Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania.

BACKGROUND: LBP is a common and serious problem affecting vast populations of the world. However, only few studies on LBP in sub-Saharan Africa have been conducted. Studies report that LBP and pelvic angle are interrelated, and African residents have a high pelvic tilt. The strategy to prevent LBP should focus on activities that promote holistic health. For that purpose, it is important to grasp the state of LBP and how it affects people's lifestyle in Tanzania to clarify the direction of implementation of physiotherapy treatment and reduce the incidences of LBP among adults. This study aimed to investigate the prevalence and presentation of low back pain (LBP) and the relationship between anthropometric measurements and LBP among people in Moshi city, Kilimanjaro region Tanzania. METHODS: Following signing consent forms, participants were given questionnaires regarding LBP and then grouped accordingly into either asymptomatic or symptomatic cohorts. Anthropometric measurements of participants' height, weight, curvature of the spine, and pelvic angle were obtained. RESULTS: A Mann-Whitney U test analysis showed a significant difference in pelvic angle, body mass index (BMI), and thoracic kyphosis angle between the asymptomatic group and the symptomatic group. No significant differences in lumbar lordosis angle or abdominal muscle strength were found between the two groups. CONCLUSIONS: A person with symptomatic LBP in Tanzania has a large anteversion of the pelvic tilt and a thoracic kyphotic posture. This study shows a relationship between sagittal spinal alignment and LBP in Tanzania, which could allow for prospective identification of subjects prone to developing LBP in the future.

Relationship between forefoot structure, including the transverse arch, and forefoot pain in patients with hallux valgus.

[Purpose] Hallux valgus occurs in the forefoot where the transverse arch is located and may be a factor involved in forefoot pain. The relationship between forefoot pain and forefoot structure is unknown. This study aimed to analyze the relationship between forefoot pain and the transverse arch in patients with hallux valgus. [Participants and Methods] In this study, 122 (197 feet) adult females (46 to 86 years old) with hallux valgus were studied. By using questionnaires, the females were divided into two groups depending on whether or not they had forefoot pain (a group with forefoot pain [P group] and a group without forefoot pain [NP group]). The hallux valgus angle was measured using a goniometer, and the transverse arch was measured using a weight-bearing plantar ultrasonography imaging device. The transverse arch measurements included the transverse arch height and length. [Results] Only the transverse arch length, even after adjustment, was significantly greater in the P group. No significant difference was found between the hallux valgus angle and the transverse arch height. [Conclusion] The greater transverse arch length in the P group was possibly due to the collapsing transverse arch support muscles. Increased width probably caused inadequate impact absorption which in turn led to forefoot pain.