Prevalence of musculoskeletal pain, and low back pain, in Blacks versus Non-Hispanic Whites (NHWs)

It is estimated that over 126.6 million people are affected by a musculoskeletal condition in America. Musculoskeletal disorders refer to injuries and conditions that affect muscles, joints, and bones. The disorders can be painful and devastating affecting the quality of life (Shmagel et al., 2016). The most prevalent disorders are arthritis, and neck and back pain. Musculoskeletal pain and lower back pain are common conditions in America (Fatoye et al., 2019). However, prevalent in some ethnic groups than in others (Campbell, 2017). Our focus is providing a summary of the Prevalence of musculoskeletal pain, and low back pain, in Blacks versus Non-Hispanic Whites (NHWs). While there is no research that has specifically studied the prevalence of the condition in Blacks versus Non-Hispanic Whites, several studies have been done on the prevalence of the conditions based on races. The findings of these studies will be used in providing the summary.

Research shows that there are racial disparities when it comes to the prevalence of musculoskeletal pain and lower back pain. Non-Hispanic whites have reported slightly higher rates of low back pain than any other race and in our case, than the blacks (Riskowsk, 2014; Dahlhamer et al., 2018). For example, in 2015, 36.4% of cases of back pain was reported among non-Hispanic whites. This is compared to 31% of blacks (Adigwme & Nelson, 2014). To support the findings, Adigwme & Nelson, (2014), studied healthcare visits for low back pain. They found than non-Hispanic white people were more likely to seek treatment for low back pain compared to blacks and other ethnic groups. On lost workdays, the study found that non-Hispanic white people lost more das compared to blacks (Adigwme & Nelson, 2014).

The findings are similar to other studies that have found non-Hispanic whites to have a higher prevalence of musculoskeletal pain and lower back pain compared to blacks. According to Meucci et al., (2015), non-Hispanic whites have shown a higher prevalence of low back pain compared to blacks. The study shows a prevalence rate of 4.1% in 1992 among non-Hispanic whites vs a 3% among blacks in the same year (Meucci et al., 2015). In 2006, non-Hispanic whites also had a higher prevalence rate of 10.5% compared to 9.8% among blacks.

Additionally, research by Singh & Andersson (2014), shows that non-Hispanic whites report more cases of low back pain than other ethnic groups. According to their study, nearly 29% of Americans experienced low back pain every year from 2013 to 2015. The condition was most prevalent among non-Hispanic white people than in any other ethnic group (Singh & Andersson, 2014). Similar findings were reported by Yang et al., (2016). Non-Hispanic white people have a higher likelihood of low back pain compared to blacks and other ethnic groups.

However, there are some studies indicating that musculoskeletal pain and low back pain tend to be more prevalent among blacks than in non-Hispanic white people. For example, Overstreet et al., (2017) argue that Blacks tend to report more cases of low back pain compared to non-Hispanic white people. Adigwme & Nelson (2014), also found blacks to report a higher number of bed days due to low back pain compared to white non-Hispanics. Cleary, musculoskeletal pain and low back pain are common problems. However, research shows that are racial disparities when it comes to the prevalence. This is especially clear in the prevalence of the conditions between non-Hispanic white people and blacks.

References

Adigweme, O. & Nelson, C. (2020). Spinal Conditions. United States Bone and Joint         Initiative. Retrieved from https://www.boneandjointburden.org/fourth-      edition/viid1/spinal-conditions

Aroke, E., Joseph, P., Roy, A., Overstreet, D., Tollefsbol, T., Vance, D. & Goodin, B. (2019).       Could epigenetics help explain racial disparities in chronic pain? Journal of Pain, 12         701–710.

Campbell, L. (2017). Musculoskeletal Disorders Addressing Disparities in Prevalence,       Severity, and Treatment. North Carolina Medical Journal, 78 (5), 315-317.

Dahlhamer, J., Lucas, J., Zelayaa, C., Mahin, R., Mackey, S…Korff, M., & Helmick, C.   (2018). Prevalence of Chronic Pain and High-Impact Chronic Pain among Adults —     United States, 2016. Centers for Disease Contrl and Prevention. Retrieved from          https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm

Fatoye, F., Gebrye, T. & Odeyemi, I. (2019). Real-world incidence and prevalence of low            back pain using routinely collected data. Rheumatology International, 39 (4), 619-      626.

Ganesan, S., Acharya, A., Chauhan, R., Acharya, S. (2017). Prevalence and risk factors             for        low back pain in 1,355 young adults:  a cross-sectional study. Asian Spine Journal,      11(4), 610-700.

Karppinen, J. (2017). Is Low Back Pain a Genetic Problem? Global Spine Journal, 4 (1).

Manchikanti, L., Singh, V., Falco, F., Benyamin, R. & Hirsch, J. (2014). Epidemiology of low        back pain in adults. Neuromodulation, 17(2), 3-10.

Meucci, R., Fassa, A. & Faria, N. (2015). Prevalence of chronic low back pain: Systematic          review. Revista de saude publica, 49:1-10.

Overstreet, D., Browning, W., Penn, T., Trost, Z. & Doodin, B. (2017). Racial Differences in         Appraisal of Physical Activity among Community-Dwelling Adults with Chronic Low      Back Pain. Journal of Pain, 18 (4), 84-85.

Ramdas, J. & Jella, V. (2018). Prevalence and risk factors of low back pain. International             Journal of Advances in Medicine, 5 (5), 1-4.

Riskowski, J. (2014). Associations of Socioeconomic Position and Pain Prevalence in the            United States: Findings from the National Health and Nutrition Examination Survey.         Pain Medicine, 15, 1508-1521.

Shmagel, A., Foley, R. & Ibrahim, H. (2016). Epidemiology of Chronic Low Back Pain in US        Adults: Data from the 2009–2010 National Health and Nutrition Examination Survey.     Arthritis Care & Research, 68 (11), 1688-1694.     

Singh, K. & Andersson, G. (2020). Low Back Pain. United States Bone and Joint Initiative.           Retrieved from https://www.boneandjointburden.org/fourth-edition/iiaa0/low-back-      pain

Yang, H., Haldeman, S., LU, M. & Baker, D. (2016). Low Back Pain Prevalence and Related       Workplace Psychosocial Risk Factors: A Study Using Data from the 2010 National     Health Interview Survey. Journal of Manipulative Physiological Therapeutics, 39(7):        459–472

Genomics of low back pain

Various factors are considered responsible for low back pain including occupational, psychosocial, structural factors, and genetic influences (Eskola et al., 2014). The main cause of disability across the world which also imposes a huge economic burden on society (Hoy et al., 2015). Currently, researchers are focusing on genetic influences and the role they play in low back pain. Various studies indicate that genetic variability plays a role in the development of low back pain. These studies show the relationship between intervertebral disc degeneration, genetic defects, and low back pain.

 Research shows that genetic variability may play a role in low back pain (Karppinen, 2017). One of these factors is the intervertebral disc degeneration (IDD). Various genetic defects have been linked with IDD in humans (Martisosyan et al., 2016). Therefore, genetic factors may cause IDD through biological and mechanical mechanisms. This can happen with or without the presence of other risk factors such as spine deformity, aging, and spine injury (Feng et al., 2016). For instance, genetic defects may cause functional and structural changes in some collagens within an IVD. This compromises the mechanical properties of the disc making it susceptible to external stress (Feng et al., 2016). According to Bjorland et al (2019), genetic variability has a role in pain perception, inflammation, and degenerative changes and may have a role in low back pain. For example, genetic variants in genes encoding proteins such as collagen may have an effect on the intervertebral discs’ degeneration.

The findings are similar to Kraatari’s (2018) study which shows that genetic factors play a role in low back pain. According to the author, lumbar disc degeneration (DD) contributes to low back pain. Studies show that genetic factors play a significant role in the development of lumbar DD (Määttä et al., 2015). Modic change, a phenotype of lumbar DD, is associated with low back pain. The average prevalence of modic change has been shown as 43% among individuals with low back pain compared to 6% in individuals without low back pain. These findings lead to the association of modic change with low back pain. Kraatari (2018) found that modic change was partly heritable. The study also found a genetic locus on chromosome 9 to be meaningfully associated with modic change using genome-wide meta-analysis. These findings indicated that genetic factors play a role in the development of modic change.

Research also shows that demographic factors such as sex, race, and ethnicity have an effect on genetic factors that play a role in low back pain (Katerina et al., 2016). For instance, sex was found to influence the heritability of chronic pain. In tests of the genetic contribution to pain, studies have reported heritability for lower back pain, supporting contributions of genetic (Jurik, 2016). Similar studies that focused on male twins reported heritability for back pain and heritability of chronic pain is shown to be mediated by common genetic factors. This suggests that when studying the genomics of low back pain, demographic factors should be considered. Low back pain is a common problem for human beings. Research shows that environmental factors contribute to the problem. However, research on the genomics of low back pain shows that it is inevitable that genetic factors play a role in low back pain (Perera, 2018). This means that genetics influence some cases of low back pain. Additionally, demographic factors cannot be ignored when studying the role of genetics in low back pain.

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