Low back pain in a natural disaster

Area of Science:

• Emergency Medicine
• Pain Management
• Epidemiology

Background:

• Low back pain (LBP) is typically self-limiting, but acute to chronic transition involves physical and psychological factors.
• In mass emergency settings, identifying all contributing factors and differentiating life-threatening LBP is crucial.
• Natural disasters can induce emotional stress, potentially amplifying pain perception and increasing chronic pain risk.

Purpose of the Study:

• To estimate the prevalence of LBP in patients presenting to advanced medical presidiums (AMPs) post-earthquake.
• To evaluate the frequency and types of pain medications used.
• To assess the short-term efficacy of pain management strategies for LBP.

Main Methods:

• The study was conducted in four AMPs during the first 5 weeks after an earthquake.
• Data collected included trauma type, pain intensity (Verbal Numerical Rating Scale - vNRS), and LBP diagnosis (primary vs. secondary).
• Therapeutic treatments administered were analyzed.

Main Results:

• Acute LBP prevalence was 4.9% among first accesses to AMPs, comprising 14.1% of all treated pain conditions.
• Forty percent of LBP cases were relapsed chronic pain, while 60% were new episodes.
• Pain treatment demonstrated short-term effectiveness, with significant vNRS reduction.

Conclusions:

• The emotional stress from natural disasters can activate the sympathetic nervous system, potentially exacerbating nociception.
• This heightened physiological response may contribute to the prevalence of primary non-specific LBP (NSLBP).
• NSLBP in disaster settings may represent a risk factor for pain chronification.