University of Oulu

Mertimo, T., Heikkala, E., Niinimäki, J. et al. The role of co-occurring insomnia and mental distress in the association between lumbar disc degeneration and low back pain related disability. BMC Musculoskelet Disord 24, 293 (2023). https://doi.org/10.1186/s12891-023-06365-2

The role of co-occurring insomnia and mental distress in the association between lumbar disc degeneration and low back pain related disability

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Author: Mertimo, Teija1,2; Heikkala, Eveliina2,3; Niinimäki, Jaakko3,4;
Organizations: 1Faculty of Medicine and Health Technology, Tampere University Hospital and University of Tampere, P.O. Box 607, Tampere, FI-33014, Finland
2Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O. Box 5000, Oulu, FI- 90014, Finland
3Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, Oulu, FI-90014, Finland
4Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, Oulu, FI-90014, Finland
5Department of Radiology, Turku University Hospital, Kiinamyllynkatu 4-8, Turku, FI-20520, Finland
6Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, Oulu, FI-90014, Finland
7Department of Rehabilitation and Psychosocial Support, Tampere University Hospital, P.O. Box 2000, Tampere, FI-33521, Finland
8Rehabilitation Services of South Karelia Social and Health Care District, Valto Käkelän katu 3, Lappeenranta, FI- 53130, Finland
9Finnish Institute of Occupational Health, Aapistie 1, Oulu, FI-90220, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2023051143418
Language: English
Published: Springer Nature, 2023
Publish Date: 2023-05-11
Description:

Abstract

Background: Lumbar disc degeneration (LDD) is associated with low back pain (LBP). Although both insomnia and mental distress appear to influence the pain experience, their role in the association between LDD and LBP is uncertain. Our objective was to investigate the role of co-occurring insomnia and mental distress in the association between LDD and LBP-related disability.

Methods: A total of 1080 individuals who had experienced LBP during the previous year underwent 1.5-T lumbar magnetic resonance imaging, responded to questionnaires, and participated in a clinical examination at the age of 47. Full data was available for 843 individuals. The presence of LBP and LBP-related disability (numerical rating scale, range 0–10) were assessed using a questionnaire. LDD was assessed by a Pfirrmann-based sum score (range 0–15, higher values indicating higher LDD). The role of insomnia (according to the five-item Athens Insomnia Scale) and mental distress (according to the Hopkins Symptom Check List-25) in the association between the LDD sum score and LBP-related disability was analyzed using linear regression with adjustments for sex, smoking, body mass index, education, leisure-time physical activity, occupational physical exposure, Modic changes, and disc herniations.

Results: A positive association between LDD and LBP-related disability was observed among those with absence of both mental distress and insomnia (adjusted B = 0.132, 95% CI = 0.028–0.236, p = 0.013), and among those with either isolated mental distress (B = 0.345 CI = 0.039–0.650, p = 0.028) or isolated insomnia (B = 0.207, CI = 0.040–0.373, p = 0.015). However, among individuals with co-occurring insomnia and mental distress, the association was not significant (B = -0.093, CI = -0.346-0.161, p = 0.470).

Conclusions: LDD does not associate with LBP-related disability when insomnia and mental distress co-occur. This finding may be useful when planning treatment and rehabilitation that aim to reduce disability among individuals with LDD and LBP. Future prospective research is warranted.

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Series: BMC musculoskeletal disorders
ISSN: 1471-2474
ISSN-E: 1471-2474
ISSN-L: 1471-2474
Volume: 24
Issue: 1
Article number: 293
DOI: 10.1186/s12891-023-06365-2
OADOI: https://oadoi.org/10.1186/s12891-023-06365-2
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: The Northern Finland Birth Cohort 1966 study received financial support from: University of Oulu, Oulu, Finland (Grant no. 65354, 24000692), Oulu University Hospital, Oulu, Finland (Grant no. 2/97, 8/97, 24301140), European Regional Development Fund (Grant no. 539/2010 A31592).
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