student profile: Ms Ana Paula Moura Campos Carvalho Silva


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Thesis work

Thesis title: The relationship between Low Back Pain, Diabetes and Physical Activity

Supervisors: Alison HARMER , Paulo FERREIRA , Manuela FERREIRA , Marina DE BARROS PINHEIRO

Thesis abstract:

Low back pain (LBP) and type 2 diabetes (T2D) have high prevalence rates, lead to significant disability and cause significant economic and social burdens worldwide. Furthermore, LBP and T2D have some common risk factors, such as genetic predisposition, obesity, and physical inactivity.
Regarding LBP, studies have shown that genetics plays a role in the development of chronic symptoms. However, the influences of genetics on pain intensity and activity limitation remains unclear. Another factor that is associated with LBP is inadequate physical activity. Physical activity is considered one of the modifiable risks for LBP and likely influences other comorbidities, such as diabetes. However, the effect of physical activity on low back pain is still controversial, and most studies have not considered the influence of genetics. It is, therefore, important to use study designs that consider the genetic influence, such as the twin research design. Data from twin studies are very valuable as it enables researchers to evaluate and distinguish genetic influences from environmental influences.
People with type 2 diabetes often have comorbid conditions such as musculoskeletal pain (e.g. LBP). Many people with T2D use the insulin-sensitizing drug metformin to assist with metabolic control. Emerging evidence indicates that metformin could have a role in pain management by activating AMP-activated protein kinase (AMPK), which has been shown to decrease chronic pain. However, there is a dearth of studies that clarify any relationship between metformin, musculoskeletal pain (especially LBP) and T2D, and few, if any, studies have considered the level of physical activity in analyses. Furthermore, the presence of comorbid LBP and diabetes may lead to high levels of disability and reduction in quality of life. Therefore exploring this relationship is important.
The main aims of this thesis are to investigate: (i) The effects of genetics on pain and activity limitation in low back pain; (ii) The effects of physical activity in low back pain; and (iii) the relationships between physical activity, low back pain and diabetes
The first aim will be approached using data from da Spanish Twins database to examine effects of genetic on pain and activity limitation in low back pain. The second aim will be addressed using the AUTBACK study to investigate the effect of physical activity on prognosis of LBP and the effect of physical activity on the incidence and recurrence of LBP; and the third aim will be approached with data from the UK Biobank database to quantify relationships between physical activity, low back pain and diabetes.

Selected publications

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Journals

  • Zadro, J., Shirley, D., Ferreira, M., Moura Campos Carvalho Silva, A., Lamb, S., Cooper, C., Ferreira, P. (2018). Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis. Pain Physician, 21(2), 121-145.
  • Zadro, J., Shirley, D., Ferreira, M., Moura Campos Carvalho Silva, A., Lamb, S., Cooper, C., Ferreira, P. (2017). Mapping the association between vitamin D and low back pain: A systematic review and meta-analysis of observational studies. Pain Physician, 20(7), 611-640.

2018

  • Zadro, J., Shirley, D., Ferreira, M., Moura Campos Carvalho Silva, A., Lamb, S., Cooper, C., Ferreira, P. (2018). Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis. Pain Physician, 21(2), 121-145.

2017

  • Zadro, J., Shirley, D., Ferreira, M., Moura Campos Carvalho Silva, A., Lamb, S., Cooper, C., Ferreira, P. (2017). Mapping the association between vitamin D and low back pain: A systematic review and meta-analysis of observational studies. Pain Physician, 20(7), 611-640.

Note: This profile is for a student at the University of Sydney. Views presented here are not necessarily those of the University.