Patient-reported disability in the general Japanese population was associated with medical care visits for low back pain, regardless of pain intensity
Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the inte...
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Published in | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association Vol. 20; no. 4; pp. 742 - 749 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Tokyo
Elsevier B.V
01.07.2015
Springer Japan Springer Nature B.V |
Subjects | |
Online Access | Get full text |
ISSN | 0949-2658 1436-2023 1436-2023 |
DOI | 10.1007/s00776-015-0719-3 |
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Abstract | Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the interactive relationships are related to medical care visits. However, it remains unclear whether the association between patient-reported disability and medical care visits for low back pain (LBP) are dependent on the pain intensity. The aims of this study were to examine the prevalence of medical care visits among members of the Japanese general population and to analyze the association between patient-reported disability and medical care visits for LBP patients, regardless of the pain intensity.
From a random sample of the general Japanese population (n = 2962), we focused on those who experienced LBP within the past month. Subjects were asked about the number of medical care visits (medical clinic or complementary/alternative medical clinic) for LBP. Patient- reported disability was assessed using the Roland-Morris disability questionnaire (RDQ). Pain intensity of LBP was assessed by visual analog scale. To examine the association between RDQ and medical care visits among people with LBP, we used multiple logistic regression analysis and the trend analysis for the RDQ.
Of 841 reporting LBP in the past month, 285 (33.9 %) visited a medical care facility. After adjusting for pain intensity and other confounding factors, the odds ratios for the RDQ categories 1-5, 6-10, 11-15, and >16 were compared with the RDQ categories 0, 1.13 (95 % CI 0.731.73), 2.05 (95 % CI 1.17-3.60), 2.21 (95 % CI 1.06-4.62), and 4.0 (95 % CI 1.60-9.98), respectively (p for trend <0.01).
Patient-reported disability was associated with medical care visits for LBP, regardless of the pain intensity, with the results similar to those obtained for other races/ethnicities. |
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AbstractList | Background
Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the interactive relationships are related to medical care visits. However, it remains unclear whether the association between patient-reported disability and medical care visits for low back pain (LBP) are dependent on the pain intensity. The aims of this study were to examine the prevalence of medical care visits among members of the Japanese general population and to analyze the association between patient-reported disability and medical care visits for LBP patients, regardless of the pain intensity.
Methods
From a random sample of the general Japanese population (
n
= 2962), we focused on those who experienced LBP within the past month. Subjects were asked about the number of medical care visits (medical clinic or complementary/alternative medical clinic) for LBP. Patient-reported disability was assessed using the Roland-Morris disability questionnaire (RDQ). Pain intensity of LBP was assessed by visual analog scale. To examine the association between RDQ and medical care visits among people with LBP, we used multiple logistic regression analysis and the trend analysis for the RDQ.
Results
Of 841 reporting LBP in the past month, 285 (33.9 %) visited a medical care facility. After adjusting for pain intensity and other confounding factors, the odds ratios for the RDQ categories 1–5, 6–10, 11–15, and ≥16 were compared with the RDQ categories 0, 1.13 (95 % CI 0.73–1.73), 2.05 (95 % CI 1.17–3.60), 2.21 (95 % CI 1.06–4.62), and 4.0 (95 % CI 1.60–9.98), respectively (
p
for trend <0.01).
Conclusions
Patient-reported disability was associated with medical care visits for LBP, regardless of the pain intensity, with the results similar to those obtained for other races/ethnicities. Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the interactive relationships are related to medical care visits. However, it remains unclear whether the association between patient-reported disability and medical care visits for low back pain (LBP) are dependent on the pain intensity. The aims of this study were to examine the prevalence of medical care visits among members of the Japanese general population and to analyze the association between patient-reported disability and medical care visits for LBP patients, regardless of the pain intensity. From a random sample of the general Japanese population (n = 2962), we focused on those who experienced LBP within the past month. Subjects were asked about the number of medical care visits (medical clinic or complementary/alternative medical clinic) for LBP. Patient-reported disability was assessed using the Roland-Morris disability questionnaire (RDQ). Pain intensity of LBP was assessed by visual analog scale. To examine the association between RDQ and medical care visits among people with LBP, we used multiple logistic regression analysis and the trend analysis for the RDQ. Of 841 reporting LBP in the past month, 285 (33.9 %) visited a medical care facility. After adjusting for pain intensity and other confounding factors, the odds ratios for the RDQ categories 1-5, 6-10, 11-15, and ≥ 16 were compared with the RDQ categories 0, 1.13 (95 % CI 0.73-1.73), 2.05 (95 % CI 1.17-3.60), 2.21 (95 % CI 1.06-4.62), and 4.0 (95 % CI 1.60-9.98), respectively (p for trend <0.01). Patient-reported disability was associated with medical care visits for LBP, regardless of the pain intensity, with the results similar to those obtained for other races/ethnicities. Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the interactive relationships are related to medical care visits. However, it remains unclear whether the association between patient-reported disability and medical care visits for low back pain (LBP) are dependent on the pain intensity. The aims of this study were to examine the prevalence of medical care visits among members of the Japanese general population and to analyze the association between patient-reported disability and medical care visits for LBP patients, regardless of the pain intensity. From a random sample of the general Japanese population (n = 2962), we focused on those who experienced LBP within the past month. Subjects were asked about the number of medical care visits (medical clinic or complementary/alternative medical clinic) for LBP. Patient- reported disability was assessed using the Roland-Morris disability questionnaire (RDQ). Pain intensity of LBP was assessed by visual analog scale. To examine the association between RDQ and medical care visits among people with LBP, we used multiple logistic regression analysis and the trend analysis for the RDQ. Of 841 reporting LBP in the past month, 285 (33.9 %) visited a medical care facility. After adjusting for pain intensity and other confounding factors, the odds ratios for the RDQ categories 1-5, 6-10, 11-15, and >16 were compared with the RDQ categories 0, 1.13 (95 % CI 0.731.73), 2.05 (95 % CI 1.17-3.60), 2.21 (95 % CI 1.06-4.62), and 4.0 (95 % CI 1.60-9.98), respectively (p for trend <0.01). Patient-reported disability was associated with medical care visits for LBP, regardless of the pain intensity, with the results similar to those obtained for other races/ethnicities. Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the interactive relationships are related to medical care visits. However, it remains unclear whether the association between patient-reported disability and medical care visits for low back pain (LBP) are dependent on the pain intensity. The aims of this study were to examine the prevalence of medical care visits among members of the Japanese general population and to analyze the association between patient-reported disability and medical care visits for LBP patients, regardless of the pain intensity. From a random sample of the general Japanese population (n = 2962), we focused on those who experienced LBP within the past month. Subjects were asked about the number of medical care visits (medical clinic or complementary/alternative medical clinic) for LBP. Patient-reported disability was assessed using the Roland-Morris disability questionnaire (RDQ). Pain intensity of LBP was assessed by visual analog scale. To examine the association between RDQ and medical care visits among people with LBP, we used multiple logistic regression analysis and the trend analysis for the RDQ. Of 841 reporting LBP in the past month, 285 (33.9 %) visited a medical care facility. After adjusting for pain intensity and other confounding factors, the odds ratios for the RDQ categories 1-5, 6-10, 11-15, and [greater than or equal to]16 were compared with the RDQ categories 0, 1.13 (95 % CI 0.73-1.73), 2.05 (95 % CI 1.17-3.60), 2.21 (95 % CI 1.06-4.62), and 4.0 (95 % CI 1.60-9.98), respectively (p for trend <0.01). Patient-reported disability was associated with medical care visits for LBP, regardless of the pain intensity, with the results similar to those obtained for other races/ethnicities. Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the interactive relationships are related to medical care visits. However, it remains unclear whether the association between patient-reported disability and medical care visits for low back pain (LBP) are dependent on the pain intensity. The aims of this study were to examine the prevalence of medical care visits among members of the Japanese general population and to analyze the association between patient-reported disability and medical care visits for LBP patients, regardless of the pain intensity.BACKGROUNDRace/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to race/ethnicity. It has been hypothesized that there is an interactive relationship between pain intensity and patient-reported disability and that the interactive relationships are related to medical care visits. However, it remains unclear whether the association between patient-reported disability and medical care visits for low back pain (LBP) are dependent on the pain intensity. The aims of this study were to examine the prevalence of medical care visits among members of the Japanese general population and to analyze the association between patient-reported disability and medical care visits for LBP patients, regardless of the pain intensity.From a random sample of the general Japanese population (n = 2962), we focused on those who experienced LBP within the past month. Subjects were asked about the number of medical care visits (medical clinic or complementary/alternative medical clinic) for LBP. Patient-reported disability was assessed using the Roland-Morris disability questionnaire (RDQ). Pain intensity of LBP was assessed by visual analog scale. To examine the association between RDQ and medical care visits among people with LBP, we used multiple logistic regression analysis and the trend analysis for the RDQ.METHODSFrom a random sample of the general Japanese population (n = 2962), we focused on those who experienced LBP within the past month. Subjects were asked about the number of medical care visits (medical clinic or complementary/alternative medical clinic) for LBP. Patient-reported disability was assessed using the Roland-Morris disability questionnaire (RDQ). Pain intensity of LBP was assessed by visual analog scale. To examine the association between RDQ and medical care visits among people with LBP, we used multiple logistic regression analysis and the trend analysis for the RDQ.Of 841 reporting LBP in the past month, 285 (33.9 %) visited a medical care facility. After adjusting for pain intensity and other confounding factors, the odds ratios for the RDQ categories 1-5, 6-10, 11-15, and ≥ 16 were compared with the RDQ categories 0, 1.13 (95 % CI 0.73-1.73), 2.05 (95 % CI 1.17-3.60), 2.21 (95 % CI 1.06-4.62), and 4.0 (95 % CI 1.60-9.98), respectively (p for trend <0.01).RESULTSOf 841 reporting LBP in the past month, 285 (33.9 %) visited a medical care facility. After adjusting for pain intensity and other confounding factors, the odds ratios for the RDQ categories 1-5, 6-10, 11-15, and ≥ 16 were compared with the RDQ categories 0, 1.13 (95 % CI 0.73-1.73), 2.05 (95 % CI 1.17-3.60), 2.21 (95 % CI 1.06-4.62), and 4.0 (95 % CI 1.60-9.98), respectively (p for trend <0.01).Patient-reported disability was associated with medical care visits for LBP, regardless of the pain intensity, with the results similar to those obtained for other races/ethnicities.CONCLUSIONSPatient-reported disability was associated with medical care visits for LBP, regardless of the pain intensity, with the results similar to those obtained for other races/ethnicities. |
Author | Ono, Rei Kikuchi, Shinichi Konno, Shinichi Takegami, Misa Suzukamo, Yoshimi Yamazaki, Shin Fukuhara, Shunichi |
Author_xml | – sequence: 1 givenname: Rei surname: Ono fullname: Ono, Rei email: ono@phoenix.kobe-u.ac.jp organization: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma, Kobe, Hyogo 654-0142, Japan – sequence: 2 givenname: Shin surname: Yamazaki fullname: Yamazaki, Shin organization: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, YoshidaKonoe, Sakyo, Kyoto, Japan – sequence: 3 givenname: Misa surname: Takegami fullname: Takegami, Misa organization: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, YoshidaKonoe, Sakyo, Kyoto, Japan – sequence: 4 givenname: Yoshimi surname: Suzukamo fullname: Suzukamo, Yoshimi organization: Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Japan – sequence: 5 givenname: Shinichi surname: Konno fullname: Konno, Shinichi organization: Department of Orthopedic Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan – sequence: 6 givenname: Shinichi surname: Kikuchi fullname: Kikuchi, Shinichi organization: Department of Orthopedic Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan – sequence: 7 givenname: Shunichi surname: Fukuhara fullname: Fukuhara, Shunichi organization: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, YoshidaKonoe, Sakyo, Kyoto, Japan |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25862328$$D View this record in MEDLINE/PubMed |
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Copyright | 2015 The Japanese Orthopaedic Association The Japanese Orthopaedic Association 2015 |
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Keywords | Pain Intensity Medical Care Visit Japanese General Population Multiple Logistic Regression Analysis Japanese Health Insurance System |
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Who goes where? publication-title: Med Care doi: 10.1097/00005650-200109000-00006 – volume: 54 start-page: 667 issue: 4 year: 2006 end-page: 673 ident: CR16 article-title: Use of health-related, quality-of-life metrics to predict mortality and hospitalizations in community-dwelling seniors publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.2006.00681.x – volume: 24 start-page: 725 issue: 8 year: 2008 end-page: 730 ident: CR28 article-title: Higher internality of health locus of control is associated with the use of complementary and alternative medicine providers among patients seeking care for acute low-back pain publication-title: Clin J Pain doi: 10.1097/AJP.0b013e3181759261 – volume: 318 start-page: 291 issue: 5 year: 1988 end-page: 300 ident: CR1 article-title: Back pain and sciatica publication-title: New Engl J Med. doi: 10.1056/NEJM198802043180506 – volume: 28 start-page: 1195 issue: 11 year: 2003 end-page: 1202 ident: CR4 article-title: Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population publication-title: Spine – volume: 21 start-page: 122 issue: 1 year: 2012 ident: 10.1007/s00776-015-0719-3_bb0095 article-title: Responsiveness of the Oswestry Disability Index and the Roland-Morris Disability Questionnaire in Italian subjects with sub-acute and chronic low back pain publication-title: Eur Spine J doi: 10.1007/s00586-011-1959-3 – volume: 39 start-page: 956 issue: 9 year: 2001 ident: 10.1007/s00776-015-0719-3_bb0030 article-title: The treatment of neck and low back pain: who seeks care? Who goes where? publication-title: Med Care doi: 10.1097/00005650-200109000-00006 – volume: 327 start-page: 323 issue: 7410 year: 2003 ident: 10.1007/s00776-015-0719-3_bb0025 article-title: Acute low back pain: systematic review of its prognosis publication-title: BMJ doi: 10.1136/bmj.327.7410.323 – volume: 318 start-page: 291 issue: 5 year: 1988 ident: 10.1007/s00776-015-0719-3_bb0005 article-title: Back pain and sciatica publication-title: New Engl J Med doi: 10.1056/NEJM198802043180506 – volume: 21 start-page: 327 issue: 5 year: 1989 ident: 10.1007/s00776-015-0719-3_bb0010 article-title: Descriptive epidemiology and public health aspects of low back pain publication-title: Ann Med doi: 10.3109/07853898909149216 – volume: 133 start-page: 826 issue: 8 year: 1998 ident: 10.1007/s00776-015-0719-3_bb0070 article-title: Effect of surgery on health-related quality of life in patients with inflammatory bowel disease: a prospective study publication-title: Arch Surg doi: 10.1001/archsurg.133.8.826 – volume: 20 start-page: 1889 issue: 17 year: 1995 ident: 10.1007/s00776-015-0719-3_bb0015 article-title: Estimating the prevalence of low back pain in the general population: evidence from the South Manchester Back Pain Survey publication-title: Spine doi: 10.1097/00007632-199509000-00009 – volume: 57 start-page: 656 issue: 4 year: 2007 ident: 10.1007/s00776-015-0719-3_bb0110 article-title: US national prevalence and correlates of low back and neck pain among adults publication-title: Arthritis Rheum doi: 10.1002/art.22684 – volume: 31 start-page: 194 issue: 3 year: 2003 ident: 10.1007/s00776-015-0719-3_bb0130 article-title: To seek or not to seek? Care-seeking behaviour among people with low-back pain publication-title: Scand J Public Health doi: 10.1080/14034940210134086 – volume: 30 start-page: 581 issue: 5 year: 2005 ident: 10.1007/s00776-015-0719-3_bb0100 article-title: Early patterns of care for occupational back pain publication-title: Spine doi: 10.1097/01.brs.0000154613.17511.dd – volume: 54 start-page: 667 issue: 4 year: 2006 ident: 10.1007/s00776-015-0719-3_bb0080 article-title: Use of health-related, quality-of-life metrics to predict mortality and hospitalizations in community-dwelling seniors publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.2006.00681.x – volume: 9 start-page: 262 issue: 4 year: 1999 ident: 10.1007/s00776-015-0719-3_bb0115 article-title: The effect of comorbidity on care seeking for back problems in the United States publication-title: Ann Epidemiol doi: 10.1016/S1047-2797(98)00059-3 – volume: 8 start-page: 75 issue: 1 year: 2007 ident: 10.1007/s00776-015-0719-3_bb0045 article-title: Pain in aging community-dwelling adults in the United States: non-Hispanic whites, non-Hispanic blacks, and Hispan- ics publication-title: J Pain doi: 10.1016/j.jpain.2006.06.002 – volume: 317 start-page: 1564 issue: 7172 year: 1998 ident: 10.1007/s00776-015-0719-3_bb0120 article-title: Community survey of factors associated with consultation for low back pain publication-title: BMJ doi: 10.1136/bmj.317.7172.1564 – volume: 100 start-page: 119 issue: 1-2 year: 2002 ident: 10.1007/s00776-015-0719-3_bb0050 article-title: Race/ethnic differences in health care use for orofacial pain among older adults publication-title: Pain doi: 10.1016/S0304-3959(02)00256-7 – volume: 8 start-page: 48 issue: 3 year: 2005 ident: 10.1007/s00776-015-0719-3_bb0090 article-title: Usefulness of five-item and three-item mental health inventories to screen for depressive symptoms in the general population of Japan publication-title: Health Qual Life Outcomes doi: 10.1186/1477-7525-3-48 – volume: 24 start-page: 725 issue: 8 year: 2008 ident: 10.1007/s00776-015-0719-3_bb0140 article-title: Fuku- hara S. Higher internality of health locus of control is associated with the use of complementary and alternative medicine providers among patients seeking care for acute low-back pain publication-title: Clin J Pain doi: 10.1097/AJP.0b013e3181759261 – volume: 64 start-page: 339 issue: 1 year: 2003 ident: 10.1007/s00776-015-0719-3_bb0075 article-title: Health-related quality of life as a predictor of mortality and hospitalization: the dialysis outcomes and practice patterns study (DOPPS) publication-title: Kidney Int doi: 10.1046/j.1523-1755.2003.00072.x – volume: 31 start-page: 931 issue: 8 year: 2006 ident: 10.1007/s00776-015-0719-3_bb0135 article-title: Discrepancy between disability and the severity of low back pain: demographic, psychologic, and employment- related factors publication-title: Spine doi: 10.1097/01.brs.0000209319.94256.89 – volume: 28 start-page: 1195 issue: 11 year: 2003 ident: 10.1007/s00776-015-0719-3_bb0020 article-title: Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population publication-title: Spine doi: 10.1097/01.BRS.0000067430.49169.01 – volume: 11 start-page: 343 issue: 4 year: 2010 ident: 10.1007/s00776-015-0719-3_bb0055 article-title: Race, care seeking, and utilization for chronic back and neck pain: population perspectives publication-title: J Pain doi: 10.1016/j.jpain.2009.08.003 – volume: 6 start-page: 301 issue: 5 year: 2005 ident: 10.1007/s00776-015-0719-3_bb0060 article-title: Access to care for chronic pain: racial and ethnic differences publication-title: J Pain doi: 10.1016/j.jpain.2004.12.008 – volume: 27 start-page: E109 issue: 5 year: 2002 ident: 10.1007/s00776-015-0719-3_bb0105 article-title: A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain publication-title: Spine doi: 10.1097/00007632-200203010-00017 – volume: 20 start-page: 123 issue: 2 year: 2006 ident: 10.1007/s00776-015-0719-3_bb0065 article-title: A randomized controlled trial to evaluate intensity of community-based rehabilitation provision following stroke or hip fracture in old age publication-title: Clin Rehabil doi: 10.1191/0269215506cr933oa – volume: 8 start-page: 543 issue: 4 year: 2003 ident: 10.1007/s00776-015-0719-3_bb0085 article-title: Committee on Science Project, Japanese Orthopaedic Association. Validation of the Japanese version of the Roland-Morris Disability Questionnaire publication-title: J Orthop Sci doi: 10.1007/s00776-003-0679-x – volume: 14 start-page: 66 issue: 7 year: 2006 ident: 10.1007/s00776-015-0719-3_bb0125 article-title: Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population publication-title: BMC Musculoskelet Disord doi: 10.1186/1471-2474-7-66 – volume: 27 start-page: 327 issue: 5 year: 2004 ident: 10.1007/s00776-015-0719-3_bb0035 article-title: Low back pain in Australian adults. Health provider utilization and care seeking publication-title: J Manipulative Physiol Ther doi: 10.1016/j.jmpt.2004.04.006 – volume: 14 start-page: 747 issue: 7 year: 2010 ident: 10.1007/s00776-015-0719-3_bb0040 article-title: Factors defining care-seeking in low back pain- a meta-analysis of population based surveys publication-title: Eur J Pain doi: 10.1016/j.ejpain.2009.11.005 |
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Snippet | Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to... Background Race/ethnicity is known to affect pain severity and the emotional aspects of pain, with medical care visits also reported to differ according to... |
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StartPage | 742 |
SubjectTerms | Adult Aged Cross-Sectional Studies Disability Evaluation Disabled Persons - rehabilitation Female Follow-Up Studies Humans Japan - epidemiology Low Back Pain - diagnosis Low Back Pain - epidemiology Low Back Pain - rehabilitation Male Medicine Medicine & Public Health Middle Aged Odds Ratio Office Visits - statistics & numerical data Original Article Orthopedics Pain Measurement - methods Population Surveillance Prevalence Retrospective Studies Rheumatology Surveys and Questionnaires Young Adult |
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Title | Patient-reported disability in the general Japanese population was associated with medical care visits for low back pain, regardless of pain intensity |
URI | https://www.clinicalkey.com/#!/content/1-s2.0-S094926581530052X https://dx.doi.org/10.1007/s00776-015-0719-3 https://link.springer.com/article/10.1007/s00776-015-0719-3 https://www.ncbi.nlm.nih.gov/pubmed/25862328 https://www.proquest.com/docview/1698157118 https://www.proquest.com/docview/1698960939 |
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