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Spinal pain is a significant global health issue, affecting millions and ranking as one of the leading causes of disability worldwide. Despite the wide scope of research conducted on spinal and associated pain, the lack of standardised core outcome measures poses challenges for comparing and synthesising research data. Core Outcome Sets (COSs) are intended to harmonise assessment and facilitate comparison across studies. This review aimed to identify, map, and examine published core outcome sets (COSs) designed for the assessment of spinal pain-including cervical, thoracic, lumbar-and spinal-related limb, trunk, abdomen, or pelvic pain. It also sought to synthesise consistent outcome domains across these COSs, categorising them by anatomical region and measurement type, including patient-reported, physical, biological, psychological, social, and environmental measures. This systematic review followed PRISMA guidelines and was registered with PROSPERO. A comprehensive literature search of 13 electronic databases and grey literature sources was conducted from 2000 to April 2025. Two independent reviewers assessed study eligibility and quality using predefined criteria. Data extraction was performed to identify core outcome domains, and a thematic analysis was conducted to categorise domains based on anatomical regions, patient-reported outcomes, performance measures, and biopsychosocial factors. Thirteen studies met inclusion criteria, addressing core outcome sets for cervical (n = 4), thoracolumbar (n = 1), and lumbar (n = 8) spinal regions. Patient-reported outcome measures were the most frequently recommended outcome type. The most commonly endorsed domains were physical function n = 9 (100%), pain intensity n = 8 (88.9%), participation in work or daily activities n = 7 (77.8%), and disability n = 6 (66.7%). However, few studies incorporated psychological, social, environmental, or physiological domains, highlighting critical gaps in the multidimensional assessment of spinal pain. This systematic review identified key domains in current use and significant gaps in biopsychosocial and biological measurement. Findings will support researchers, clinicians, and policymakers in selecting appropriate outcomes for spinal pain research and practice. A Delphi study to develop an internationally agreed \"Essential Universal Set\" for spinal pain, inclusive of multidimensional biopsychosocial domains, is a sound next step.

Spinal pain is a significant global health issue, affecting millions and ranking as one of the leading causes of disability worldwide. Despite the wide scope of research conducted on spinal and associated pain, the lack of standardised core outcome measures poses challenges for comparing and synthesising research data. Core Outcome Sets (COSs) are intended to harmonise assessment and facilitate comparison across studies. This review aimed to identify, map, and examine published core outcome sets (COSs) designed for the assessment of spinal pain-including cervical, thoracic, lumbar-and spinal-related limb, trunk, abdomen, or pelvic pain. It also sought to synthesise consistent outcome domains across these COSs, categorising them by anatomical region and measurement type, including patient-reported, physical, biological, psychological, social, and environmental measures. This systematic review followed PRISMA guidelines and was registered with PROSPERO. A comprehensive literature search of 13 electronic databases and grey literature sources was conducted from 2000 to April 2025. Two independent reviewers assessed study eligibility and quality using predefined criteria. Data extraction was performed to identify core outcome domains, and a thematic analysis was conducted to categorise domains based on anatomical regions, patient-reported outcomes, performance measures, and biopsychosocial factors. Thirteen studies met inclusion criteria, addressing core outcome sets for cervical (n = 4), thoracolumbar (n = 1), and lumbar (n = 8) spinal regions. Patient-reported outcome measures were the most frequently recommended outcome type. The most commonly endorsed domains were physical function n = 9 (100%), pain intensity n = 8 (88.9%), participation in work or daily activities n = 7 (77.8%), and disability n = 6 (66.7%). However, few studies incorporated psychological, social, environmental, or physiological domains, highlighting critical gaps in the multidimensional assessment of spinal pain. This systematic review identified key domains in current use and significant gaps in biopsychosocial and biological measurement. Findings will support researchers, clinicians, and policymakers in selecting appropriate outcomes for spinal pain research and practice. A Delphi study to develop an internationally agreed \"Essential Universal Set\" for spinal pain, inclusive of multidimensional biopsychosocial domains, is a sound next step.

The global rise in lower-limb amputations is mainly due to diabetes and vascular complications. Amputations cause serious physical and psycho-social disabilities which impair locomotion and compromise patients quality of life. Biopsychosocial factors such as altered gait parameters, poor prosthetic fit, depression, fear avoidance behaviours and stigma increase the risk of individuals incurring lower back pain; the leading cause of secondary disability amongst persons with lower-limb amputation. Exploring the potential mechanistic pathways of lower back pain development is important to inform timely patient-centred programmes of care. Currently, limited information exists to inform the design of such programmes. Thus, there is a pressing need to understand the bio-behavioural, psychological, and social features of individuals with lower-limb amputation in the presence of lower back pain. This proposed study protocol employs a prospective longitudinal study design that aims to explore the determinants of lower back pain amongst 30 adults with unilateral lower-limb amputation over 12-months. Biomechanical gait variables, trunk and lower-limb muscle activations, and objective pain measurements will be monitored every 3-months, and their relationship will be investigated. This information can be used to explore the characteristics of lower back pain and will inform future care management and rehabilitation processes. A data repository will be created and will be accessible through the University of Bath library website (https://library.bath.ac.uk/home).

The global rise in lower-limb amputations is mainly due to diabetes and vascular complications. Amputations cause serious physical and psycho-social disabilities which impair locomotion and compromise patients quality of life. Biopsychosocial factors such as altered gait parameters, poor prosthetic fit, depression, fear avoidance behaviours and stigma increase the risk of individuals incurring lower back pain; the leading cause of secondary disability amongst persons with lower-limb amputation. Exploring the potential mechanistic pathways of lower back pain development is important to inform timely patient-centred programmes of care. Currently, limited information exists to inform the design of such programmes. Thus, there is a pressing need to understand the bio-behavioural, psychological, and social features of individuals with lower-limb amputation in the presence of lower back pain. This proposed study protocol employs a prospective longitudinal study design that aims to explore the determinants of lower back pain amongst 30 adults with unilateral lower-limb amputation over 12-months. Biomechanical gait variables, trunk and lower-limb muscle activations, and objective pain measurements will be monitored every 3-months, and their relationship will be investigated. This information can be used to explore the characteristics of lower back pain and will inform future care management and rehabilitation processes. A data repository will be created and will be accessible through the University of Bath library website (https://library.bath.ac.uk/home).

To identify impaired trunk movement during work-related activity in individuals with low back pain (LBP) and investigate whether abnormalities were caused by generalized fear of movement-related pain. This cross-sectional study was conducted at a hospital in Japan. We recruited 35 participants with LBP (LBP group; 26 males, 9 females) and 20 healthy controls (HC group) via posters at our hospital. The task required lifting an object. We used a 3D motion capture system to calculate the peak angular velocity of trunk flexion and extension during a lifting task. Pain-related factors for the LBP group were assessed using the visual analogue scale (VAS) for pain intensity over the past 4 weeks and during the task, the Tampa Scale for Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Pain Anxiety Symptoms Scale-20 (PASS-20). We compared kinematic variables between groups with a generalized linear mixed model and investigated the relationship between kinematic variables, VAS scores, and psychological factors by performing a mediation analysis. The peak angular velocity of trunk extension showed significant main effects on the group factors (LBP group vs. HC group) and their interactions; the value of the kinematic variable was lower at Trial 1 in the LBP group. No LBP participant reported pain during the experiment. The mediation analysis revealed that the relationship between the VAS score for pain intensity over the past 4 weeks and the peak angular velocity of trunk extension in the first trial was completely mediated by the TSK (complete mediation model, 95% bootstrapped CI: 0.07-0.56). Individuals with LBP had reduced trunk extension during a lifting task. Generalized fear of movement-related pain may contribute to such impaired trunk movement. Our findings suggest that intervention to ameliorate fear of movement may be needed to improve LBP-associated disability.

To identify impaired trunk movement during work-related activity in individuals with low back pain (LBP) and investigate whether abnormalities were caused by generalized fear of movement-related pain. This cross-sectional study was conducted at a hospital in Japan. We recruited 35 participants with LBP (LBP group; 26 males, 9 females) and 20 healthy controls (HC group) via posters at our hospital. The task required lifting an object. We used a 3D motion capture system to calculate the peak angular velocity of trunk flexion and extension during a lifting task. Pain-related factors for the LBP group were assessed using the visual analogue scale (VAS) for pain intensity over the past 4 weeks and during the task, the Tampa Scale for Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Pain Anxiety Symptoms Scale-20 (PASS-20). We compared kinematic variables between groups with a generalized linear mixed model and investigated the relationship between kinematic variables, VAS scores, and psychological factors by performing a mediation analysis. The peak angular velocity of trunk extension showed significant main effects on the group factors (LBP group vs. HC group) and their interactions; the value of the kinematic variable was lower at Trial 1 in the LBP group. No LBP participant reported pain during the experiment. The mediation analysis revealed that the relationship between the VAS score for pain intensity over the past 4 weeks and the peak angular velocity of trunk extension in the first trial was completely mediated by the TSK (complete mediation model, 95% bootstrapped CI: 0.07-0.56). Individuals with LBP had reduced trunk extension during a lifting task. Generalized fear of movement-related pain may contribute to such impaired trunk movement. Our findings suggest that intervention to ameliorate fear of movement may be needed to improve LBP-associated disability.

Chronic back pain is prevalent in Brazil, leading to enormous healthcare costs and social burdens. It also disproportionately affects low-income and less-healthy people. This study examines the associations of chronic back pain with biological, psychological, and social factors; how it limits usual activities; and how chronic back pain influences the use of treatment services. Using Brazil's National Health Survey (PNS-2019), multivariate logistic regressions were conducted to examine how biological, psychological, and social factors correlate with chronic back pain, limitations on usual activities, and pain treatment. PNS-2019 data showed that 23.4% (95% CI 22.8-24.0) of Brazilian adults aged over 20 reported back pain. A higher prevalence of chronic back pain was associated with biological factors (older age, being female, overweight or obese, current smoking, and having more chronic conditions), lower social conditions (low education, low per capita household income, non-married, and living in rural areas), and poor psychological health (more depressive symptoms). Chronic back pain is more likely to limit usual activities among those with low social conditions (lower education, lower income), poor physical and behavioral health (obese, current smokers, and those with a greater number of chronic conditions), and worse psychological health (more depressive symptoms). However, married people and those who do not consume alcohol were also more likely to report limited activities. Among those with back pain, 68% received at least one form of treatment. Those with intense limitations on their usual activities were 2.2 times as likely to report treatment. People with higher social conditions (higher income, college education, and private health insurance) were more likely to receive treatment. The results show significant biological, psychological, and social disparities in the prevalence of chronic back pain in Brazil. The findings point to the need for tailored policies and prevention programs with attention to vulnerable groups. Even though Brazil has universal health care, those with better socioeconomic conditions are more likely to receive treatment.

Chronic back pain is prevalent in Brazil, leading to enormous healthcare costs and social burdens. It also disproportionately affects low-income and less-healthy people. This study examines the associations of chronic back pain with biological, psychological, and social factors; how it limits usual activities; and how chronic back pain influences the use of treatment services. Using Brazil's National Health Survey (PNS-2019), multivariate logistic regressions were conducted to examine how biological, psychological, and social factors correlate with chronic back pain, limitations on usual activities, and pain treatment. PNS-2019 data showed that 23.4% (95% CI 22.8-24.0) of Brazilian adults aged over 20 reported back pain. A higher prevalence of chronic back pain was associated with biological factors (older age, being female, overweight or obese, current smoking, and having more chronic conditions), lower social conditions (low education, low per capita household income, non-married, and living in rural areas), and poor psychological health (more depressive symptoms). Chronic back pain is more likely to limit usual activities among those with low social conditions (lower education, lower income), poor physical and behavioral health (obese, current smokers, and those with a greater number of chronic conditions), and worse psychological health (more depressive symptoms). However, married people and those who do not consume alcohol were also more likely to report limited activities. Among those with back pain, 68% received at least one form of treatment. Those with intense limitations on their usual activities were 2.2 times as likely to report treatment. People with higher social conditions (higher income, college education, and private health insurance) were more likely to receive treatment. The results show significant biological, psychological, and social disparities in the prevalence of chronic back pain in Brazil. The findings point to the need for tailored policies and prevention programs with attention to vulnerable groups. Even though Brazil has universal health care, those with better socioeconomic conditions are more likely to receive treatment.

Although low back pain (LBP) beliefs have been well investigated in mainstream healthcare discipline students, the beliefs within sports-related study students, such as Sport and Exercise Science (SES), Sports Therapy (ST), and Sport Performance and Coaching (SPC) programmes have yet to be explored. This study aims to understand any differences in the beliefs and fear associated with movement in students enrolled in four undergraduate study programmes-physiotherapy (PT), ST, SES, and SPC. 136 undergraduate students completed an online survey. All participants completed the Tampa Scale of Kinesiophobia (TSK) and Back Beliefs Questionnaire (BBQ). Two sets of two-way between-subjects Analysis of Variance (ANOVA) were conducted for each outcome of TSK and BBQ, with the independent variables of the study programme, study year (1st, 2nd, 3rd), and their interaction. There was a significant interaction between study programme and year for TSK (F(6, 124) = 4.90, P < 0.001) and BBQ (F(6, 124) = 8.18, P < 0.001). Post-hoc analysis revealed that both PT and ST students had lower TSK and higher BBQ scores than SES and SPC students particularly in the 3rd year. The beliefs of clinicians and trainers managing LBP are known to transfer to patients, and more negative beliefs have been associated with greater disability. This is the first study to understand the beliefs about back pain in various sports study programmes, which is timely, given that the management of injured athletes typically involves a multidisciplinary team.