia, Hospital Universitario La Paz, Madrid, Spain

Background: The objective of the study was to study the association between low back pain (LBP), neck pain (NP), and diabetes while controlling for many sociodemographic characteristics, comorbidities, and lifestyle variables. The study also aimed to identify which of these variables is independently associated with LBP and NP among diabetes sufferers.
Methods: A case–control study using data taken from the European Health Interview Surveys for Spain was conducted in 2009/2010 (n=22,188) and 2014 (n=22,842). We selected subjects ≥40 years of age. Diabetes status was self-reported. One non-diabetic control was matched by the year of survey, age, and sex for each diabetic case. The presence of LBP and NP was defined as the affirmative answer to both of the questions: “Have you suffered chronic LBP/NP over the last 12 months?” and “Has your physician confirmed the diagnosis?” Independent variables included demographic and socioeconomic characteristics, health status variables, lifestyles, and pain characteristics.
Results: The prevalence of NP (32.2% vs 26.8%) and LBP (37.1% vs 30.3%) was significantly higher among those suffering from diabetes. Multivariable analysis showed that diabetes was associated with a 1.19 (95% CI 1.04–1.36) and 1.20 (95% CI 1.06–1.35) higher risk of NP and LBP. Among diabetic subjects, being female, concomitant mental or respiratory disorders, being obese, and physically inactive are variables associated with suffering from these pains. Those suffering NP had 8 times higher risk of reporting LBP than those without NP and the same association is found among those suffering from LBP.
Conclusion: The prevalence and intensity of NP and LBP are high among people with diabetes, affecting them significantly more than their age- and sex-matched non-diabetic controls. Specific preventive and educational strategies must be implemented to reduce the incidence, severity, and negative effect on the quality of NP and LBP among diabetic patients.

Keywords: low back pain, neck pain, diabetes, survey

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