The Association Between Atherosclerosis and Low Back Pain: A Systematic Review

OBJECTIVE: To assess the evidence of association between atherosclerosis and low back pain (LBP). TYPE: Focused systematic review. LITERATURE SURVEY: PubMed, Web of Science, CINAHL, and EMBASE were searched for original research articles, not limited by language, from January 1, 1990, to October 31, 2016. METHODOLOGY: Titles and then abstracts were identified using predefined search terms and excluded based on lack of relevancy. This was followed by full-text reviews. Two authors independently assessed methodological quality based on Cochrane Handbook for Systematic Reviews of Interventions. SYNTHESIS: A total of 26 studies met the inclusion criteria. The quality of the studies was low to moderate. There was significant heterogeneity across articles with respect to methodology. There was insufficient evidence to support an association between ischemia and low back pain. CONCLUSIONS: The cause of LBP remains poorly understood. Better insight into how intervertebral disk changes relate to LBP is needed to guide future research. High-quality prospective studies are needed to answer the question of whether atherosclerosis is a risk factor for LBP. LEVEL OF EVIDENCE: II.