The presence of respiratory disorders in individuals with low back pain: A systematic review

• The presence of LBP is associated with the presence of respiratory disorders (RD).
• These RD include dyspnea, asthma, allergy, and respiratory infections.
• The causal link between LBP and RD must be examined by future prospective studies.
• The high comorbidity of other disorders in LBP patients must be taken into account.

BackgroundInspiratory muscles, such as the diaphragm, play a key role in both respiration and spinal control. Therefore, diaphragm dysfunctions are often related to low back pain (LBP). However, few is known on the association between the presence of LBP and the presence of respiratory disorders (RD).ObjectivesTo perform a systematic review on the relation between RD and LBP.Study designSystematic review.MethodsTwo reviewers searched on PubMed/MEDLINE for studies concerning LBP and RD, from 1950 up to January 2016. The search string consisted of the following key words: low back pain, dyspnea, respiratory problems, lung diseases, comorbidity, pulmonary disease, chronic obstructive, smoking, asthma, allergy, sinusitis, respiratory tract infection and hyperventilation. The aim was to evaluate a potential correlation, co-occurrence or causality between RD and LBP.ResultsA total of 16 articles were included. A significant correlation between the presence of LBP and the presence of RD such as dyspnea, asthma, different forms of allergy, and respiratory infections was found. No correlation was found between Chronic Obstructive Pulmonary Disease (COPD) and LBP, and no articles were found on the correlation between hyperventilation and LBP.ConclusionsThis is the first study providing an overview of the literature on the relation between LBP and RD. Immunological, biomechanical, psychosocial and socio-economic factors might explain this correlation. Smoking is likely to contribute. Future studies must reveal the causative relationship.Level of evidenceTherapy, level 2a.