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Table 3 Summary of results of included studies

From: The association between headache and low back pain: a systematic review

Study ID Results ORs (95% CI) for association between LBP and headache n included in analysis
Cross-sectional Studies
 Child and Adolescent Studies
  Ghandour et al., 2004 [15] In those with LBP more than once a week, 45% (CI 43.8–46.1) experienced headache more than once a week. Those with headaches more than once a week, 34% (CI 32.6–34.4) experienced LBP more than once a week. 2.1 (2.09–2.1) a n 8250
  Sjolie et al., 2002 [16] 33 girls reporting LBP also had weekly headache. 22 boys reporting LBP experienced weekly headache. 2.5 (CI 0.8–8.0) LBP and weekly headache b n 82
  Swain et al., 2014 [17] 12% of adolescents had LBP and headache. Univariate logistic modelling found adolescents with pain were at increased odds of experiencing co-existing pain. 2.9 (2.8–2.9) n 404 206
n of headache and LBP 26 059
 Adult Studies
  Ashina et al., 2018 [18] Lifetime relative frequency of LBP was higher in individuals with any primary headache (migraine and/or tension type headache) than those with no primary headache 87% vs, 78%. There was a positive correlation with the number of days with tension type headache or migraine in past year and number of days with LBP in last year correlation r 0.25, p < 0.001.
Logistic regression analysis of those with chronic headache with LBP, 33 (83%), those without LBP 7 (18%).
OR Primary headache including (migraine and tension type headache, with LBP) 1.7 (1.2–2.5).
Episodic headache and LBP 1.7 (1.2–2.5).
Pure migraine and LBP1.2 (0.7–2.1).
Migraine and tension type headache 2.4 (1.3–4.4).
OR Chronic headache and LBP 1.9 (0.8–4.5).
n 796
  Bejia et al. 2005 [19] In patients with LBP (n = 176), 29% had migraine. In patients with no LBP (n = 174), 14% of these had migraine. 2.55 (1.49–4.38) c n 350
  Bener et al., 2015 [20] LBP (n = 1034), 411 (40%) had headache, without LBP (n = 795), 198 (25%) had headache p < 0.001.
Of those with LBP, 422 had it for < 6 weeks and 612 had it for >/= 6 weeks.
1.99 (1.62–2.44) d n 1034 LBP
  Yoon et al., 2013 [10] In 5605 who reported headaches in previous year, 255 had chronic headache and 5350 had episode headache. Migraine or those with migraine and including co-existing TTH diagnosed in 2933 respondents of whom 182 had chronic migraine and 2751 had episodic migraine.
76% of people with episodic headache had LBP, and 88% of those with chronic headache reported LBP.
Chronic LBP occurred at higher rate in chronic versus episodic headache subtypes and at higher rate in migraine versus tension type headache subtypes.
Frequent LBP among headache subtypes 8% of those with no headache, 15% of those episodic headaches, 57% of those with chronic headache reported frequent LBP.
OR LBP and episodic headache 3.8 (9 3.4–4.2) (n 8611)
OR LBP and chronic headache 8 (5.3–12.1) eLBP and episodic migraine 4.8 (4.2–5.5) (n 6099)
OR LBP and chronic migraine 9.3 (5.6–15.5)
OR LBP and episodic migraine with no coexisting tension type headache 4.6 (4–5.4) (n 4940)
OR LBP and chronic migraine with no coexisting tension type headache 9.5 (4.9–18.4)
OR LBP episodic tension type headache 3.5 (3–4.1) (n 4524)
OR LBP and chronic tension type headache 4.4 (2.1–9.2).
n 8611
 Older Adult studies
  Ahangar et al. 2016 [21] Headache independently associated with LBP. 51% with LBP had concomitant headache. 2.78 (2.22–3.49) f n with LBP 942
 Twin Studies
  Hartvigsen et al., 2004 (Hartvigsen et al., 2003) [22, 23] 25% of participants (CI 95% 24–72%) experienced LBP in the last month.
The prevalence was significantly different for men and women 20% (CI 18–22%) vs. 29% (CI 28–31%).
15% of those with LBP experienced migraine (females 15%, males 5%). OR of having LBP with migraine 1.72 (CI 1.38–2.15).
1.72 (1.38–2.15) n 4484
  Hestbaek et al., 2004 [24] 8210 of the cohort reported headache, 3704 reported LBP. LBP > 30 days in past year (reference 0 days in past year) odds ratio 3.4 (2.32–4.98). n in analysis not stated.
  Schur et al., 2007 [25] 17% of participants reported high proportions of depression, LBP, and headache. 2.7 (CI 2.0–3.6)g n 3937
Cohort Studies
 Child and Adolescent Studies
  Jones et al., 2003 [26] A total of 8% of children (95% CI 5.8–9.2) reported headaches on 7 days during the month before the baseline survey.
933 children of 1046 who were LBP free at baseline participated at follow-up at median time 12.4 months (IQR 11.9–13.6), 168 reported LBP lasting > 1 day in the month before follow up survey.
1.82 (CI 1.04–3.18)h n 933
 Adult Studies
  Angst et al., 2017 [27] 344 subjects reported lumbar LBP, 101 lumbar LBP only, 303 cervical LBP, 243 reported both cervical and lumbar LBP.
Lumbar LBP observed with headache (migraine/tension headache) OR 2.38 (CI 1.78–3.20)- moderate association. Cervical LBP also observed with headache (migraine/tension headache) odds ratio 2.62 (CI 1.94–3.53)
2.38 (CI 1.78–3.20) n 499
 Twin Studies
  Hestbaek et al., 2006 [28] LBP reported in 3223 (34%). LBP- long 588 (6%)- 559 (95%) of which had headache, 134 (23%) of which had headache-long.
Headache in 8266 (86%) of original sample (n = 9600)- 2974 (36%) had LBP, 559 (7%) LBP long, headache-long 591 (7%).
Headache-long term- 591 (6%) of total sample of which 334 (57%) had LBP, 134 (23%) had LBP-long term.
Multivariate logistic regression analysis was used to identify the association between health status at baseline and persistent LBP at follow-up.
Results presented are the analysis of persistent LBP and persistent headache; model II included persistent LBP and persistent headache (LBP-long, headache- long).
If persons in addition to persistent LBP in 1994 suffered from headache at al, the one-year prevalence of persistent LBP at follow-up was 27%, if headache was long lasting prevalence was 36%.
1.55 (1.13–2.11) (females)
2.4 (1.21–4.74) (males)
n 592
  1. a OR in paper calculated by review statistician using weighted population estimates (raw data comorbidity not reported
  2. b Review presents study model 3 results ordinal logistic regression analysis, model adjusting for frequency of physical activity, gender, each other, time spent on television/computer and BMI
  3. c OR calculated by review statistician
  4. d OR calculated by review statistician
  5. e OR in paper corrected by review statistician
  6. f Adjusted for age and sex, and adjusted odds ratio of chronic tension headache with concomitant LBP
  7. g OR calculated by review statistician
  8. h Model 3- adjusted for age, gender, smoking status, drinking status, education level, BMI
  9. 1 LBP, LBP, 2 OR, Odds ratios, 3 CI, Confidence intervals