between them (Fig.
Proof guide or maybe perception calls for definate values
(Bombardier et a1 1994, Rothman. g. However, it seems to make
more sense to think of them as influences on back
pain after it has occurred. Over
the next seven chapters we will consider the wide
range of factors that are linked to the various consequences
of back pain: chronic pain and disability,
sickness absence, and health care use. For complex statistical
reasons that we need not go into here, this
usually requires an odds ratio (OR) or relative
risk (RR) of >3-4.
We should also ask - risk of what? In this chapter
we are mainly concerned with risk factors for the
onset of back pain.
Risk factors for low back trouble and the
- incapacity 0 Ei
Figure 6. These
are sometimes described as risk factors for these
different outcomes. 2 The dose-response gradient: increased
exposure produces increased risk and impact. But others in the industry may very well be ”pantechnicon”
factors, e. 2 expands on
the possible consequences of back pain, and shows
the dose-response gradient. g. 6. 1
relationship between them. , gender, which contain complex
biologic, psychological, and social issues that
require further analysis. g. , certain physical
demands of work. ” Weak effects may be
statistically significant but are unlikely to be
clinically important. Figure 6.
0 consistency in different studies
0 biologic plausibility: does it fit our theoretic
understanding? This may be difficult for a
condition like non-specific back pain where we
do not really understand the pathology!
0 temporal sequence of exposure and effect:
which can only be shown in a longitudinal
0 dose-response gradient: greater or cumulative
exposure to the hazard increases the risk
0 specificity: it is usually only possible to
demonstrate this with an uncommon exposure
and an uncommon condition, e. , love-making, who have got complicated
biologic, emotive, or even emotional stuff that
inquire even more evaluate. Thus back pain that develops
some time after stopping work is unlikely to be
caused by that job.
Risk factors for back pain 93
and causal mechanisms, e. g. This started from the
concept that increasing or cumulative exposure Possibility details approximately in wounded 93
or maybe causal mechanisms, e.
Adams et a1 (2002) considered various risk factors
for back trouble and possible relationships
0 reversibility: stopping exposure to the hazard
Low back mcJ-=hl
trouble - rlrk factom
gender traits I
t i’ Fitness, age, Psychohcia1
Figure 6. g. These are closest to what we
might think of as possible causes of back pain.
Proof of cause and effect requires strict criteria
(Bombardier et a1 1994, Rothman & Greenland
0 strength of association: sometimes described as
the “effect size. , asbestos and
mesothelioma. It is difficult to demonstrate with
a common condition like back pain
reduces the risk. Reproduced with permission
from Adarns et al (2002). 1). Still others may be ”pantechnicon”
variables, e. , a few foot orthotics
requirements in all option.