Factors that influence low back pain in people with a stoma

Iseult Wilson, Sheila Lennon, Evie McCrum-Gardner, Daniel Paul Kerr

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: People with a stoma believe that there is a link between their surgery and low back pain (LBP). Aim: To explore factors relating to (i) core stability in people with a stoma and LBP and (ii) biopsychosocial factors related to LBP. Methods: Adults with an ileostomy and LBP (n = 17) completed (i) a range of standardised instruments, (ii) clinical tests and (iii) an ultrasound scan of right and left transversus abdominis (TrA).Results: The findings showed moderate pain and disability: RMDQ: median = 12 (IQR: 9.5–13), EQ-5D health state: mean = 6.9 (±1.75), BPI pain severity: median = 4.5 (IQR: 2.87–5.4). The TrA contraction was less on the operated than the unoperated side and this was linked to less control for BKFO to the operated side, and the presence of a parastomal hernia. Co-morbidities were associated with greater balance problems during the stork test (p <0.05). Men had more fear avoidance (p <0.05) on the FABQ regarding physical activity. Discussion: Abdominal function may be altered after stoma surgery leading to reduced ability to perform functional tasks and a possible increased risk of backpain. These results should be viewed with caution due to the small sample size.
LanguageEnglish
Pages522-530
JournalDISABILITY AND REHABILITATION
Volume34
Issue number6
DOIs
Publication statusPublished - Jan 2012

Fingerprint

Low Back Pain
Abdominal Muscles
Pain
Ileostomy
Aptitude
Hernia
Sample Size
Fear
Exercise
Morbidity
Health

Cite this

Wilson, Iseult ; Lennon, Sheila ; McCrum-Gardner, Evie ; Kerr, Daniel Paul. / Factors that influence low back pain in people with a stoma. In: DISABILITY AND REHABILITATION. 2012 ; Vol. 34, No. 6. pp. 522-530.
@article{f9df1b57e9e644ddb742e465e894e664,
title = "Factors that influence low back pain in people with a stoma",
abstract = "Purpose: People with a stoma believe that there is a link between their surgery and low back pain (LBP). Aim: To explore factors relating to (i) core stability in people with a stoma and LBP and (ii) biopsychosocial factors related to LBP. Methods: Adults with an ileostomy and LBP (n = 17) completed (i) a range of standardised instruments, (ii) clinical tests and (iii) an ultrasound scan of right and left transversus abdominis (TrA).Results: The findings showed moderate pain and disability: RMDQ: median = 12 (IQR: 9.5–13), EQ-5D health state: mean = 6.9 (±1.75), BPI pain severity: median = 4.5 (IQR: 2.87–5.4). The TrA contraction was less on the operated than the unoperated side and this was linked to less control for BKFO to the operated side, and the presence of a parastomal hernia. Co-morbidities were associated with greater balance problems during the stork test (p <0.05). Men had more fear avoidance (p <0.05) on the FABQ regarding physical activity. Discussion: Abdominal function may be altered after stoma surgery leading to reduced ability to perform functional tasks and a possible increased risk of backpain. These results should be viewed with caution due to the small sample size.",
author = "Iseult Wilson and Sheila Lennon and Evie McCrum-Gardner and Kerr, {Daniel Paul}",
note = "Reference text: 1. Wilson IM, Kerr DP, Lennon S. Low back pain in people with a stoma: A postal survey. Disabil Rehabil 2009;31:1937–1942. 2. Wilson IM, Kerr DP, Lennon S. Do people with an ileostomy have a different back pain experience to those with a colostomy? A postal survey in Northern Ireland. Disabil Rehabil 2010;32:1847–1854. 3. Wilson IM, Kerr DP, Lennon S. Low back pain in people with a stoma: Patients’ views. J Wound Ostomy Continence Nursing 2007;34:515– 520. 4. Smith MD, Russell AM, Hodges PW. How common is back pain in women with gastrointestinal problems? Clin J Pain 2008;24:199–203. 5. Woby SR, Watson PJ, Roach NK, Urmston M. Are changes in fear-avoidance beliefs, catastrophizing, and appraisals of control, predictive of changes in chronic low back pain and disability? Eur J Pain 2004;8:201–210. 6. Denison E, Asenl{\"o}f P, Lindberg P. Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care. Pain 2001;111:245–252. 7. Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz NP, Kerns RD, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 2005;113:9–19. 8. Lee D. The pelvic girdle: An approach to the examination and treatment of the lumbo–pelvic–hip region. 2nd ed. Philadelphia, PA: Churchill Livingstone; 1999. 9. World Health Organization. ICF checklist: International classification of functioning, disability and health. 2003. 10. Turk DC, Dworkin RH, Allen RR, Bellamy N, Brandenburg N, Carr DB, Cleeland C, et al. Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain 2003;106:337–345. 11. K{\"o}nig HH, Ulshofer A, Gregor M, Von Tirpitz C, Reinshagen M, Adler G, Leidl R. Validation of the EuroQol questionnaire in patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2002;14:1205–1215. 12. Stark RG, Reitmeir P, Leidl R, K{\"o}nig HH. Validity, reliability, and responsiveness of the EQ-5D in inflammatory bowel disease in Germany. Inflamm Bowel Dis 2010;16:42–51. 13. Stinson MD, Porter-Armstrong AP, Eakin PA. Pressure mapping systems: Reliability of pressure map interpretation. Clin Rehabil 2003;17:504–511. 14. Cresswell AG, Oddsson L, Thorstensson A. The influence of sudden perturbations on trunk muscle activity and intra-abdominal pressure while standing. Experiment Brain Res 1994;98:336–341. 15. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: A motor control evaluation of transversus abdominis. Spine 1996;21:2640–2650. 16. Hodges PW. Core stability exercise in chronic low back pain. Orthop Clin North Am 2003;34:245–254. 17. Koppenhaver SL, Parent EC, Teyhen DS, Herbert JJ, Fritz JM. The effect of averaging multiple trials on measurement error during ultrasound imaging of transversus abdominis and lumbar multifidus muscles in individuals with low back pain. J Orthop Sports Phys Ther 2009;39:604–611. 18. Pallant J. SPSS survival manual. A step by step guide to data analysis using SPSS version 12. 2nd ed. London: Open University Press; 2005. 19. Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A fear-avoidance beliefs questionnaire (FABQ) and the role of fearavoidance beliefs in chronic low back pain and disability. Pain 1993;52:157–168. 20. Critchley DJ, Coutts FJ. Abdominal muscle function in chronic low back pain patients: Measurement with real-time ultrasound scanning. Physiotherapy 2002;88:322–332. 21. Mew R. Comparison of changes in abdominal muscle thickness between standing and crook lying during active abdominal hollowing using ultrasound imaging. Man Ther 2009 12;14:690–695. 22. Keogh E. Sex and gender differences in pain: A selective review of biological and psychosocial factors. J Men Health Gend 2006;3:236–243. 23. Robinson ME, Dannecker EA, George SZ, Otis J, Atchison JW, Fillingim RB. Sex differences in the associations among psychological factors and pain report: A novel psychophysical study of patients with chronic low back pain. J Pain 2005;6:463–470. 24. Hirsh AT, Waxenberg LB, Atchison JW, Gremillion HA, Robinson ME. Evidence for sex differences in the relationships of pain, mood, and disability. J Pain 2006 8;7:592–601. 25. Robinson ME, Riley III JL, Myers CD, Papas RK, Wise EA, Waxenberg LB, Fillingim RB. Gender role expectations of pain: Relationship to sex differences in pain. J Pain 2001;2:251–257. 26. Biering-Sorensen F, Lund J, Hoydalsmo OJ, Darre EM, Deis A, Kryger P, Muller CF. Risk indicators of disability pension. A 15 year follow-up study. Dan Med Bull 1999;46:258–262. 27. Hestbaek L, Leboeuf-Yde C, Manniche C. Is low back pain part of a general health pattern or is it a separate and distinctive entity? A critical literature review of comorbidity with low back pain. J Manipulative Physiol Ther 2003;26:243–252. 28. Holmberg S, Thelin A, Stiernstrom EL, Svardsudd K. Low back pain comorbidity among male farmers and rural referents: A populationbased study. Ann Agric Environ Med 2005;12:261–268. 29. Hestbaek L, Leboeuf-Yde C, Kyvik KO, Vach W, Russell MB, Skadhauge L, Svendsen A, Manniche C. Comorbidity with low back pain: A cross-sectional population-based survey of 12- to 22-year-olds. Spine 2004;29:1483–1491. 30. Krouse RS, Grant M, Rawl SM, Mohler MJ, Baldwin CM, Coons SJ, McCorkle R, et al. Coping and acceptance: The greatest challenge for veterans with intestinal stomas. J Psychosom Res 2009;66: 227–233. 31. Nicholas MK, Asghari A, Blyth FM. What do the numbers mean? Normative data in chronic pain measures. Pain 2008;134:158–173. 32. Pincus T, Vogel S, Burton AK, Santos R, Field AP. Fear avoidance and prognosis in back pain: A systematic review and synthesis of current evidence. Arthritis Rheum 2006;54:3999–4010. 33. Leonhardt C, Lehr D, Chenot JF, Keller S, Luckmann J, Basler HD, Baum E, et al. Are fear-avoidance beliefs in low back pain patients a risk factor for low physical activity or vice versa? A cross-lagged panel analysis. Psychosoc Med 2009;6:1–12. 34. Tsao H, Hodges PW. Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. J Electromyogr Kinesiol 2008;18:559–567. 35. Ferreira PH, Ferreira ML, Hodges PW. Changes in recruitment of the abdominal muscles in people with low back pain: Ultrasound measurement of muscle activity. Spine 2004;29:2560–2566. 36. Cholewicki J, Silfies SP, Shah RA, Greene HS, Reeves NP, Alvi K, Goldberg B. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine 2005;30:2614–2620.",
year = "2012",
month = "1",
doi = "10.3109/09638288.2011.613515",
language = "English",
volume = "34",
pages = "522--530",
journal = "Disability and Rehabilitation",
issn = "0963-8288",
number = "6",

}

Factors that influence low back pain in people with a stoma. / Wilson, Iseult; Lennon, Sheila; McCrum-Gardner, Evie; Kerr, Daniel Paul.

In: DISABILITY AND REHABILITATION, Vol. 34, No. 6, 01.2012, p. 522-530.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors that influence low back pain in people with a stoma

AU - Wilson, Iseult

AU - Lennon, Sheila

AU - McCrum-Gardner, Evie

AU - Kerr, Daniel Paul

N1 - Reference text: 1. Wilson IM, Kerr DP, Lennon S. Low back pain in people with a stoma: A postal survey. Disabil Rehabil 2009;31:1937–1942. 2. Wilson IM, Kerr DP, Lennon S. Do people with an ileostomy have a different back pain experience to those with a colostomy? A postal survey in Northern Ireland. Disabil Rehabil 2010;32:1847–1854. 3. Wilson IM, Kerr DP, Lennon S. Low back pain in people with a stoma: Patients’ views. J Wound Ostomy Continence Nursing 2007;34:515– 520. 4. Smith MD, Russell AM, Hodges PW. How common is back pain in women with gastrointestinal problems? Clin J Pain 2008;24:199–203. 5. Woby SR, Watson PJ, Roach NK, Urmston M. Are changes in fear-avoidance beliefs, catastrophizing, and appraisals of control, predictive of changes in chronic low back pain and disability? Eur J Pain 2004;8:201–210. 6. Denison E, Asenlöf P, Lindberg P. Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care. Pain 2001;111:245–252. 7. Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz NP, Kerns RD, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 2005;113:9–19. 8. Lee D. The pelvic girdle: An approach to the examination and treatment of the lumbo–pelvic–hip region. 2nd ed. Philadelphia, PA: Churchill Livingstone; 1999. 9. World Health Organization. ICF checklist: International classification of functioning, disability and health. 2003. 10. Turk DC, Dworkin RH, Allen RR, Bellamy N, Brandenburg N, Carr DB, Cleeland C, et al. Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain 2003;106:337–345. 11. König HH, Ulshofer A, Gregor M, Von Tirpitz C, Reinshagen M, Adler G, Leidl R. Validation of the EuroQol questionnaire in patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2002;14:1205–1215. 12. Stark RG, Reitmeir P, Leidl R, König HH. Validity, reliability, and responsiveness of the EQ-5D in inflammatory bowel disease in Germany. Inflamm Bowel Dis 2010;16:42–51. 13. Stinson MD, Porter-Armstrong AP, Eakin PA. Pressure mapping systems: Reliability of pressure map interpretation. Clin Rehabil 2003;17:504–511. 14. Cresswell AG, Oddsson L, Thorstensson A. The influence of sudden perturbations on trunk muscle activity and intra-abdominal pressure while standing. Experiment Brain Res 1994;98:336–341. 15. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: A motor control evaluation of transversus abdominis. Spine 1996;21:2640–2650. 16. Hodges PW. Core stability exercise in chronic low back pain. Orthop Clin North Am 2003;34:245–254. 17. Koppenhaver SL, Parent EC, Teyhen DS, Herbert JJ, Fritz JM. The effect of averaging multiple trials on measurement error during ultrasound imaging of transversus abdominis and lumbar multifidus muscles in individuals with low back pain. J Orthop Sports Phys Ther 2009;39:604–611. 18. Pallant J. SPSS survival manual. A step by step guide to data analysis using SPSS version 12. 2nd ed. London: Open University Press; 2005. 19. Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A fear-avoidance beliefs questionnaire (FABQ) and the role of fearavoidance beliefs in chronic low back pain and disability. Pain 1993;52:157–168. 20. Critchley DJ, Coutts FJ. Abdominal muscle function in chronic low back pain patients: Measurement with real-time ultrasound scanning. Physiotherapy 2002;88:322–332. 21. Mew R. Comparison of changes in abdominal muscle thickness between standing and crook lying during active abdominal hollowing using ultrasound imaging. Man Ther 2009 12;14:690–695. 22. Keogh E. Sex and gender differences in pain: A selective review of biological and psychosocial factors. J Men Health Gend 2006;3:236–243. 23. Robinson ME, Dannecker EA, George SZ, Otis J, Atchison JW, Fillingim RB. Sex differences in the associations among psychological factors and pain report: A novel psychophysical study of patients with chronic low back pain. J Pain 2005;6:463–470. 24. Hirsh AT, Waxenberg LB, Atchison JW, Gremillion HA, Robinson ME. Evidence for sex differences in the relationships of pain, mood, and disability. J Pain 2006 8;7:592–601. 25. Robinson ME, Riley III JL, Myers CD, Papas RK, Wise EA, Waxenberg LB, Fillingim RB. Gender role expectations of pain: Relationship to sex differences in pain. J Pain 2001;2:251–257. 26. Biering-Sorensen F, Lund J, Hoydalsmo OJ, Darre EM, Deis A, Kryger P, Muller CF. Risk indicators of disability pension. A 15 year follow-up study. Dan Med Bull 1999;46:258–262. 27. Hestbaek L, Leboeuf-Yde C, Manniche C. Is low back pain part of a general health pattern or is it a separate and distinctive entity? A critical literature review of comorbidity with low back pain. J Manipulative Physiol Ther 2003;26:243–252. 28. Holmberg S, Thelin A, Stiernstrom EL, Svardsudd K. Low back pain comorbidity among male farmers and rural referents: A populationbased study. Ann Agric Environ Med 2005;12:261–268. 29. Hestbaek L, Leboeuf-Yde C, Kyvik KO, Vach W, Russell MB, Skadhauge L, Svendsen A, Manniche C. Comorbidity with low back pain: A cross-sectional population-based survey of 12- to 22-year-olds. Spine 2004;29:1483–1491. 30. Krouse RS, Grant M, Rawl SM, Mohler MJ, Baldwin CM, Coons SJ, McCorkle R, et al. Coping and acceptance: The greatest challenge for veterans with intestinal stomas. J Psychosom Res 2009;66: 227–233. 31. Nicholas MK, Asghari A, Blyth FM. What do the numbers mean? Normative data in chronic pain measures. Pain 2008;134:158–173. 32. Pincus T, Vogel S, Burton AK, Santos R, Field AP. Fear avoidance and prognosis in back pain: A systematic review and synthesis of current evidence. Arthritis Rheum 2006;54:3999–4010. 33. Leonhardt C, Lehr D, Chenot JF, Keller S, Luckmann J, Basler HD, Baum E, et al. Are fear-avoidance beliefs in low back pain patients a risk factor for low physical activity or vice versa? A cross-lagged panel analysis. Psychosoc Med 2009;6:1–12. 34. Tsao H, Hodges PW. Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. J Electromyogr Kinesiol 2008;18:559–567. 35. Ferreira PH, Ferreira ML, Hodges PW. Changes in recruitment of the abdominal muscles in people with low back pain: Ultrasound measurement of muscle activity. Spine 2004;29:2560–2566. 36. Cholewicki J, Silfies SP, Shah RA, Greene HS, Reeves NP, Alvi K, Goldberg B. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine 2005;30:2614–2620.

PY - 2012/1

Y1 - 2012/1

N2 - Purpose: People with a stoma believe that there is a link between their surgery and low back pain (LBP). Aim: To explore factors relating to (i) core stability in people with a stoma and LBP and (ii) biopsychosocial factors related to LBP. Methods: Adults with an ileostomy and LBP (n = 17) completed (i) a range of standardised instruments, (ii) clinical tests and (iii) an ultrasound scan of right and left transversus abdominis (TrA).Results: The findings showed moderate pain and disability: RMDQ: median = 12 (IQR: 9.5–13), EQ-5D health state: mean = 6.9 (±1.75), BPI pain severity: median = 4.5 (IQR: 2.87–5.4). The TrA contraction was less on the operated than the unoperated side and this was linked to less control for BKFO to the operated side, and the presence of a parastomal hernia. Co-morbidities were associated with greater balance problems during the stork test (p <0.05). Men had more fear avoidance (p <0.05) on the FABQ regarding physical activity. Discussion: Abdominal function may be altered after stoma surgery leading to reduced ability to perform functional tasks and a possible increased risk of backpain. These results should be viewed with caution due to the small sample size.

AB - Purpose: People with a stoma believe that there is a link between their surgery and low back pain (LBP). Aim: To explore factors relating to (i) core stability in people with a stoma and LBP and (ii) biopsychosocial factors related to LBP. Methods: Adults with an ileostomy and LBP (n = 17) completed (i) a range of standardised instruments, (ii) clinical tests and (iii) an ultrasound scan of right and left transversus abdominis (TrA).Results: The findings showed moderate pain and disability: RMDQ: median = 12 (IQR: 9.5–13), EQ-5D health state: mean = 6.9 (±1.75), BPI pain severity: median = 4.5 (IQR: 2.87–5.4). The TrA contraction was less on the operated than the unoperated side and this was linked to less control for BKFO to the operated side, and the presence of a parastomal hernia. Co-morbidities were associated with greater balance problems during the stork test (p <0.05). Men had more fear avoidance (p <0.05) on the FABQ regarding physical activity. Discussion: Abdominal function may be altered after stoma surgery leading to reduced ability to perform functional tasks and a possible increased risk of backpain. These results should be viewed with caution due to the small sample size.

U2 - 10.3109/09638288.2011.613515

DO - 10.3109/09638288.2011.613515

M3 - Article

VL - 34

SP - 522

EP - 530

JO - Disability and Rehabilitation

T2 - Disability and Rehabilitation

JF - Disability and Rehabilitation

SN - 0963-8288

IS - 6

ER -