Advancing Our Understanding and Management of Low Back Pain: A Global Perspective

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 3309

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Guest Editor
VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
Interests: ultrasound imaging; neck pain; low back pain; myofascial pain syndromes; elastography; science education; physiotherapy; undergraduate education; health occupations students
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Dear Colleagues,

Low back pain (LBP) is among the most common musculoskeletal conditions, affecting up to 18.3% of the global population. It is notable for its high recurrence rate, with up to 76% of individuals experiencing more than one episode. LBP can persist over long periods, with pain and disability continuing for 6 to 24 months in 54% and 47% of patients, respectively, often ranging from moderate to severe intensity. This condition impacts people of all ages and has seen a 54% increase in disability-adjusted life years between 1990 and 2015, highlighting its substantial socioeconomic burden. Contributing factors include differences in social norms, healthcare systems, and legal frameworks, with the annual economic cost of LBP reaching approximately USD 100 billion in the United States and GBP 2.8 billion in the United Kingdom. While LBP can sometimes result from specific pathoanatomical conditions affecting the lumbar spine, the vast majority of cases (90–95%) are categorized as non-specific LBP, as no identifiable cause can be determined. This Special Issue aims to bring together cutting-edge research and expert reviews to enhance our understanding of LBP, explore innovative diagnostic and therapeutic approaches, and evaluate strategies to reduce its global impact. As such, original research articles, reviews, clinical studies, and perspective papers that contribute to advancing the field are welcome.

Dr. Juan Antonio Valera-Calero
Guest Editor

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Keywords

  • low back pain
  • pain management
  • global health
  • musculoskeletal diseases
  • rehabilitation

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Published Papers (2 papers)

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Research

8 pages, 248 KiB  
Article
The Association Between Female Breast Size, Backache, and Quality of Life in Young Women: A Cross-Sectional Study
by Raphael Lotan, Natali Marmor, Sharon Weiss, Mojahed Sakhnini and Oded Hershkovich
Medicina 2025, 61(8), 1353; https://doi.org/10.3390/medicina61081353 (registering DOI) - 26 Jul 2025
Viewed by 114
Abstract
Background and Objectives: The association between female breast size and spinal back pain is widely suggested in clinical practice but remains insufficiently quantified in general, non-surgical populations in the scientific literature. Larger breasts may increase biomechanical strain on the spine, contributing to [...] Read more.
Background and Objectives: The association between female breast size and spinal back pain is widely suggested in clinical practice but remains insufficiently quantified in general, non-surgical populations in the scientific literature. Larger breasts may increase biomechanical strain on the spine, contributing to musculoskeletal pain and reduced quality of life. This study aimed to evaluate the association between breast size and back pain in a general orthopedic population of young women. Materials and Methods: A cross-sectional study was conducted among 200 women aged 18–36 who attended orthopedic clinics for non-spinal complaints. Data were collected via structured telephone questionnaires, including demographics, self-reported breast size (cup and band), pain characteristics, and SF-12 quality of life scores. Binary logistic regression, ANOVA, and chi-square analyses assessed associations between breast size, pain presence, severity, and functional outcomes. Results: Back pain prevalence increased with breast size: only 4.9% of B cup participants reported backache, compared to 85% of DD/E cup participants. VAS scores rose from 0.3 ± 1.6 (B cup) to 6.0 ± 2.9 (DD/E cup). Each 1 cm increase in band length raised the odds of back pain by 19.8% (OR = 1.198, p < 0.001), while large cup size was associated with up to 12-fold increased odds of pain. Larger breast size was also significantly associated with work limitations and social impairment. Conclusions: Breast size was strongly associated with the presence and severity of back pain, particularly in the thoracic and cervical regions. Clinicians should consider breast size in the assessment of backache, and reduction mammaplasty may have therapeutic value beyond aesthetics. Full article
13 pages, 648 KiB  
Article
Association of Quadratus Lumborum Muscle Stiffness with Chronic Low Back Pain Features: An Observational Study
by Mónica López-Redondo, Davinia Vicente-Campos, Javier Álvarez-González, Alberto Roldán-Ruiz, Sandra Sánchez-Jorge, Jorge Buffet-García, Gabriel Rabanal-Rodríguez and Juan Antonio Valera-Calero
Medicina 2025, 61(2), 270; https://doi.org/10.3390/medicina61020270 - 5 Feb 2025
Cited by 1 | Viewed by 2904
Abstract
Background and Objectives: Low back pain (LBP) is highly prevalent and often associated with altered muscle function, including in the quadratus lumborum (QL) muscle. While some studies have highlighted the clinical relevance of QL muscle stiffness in LBP, the findings remain inconsistent, [...] Read more.
Background and Objectives: Low back pain (LBP) is highly prevalent and often associated with altered muscle function, including in the quadratus lumborum (QL) muscle. While some studies have highlighted the clinical relevance of QL muscle stiffness in LBP, the findings remain inconsistent, and the role of this parameter in relation to clinical severity indicators is not well understood. Considering the high prevalence of myofascial trigger points among patients, objectively and reliably quantifying QL stiffness and its association with other clinical parameters could improve the identification of early stages of the condition before other alterations become apparent. Therefore, this study aimed to explore the association between QL stiffness and multiple indicators of LBP severity. Materials and Methods: A cross-sectional observational study was conducted involving the participation of seventy-six patients suffering from chronic LBP. An ultrasound scanner with shear-wave elastography (SWE) was used to determine the participants’ QL stiffness. Additional information was collected on LBP-associated pain intensity, disability, central sensitization, and quality of life. Results: QL muscle stiffness was negatively correlated with pain intensity (p < 0.01) and central sensitization (p < 0.01), and it was positively correlated with physical quality of life (p < 0.01). Muscle stiffness influenced the variance in pain intensity along with physical quality of life, central sensitization, and chronicity (together explaining 49% of the variance) but did not explain the variance in central sensitization. Conclusions: Assessing QL muscle stiffness in patients with LBP is recommended, as greater muscle softness is linked to higher pain intensity, central sensitization, and poorer physical quality of life. Regression analyses further highlighted that QL stiffness helps explain the variance in pain intensity, physical quality of life, central sensitization, and chronicity, but it did not directly affect the central sensitization variance. Full article
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