array:24 [
  "pii" => "S0213911103717063"
  "issn" => "02139111"
  "doi" => "10.1016/S0213-9111(03)71706-3"
  "estado" => "S300"
  "fechaPublicacion" => "2003-03-01"
  "aid" => "71706"
  "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
  "copyrightAnyo" => "2003"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Gac Sanit. 2003;17:97-107"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2978
    "formatos" => array:3 [
      "EPUB" => 147
      "HTML" => 2307
      "PDF" => 524
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0213911103717075"
    "issn" => "02139111"
    "doi" => "10.1016/S0213-9111(03)71707-5"
    "estado" => "S300"
    "fechaPublicacion" => "2003-03-01"
    "aid" => "71707"
    "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Gac Sanit. 2003;17:108-15"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3135
      "formatos" => array:3 [
        "EPUB" => 126
        "HTML" => 2546
        "PDF" => 463
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Impacto del tabaquismo y del consumo excesivo de alcohol en la mortalidad de la población de la ciudad de Barcelona: 1983–1998"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "108"
          "paginaFinal" => "115"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Impact of smoking and alcohol consumption on mortality in the population of Barcelona [Spain]: 1983–1998"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M. Jané, C. Borrell, M. Nebot, M.I. Pasarín"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "M."
              "apellidos" => "Jané"
            ]
            1 => array:2 [
              "nombre" => "C."
              "apellidos" => "Borrell"
            ]
            2 => array:2 [
              "nombre" => "M."
              "apellidos" => "Nebot"
            ]
            3 => array:2 [
              "nombre" => "M.I."
              "apellidos" => "Pasarín"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911103717075?idApp=WGSE"
    "url" => "/02139111/0000001700000002/v1_201310251615/S0213911103717075/v1_201310251615/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0213911103717051"
    "issn" => "02139111"
    "doi" => "10.1016/S0213-9111(03)71705-1"
    "estado" => "S300"
    "fechaPublicacion" => "2003-03-01"
    "aid" => "71705"
    "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Gac Sanit. 2003;17:96"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1913
      "formatos" => array:3 [
        "EPUB" => 116
        "HTML" => 1397
        "PDF" => 400
      ]
    ]
    "es" => array:8 [
      "idiomaDefecto" => true
      "titulo" => "«Notas de campo»: la llamada recibió respuesta"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "96"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "«Notes from the field»: the call received a response"
        ]
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pere Godoy"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Pere"
              "apellidos" => "Godoy"
            ]
            1 => array:1 [
              "colaborador" => "por el Equipo Editorial"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911103717051?idApp=WGSE"
    "url" => "/02139111/0000001700000002/v1_201310251615/S0213911103717051/v1_201310251615/es/main.assets"
  ]
  "es" => array:14 [
    "idiomaDefecto" => true
    "titulo" => "El dolor de espalda en la población catalana. Prevalencia, características y conducta terapéutica"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "97"
        "paginaFinal" => "107"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A. Bassols, F. Bosch, M. Campillo, J.E. Baños"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "A."
            "apellidos" => "Bassols"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Bosch"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Campillo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:4 [
            "nombre" => "J&#46;E&#46;"
            "apellidos" => "Ba&#241;os"
            "email" => array:1 [
              0 => "jbanos&#64;imim&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Departamento de Farmacolog&#237;a&#44; Terap&#233;utica y Toxicolog&#237;a&#46; Facultad de Medicina&#46; Universitat Aut&#242;noma de Barcelona&#46; Bellaterra &#40;Barcelona&#41;"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Laboratorio de Medicina Computacional&#46; Unidad de Bioestad&#237;stica&#46; Facultad de Medicina&#46; Universitat Aut&#242;noma de Barcelona&#46; Bellaterra &#40;Barcelona&#41;&#46; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#42;"
            "correspondencia" => "<span class="elsevierStyleItalic">Correspondencia</span>&#58; Dr&#46; J&#46;E&#46; Ba&#241;os&#46; Departament de Ci&#232;ncies Experimentals i de la Salut&#46; Universitat Pompeu Fabra&#46; Dr&#46; Aiguader&#44; 80&#46; 08003 Barcelona&#46; Espa&#241;a"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Back pain in the general population of Catalonia &#40;Spain&#41;&#46; Prevalence&#44; characteristics and therapeutic behavior"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2001-12-13"
    "fechaAceptado" => "2002-09-25"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec268767"
          "palabras" => array:4 [
            0 => "Dolor de espalda"
            1 => "Epidemiolog&#237;a"
            2 => "Discapacidad por dolor"
            3 => "Tratamiento analg&#233;sico"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec268768"
          "palabras" => array:4 [
            0 => "Back pain"
            1 => "Epidemiology"
            2 => "Pain-associated disabilities"
            3 => "Analgesic treatment"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El dolor de espalda es un motivo frecuente de asistencia sanitaria en los pa&#237;ses occidentales&#46; El presente estudio se dirigi&#243; a establecer la prevalencia del dolor de espalda en la poblaci&#243;n adulta de Catalu&#241;a&#44; as&#237; como sus caracter&#237;sticas&#44; su vinculaci&#243;n a las variables sociodemogr&#225;ficas&#44; la conducta terap&#233;utica seguida y las consecuencias para quienes lo sufren&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo realizado en 1994 a partir de una muestra de 1&#46;964 personas&#44; representativa de la poblaci&#243;n mayor de 18 a&#241;os y obtenida a partir del censo de 1991&#46; Los datos se obtuvieron mediante una entrevista telef&#243;nica&#46; Se determin&#243; la prevalencia de dolor en general durante los &#250;ltimos 6 meses&#46; En aquellos entrevistados que refirieron haber sufrido dolor de espalda&#44; se analizaron sus caracter&#237;sticas&#44; se investig&#243; su relaci&#243;n con las variables sociodemogr&#225;ficas&#44; y se determinaron las conductas terap&#233;uticas empleadas para aliviarlo y las consecuencias personales&#44; sociales y laborales&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El dolor de espalda present&#243; una elevada prevalencia &#40;50&#44;9&#37;&#41;&#44; apareci&#243; en todas las edades &#40;media &#91;DE&#93;&#44; 47&#44;6 &#91;17&#93; a&#241;os&#41;&#44; predomin&#243; en mujeres &#40;60&#44;7&#37;&#41;&#44; en trabajadores manuales &#40;54&#44;9&#37;&#41; y en personas con menos a&#241;os de escolarizaci&#243;n &#40;71&#44;1&#37;&#41;&#46; Era de larga evoluci&#243;n &#40;el 69&#44;2&#37;&#44; m&#225;s de 3 a&#241;os&#41;&#44; frecuente &#40;el 49&#44;7&#37;&#44; m&#225;s de la mitad de d&#237;as&#41;&#44; de duraci&#243;n variable &#40;el 27&#44;3&#37;&#44; m&#225;s de 1 semana&#41; e intensidad elevada &#40;el 51&#44;4&#37;&#44; intenso-insoportable&#41;&#46; Las opciones terap&#233;uticas m&#225;s empleadas fueron la consulta m&#233;dica &#40;71&#44;9&#37;&#41;&#44; terapias no convencionales &#40;24&#44;7&#37;&#41;&#44; fisioterapia &#40;el 22&#44;7&#37;&#44; sobre todo ejercicios f&#237;sicos y electroterapia&#41; y automedicaci&#243;n &#40;14&#44;6&#37;&#41;&#46; En general&#44; la duraci&#243;n y el grado de alivio obtenido con los diversos tratamientos fue variable&#46; El dolor de espalda limit&#243; la actividad habitual &#40;36&#44;7&#37;&#41;&#44; oblig&#243; a guardar cama &#40;22&#44;7&#37;&#41;&#44; gener&#243; baja laboral &#40;17&#37;&#41; y fue motivo de invalidez profesional &#40;6&#44;5&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El dolor de espalda constituye una situaci&#243;n cl&#237;nica de elevada frecuencia en la poblaci&#243;n catalana y un motivo muy importante de utilizaci&#243;n de atenci&#243;n m&#233;dica y de limitaci&#243;n de la actividad personal y profesional&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Back pain is a common symptom of health assistance in Western countries&#46; The goal of the present survey was to establish the prevalence of back pain in the general population in Catalonia&#44; as well as to establish its characteristics&#44; its relationship to sociodemographic variables&#44; the therapeutic behavior followed by those affected and the associated-impairment and disabilities for the sufferers&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The survey was a descriptive study including a sample of 1&#44;964 people&#44; obtained from the census &#40;1991&#41; and representative of the population older than 18 years&#46; The study was done in 1994 and data were obtained by means of a telephone interview&#46; The prevalence of pain in the last six months was determined&#46; Among those suffering back pain&#44; additional information was obtained concerning its characteristics&#44; the relationship with socio-demographic variables&#44; the therapeutic behaviors used by patients&#44; and the personal&#44; social and work impairment and disabilities&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Back pain was highly prevalent &#40;50&#46;9&#37;&#41;&#44; appeared in all ages &#40;mean age of 47&#46;6 years&#41;&#44; was the highest in women &#40;60&#46;7&#37;&#41;&#44; in manual workers &#40;54&#46;9&#37;&#41; and in those less educated &#40;71&#46;1&#37;&#41;&#46; Back pain was long lasting &#40;69&#46;2&#37; more than 3 years&#41;&#44; frequent &#40;49&#46;7&#37; more than the half of the days&#41;&#44; and highly painful &#40;severe-unbearable in 51&#46;4&#37;&#41;&#46; The therapeutic behaviors most commonly used were the visit to the physician &#40;71&#46;9&#37;&#41;&#44; the use of alternative medical treatments &#40;24&#46;7&#37;&#41;&#44; physical therapy &#40;22&#46;7&#37;&#44; physical exercises and electrotherapy&#41; and self-medication &#40;14&#46;6&#37;&#44; being acetylsalicylic acid the most employed&#41;&#46; In general&#44; the duration and degree of improvement was variable&#46; Back pain limited the daily activities &#40;36&#46;7&#37;&#41; and forced to bed rest &#40;22&#46;7&#37;&#41;&#46; It was also a significant reason for time off work &#40;17&#37;&#41; and disability pension &#40;6&#46;5&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Back pain has a very high prevalence in the Catalonian population and is an important reason to seek medical attention&#46; It greatly limits the daily personal and professional activities&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Biblograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:36 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low back pain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;A&#46; Deyo"
                            1 => "J&#46;N&#46; Weinstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM200102013440508"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2001"
                        "volumen" => "344"
                        "paginaInicial" => "363"
                        "paginaFinal" => "370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11172169"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiologic features of chronic low-back pain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Andersson GBJ"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(99)01312-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1999"
                        "volumen" => "354"
                        "paginaInicial" => "581"
                        "paginaFinal" => "585"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10470716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physician office visits for low back pain&#58; frequency&#44; clinical evaluation&#44; and treatment patterns from a U&#46;S&#46; national survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;G&#46; Hart"
                            1 => "R&#46;A&#46; Deyo"
                            2 => "D&#46;C&#46; Cherkin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "1995"
                        "volumen" => "20"
                        "paginaInicial" => "11"
                        "paginaFinal" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7709270"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Do epidemiological results replicate&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;J&#46; Linton"
                            1 => "M&#46; Ryberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "The prevalence and health-economic consequences of neck and back pain in the general population&#46; Eur J Pain"
                        "fecha" => "2000"
                        "volumen" => "4"
                        "paginaInicial" => "347"
                        "paginaFinal" => "354"
                        "itemHostRev" => array:3 [
                          "pii" => "S009167490208987X"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An overview of the incidence and costs of low back pain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;W&#46; Frymoyer"
                            1 => "W&#46;L&#46; Cats-Baril"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Orthop Clin North Am"
                        "fecha" => "1991"
                        "volumen" => "22"
                        "paginaInicial" => "263"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1826550"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incapacidad por dolor lumbar en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;A&#46; Gonz&#225;lez"
                            1 => "M&#46;A&#46; Cond&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2000"
                        "volumen" => "114"
                        "paginaInicial" => "491"
                        "paginaFinal" => "492"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Nuprin pain report Report N&#46;&#176; 851017"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Taylor"
                            1 => "N&#46; Morency"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:1 [
                        "serieFecha" => "1985"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of pain in New Zealand"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46;R&#46; James"
                            1 => "R&#46;G&#46; Large"
                            2 => "J&#46;A&#46; Bushnell"
                            3 => "J&#46;E&#46; Wells"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1991"
                        "volumen" => "44"
                        "paginaInicial" => "279"
                        "paginaFinal" => "283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2052397"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low back pain in eight areas of Britain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Walsh"
                            1 => "M&#46; Cruddas"
                            2 => "D&#46; Coggon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Epidemiol Community Health"
                        "fecha" => "1992"
                        "volumen" => "46"
                        "paginaInicial" => "227"
                        "paginaFinal" => "230"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1386619"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673600028427"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimating the prevalence of low back pain in the general population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;C&#46; Papageorgiou"
                            1 => "P&#46;R&#46; Croft"
                            2 => "S&#46; Ferry"
                            3 => "M&#46; Jayson"
                            4 => "A&#46; Silman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "1995"
                        "volumen" => "20"
                        "paginaInicial" => "1889"
                        "paginaFinal" => "1894"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8560337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An epidemiologic comparison of pain complaints"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; von Korff"
                            1 => "S&#46;F&#46; Dworkin"
                            2 => "L&#46; Le Resche"
                            3 => "A&#46; Kruger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1988"
                        "volumen" => "32"
                        "paginaInicial" => "173"
                        "paginaFinal" => "183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3362555"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of pain in a general population&#46; The results of a postal survey in a county of Sweden"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Brattberg"
                            1 => "M&#46; Thorslund"
                            2 => "A&#46; Wikman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1989"
                        "volumen" => "37"
                        "paginaInicial" => "215"
                        "paginaFinal" => "222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2748195"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An epidemiological comparison of pain complaints in the general population of Catalonia &#40;Spain&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Bassols"
                            1 => "F&#46; Bosch"
                            2 => "M&#46; Campillo"
                            3 => "M&#46; Ca&#241;ellas"
                            4 => "J&#46;E&#46; Ba&#241;os"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1999"
                        "volumen" => "83"
                        "paginaInicial" => "9"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10506667"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Back pain in Britain&#58; comparison of two prevalence surveys at an interval of 10 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;T&#46; Palmer"
                            1 => "K&#46; Walsh"
                            2 => "H&#46; Bendall"
                            3 => "C&#46; Cooper"
                            4 => "D&#46; Coggon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2000"
                        "volumen" => "320"
                        "paginaInicial" => "1577"
                        "paginaFinal" => "1578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10845966"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Back pain in primary care&#58; Predictors of high health-care costs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Engel"
                            1 => "M&#46; von Korff"
                            2 => "W&#46;J&#46; Katon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1996"
                        "volumen" => "65"
                        "paginaInicial" => "197"
                        "paginaFinal" => "204"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8826507"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "One-year prevalence of low back pain in two Swiss regions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Santos-Eggimann"
                            1 => "V&#46; Wietlisbach"
                            2 => "M&#46; Rickenbach"
                            3 => "F&#46; Paccaud"
                            4 => "F&#46; Gutzwiller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "2000"
                        "volumen" => "25"
                        "paginaInicial" => "2473"
                        "paginaFinal" => "2479"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11013499"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Back pain in primary care&#46; Outcome at 1 year"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; von Korff"
                            1 => "R&#46;A&#46; Deyo"
                            2 => "D&#46; Cherkin"
                            3 => "W&#46; Barlow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Spine"
                        "fecha" => "1993"
                        "volumen" => "18"
                        "paginaInicial" => "855"
                        "paginaFinal" => "862"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8316884"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673602099063"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cost-benefit analysis of a California county&#39;s back injury prevention program"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Shi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Public Health Rep"
                        "fecha" => "1993"
                        "volumen" => "108"
                        "paginaInicial" => "204"
                        "paginaFinal" => "211"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8464977"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Maniadakis"
                            1 => "A&#46; Gray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "The economic burden of back pain in the U&#46;K&#46; Pain"
                        "fecha" => "2000"
                        "volumen" => "84"
                        "paginaInicial" => "95"
                        "paginaFinal" => "103"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cost-of-illness study of back pain in The Netherlands"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;W&#46; van Tulder"
                            1 => "B&#46;W&#46; Koes"
                            2 => "L&#46;M&#46; Bouter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain"
                        "fecha" => "1995"
                        "volumen" => "62"
                        "paginaInicial" => "233"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8545149"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medically certified work loss&#44; recurrence and cost of wage compensation for back pain&#58; a follow-up study working population of Jersey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;J&#46; Watson"
                            1 => "C&#46;J&#46; Main"
                            2 => "G&#46; Waddell"
                            3 => "T&#46;F&#46; Gales"
                            4 => "G&#46; Purcell-Jones"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Rheumatol"
                        "fecha" => "1998"
                        "volumen" => "37"
                        "paginaInicial" => "82"
                        "paginaFinal" => "86"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9487255"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronicity of back problems during working life"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Miedema"
                            1 => "A&#46; Chorus"
                            2 => "C&#46; Wevers"
                            3 => "S&#46; van der Linden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "1998"
                        "volumen" => "23"
                        "paginaInicial" => "2021"
                        "paginaFinal" => "2029"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9779537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Jayson MIV&#46; Influence of physical&#44; psychological and behavioural factors on consultations for back pain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Wright"
                            1 => "S&#46; Barrow"
                            2 => "A&#46;D&#46; Fisher"
                            3 => "S&#46;D&#46; Horsley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Rheumatol"
                        "fecha" => "1995"
                        "volumen" => "34"
                        "paginaInicial" => "156"
                        "paginaFinal" => "161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7704462"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How does general population treat their pain&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Bassols"
                            1 => "F&#46; Bosch"
                            2 => "J&#46;E&#46; Ba&#241;os"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "A survey in Catalonia &#40;Spain&#41;&#46; J Pain Symptom Manage"
                        "fecha" => "2000"
                        "volumen" => "23"
                        "paginaInicial" => "318"
                        "paginaFinal" => "328"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11997201"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Condicions de vida i h&#224;bits de la poblaci&#243; de l&#39;&#192;rea Metropolitana de Barcelona"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Izquierdo"
                            1 => "F&#46; Miqu&#233;lez"
                            2 => "M&#46; Subirats"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Bellaterra&#58; Universitat Aut&#242;noma de Barcelona"
                        "fecha" => "1988"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Compa&#241;&#237;a Telef&#243;nica Nacional de Espa&#241;a"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "IBLET 1989"
                        "serieFecha" => "1990"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Las lumbalgias y su impacto en atenci&#243;n primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46; Gros"
                            1 => "V&#46; Bertol"
                            2 => "A&#46; Fern&#225;ndez"
                            3 => "M&#46; Mall&#233;n"
                            4 => "C&#46; Garc&#237;a"
                            5 => "C&#46; Gin&#233;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "1992"
                        "volumen" => "9"
                        "paginaInicial" => "319"
                        "paginaFinal" => "321"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1534695"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de las lumbalgias atendidas en un centro de salud"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Sabat&#233;"
                            1 => "J&#46; Bestraten"
                            2 => "J&#46;L&#46; Llor"
                            3 => "J&#46; Santigosa"
                            4 => "M&#46;J&#46; Murria"
                            5 => "A&#46; Mil&#225;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "1992"
                        "volumen" => "9"
                        "paginaInicial" => "208"
                        "paginaFinal" => "211"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1305840"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychological and occupational predictive factors for back pain among employees of a university hospital in Southern Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I&#46; Failde"
                            1 => "J&#46;L&#46; Gonz&#225;lez"
                            2 => "L&#46;P&#46; Novalbos"
                            3 => "F&#46; Casais"
                            4 => "J&#46; Mar&#237;n"
                            5 => "J&#46; Elorza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Occup Med"
                        "fecha" => "2000"
                        "volumen" => "50"
                        "paginaInicial" => "591"
                        "paginaFinal" => "596"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674901142326"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The epidemiology of low back pain in an adolescent population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;L&#46; Olsen"
                            1 => "R&#46;L&#46; Anderson"
                            2 => "S&#46;R&#46; Dearwater"
                            3 => "A&#46;M&#46; Kirska"
                            4 => "J&#46;A&#46; Cauley"
                            5 => "D&#46;J&#46; Aaron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Public Health"
                        "fecha" => "1992"
                        "volumen" => "82-4"
                        "paginaInicial" => "606"
                        "paginaFinal" => "608"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Back pain and headache in Swedish schoolchildren&#58; a longitudinal study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46; Brattberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain Clinic"
                        "fecha" => "1993"
                        "volumen" => "6"
                        "paginaInicial" => "157"
                        "paginaFinal" => "162"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674901024289"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Back pain and associated factors in French nurses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "I&#46; Niedhammer"
                            1 => "F&#46; Lert"
                            2 => "M&#46;J&#46; Marne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Arch Occup Environ Health"
                        "fecha" => "1994"
                        "volumen" => "66"
                        "paginaInicial" => "349"
                        "paginaFinal" => "357"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7896421"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unconventional medicine in the United States"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;M&#46; Eisenberg"
                            1 => "M&#46;D&#46; Ronald"
                            2 => "R&#46; Kessler"
                            3 => "C&#46; Foster"
                            4 => "F&#46; Norlock"
                            5 => "D&#46; Calkins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1993"
                        "volumen" => "28"
                        "paginaInicial" => "246"
                        "paginaFinal" => "252"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of alternative therapies&#58; estimates from the 1994 Robert Wood Johnson Foundation of National Access to Care Survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46;C&#46; Paramore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pain Symptom Manage"
                        "fecha" => "1997"
                        "volumen" => "13"
                        "paginaInicial" => "83"
                        "paginaFinal" => "89"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9095565"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The persuasive appeal of alternative medicine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;J&#46; Kaptchuk"
                            1 => "D&#46;M&#46; Eisenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1998"
                        "volumen" => "129"
                        "paginaInicial" => "1061"
                        "paginaFinal" => "1065"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9867762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of alternative medicine&#46; A marker for distress&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Holland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199906033402211"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1999"
                        "volumen" => "340"
                        "paginaInicial" => "1758"
                        "paginaFinal" => "1759"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10352171"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02139111/0000001700000002/v1_201310251615/S0213911103717063/v1_201310251615/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "18705"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02139111/0000001700000002/v1_201310251615/S0213911103717063/v1_201310251615/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911103717063?idApp=WGSE"
]
Compartir
Publique en esta revista
Información de la revista
Vol. 17. Núm. 2.
Páginas 97-107 (marzo - abril 2003)
Respuestas rápidas
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 17. Núm. 2.
Páginas 97-107 (marzo - abril 2003)
Open Access
El dolor de espalda en la población catalana. Prevalencia, características y conducta terapéutica
Back pain in the general population of Catalonia (Spain). Prevalence, characteristics and therapeutic behavior
Visitas
6272
A. Bassolsa, F. Boscha, M. Campillob, J.E. Bañosa,
Autor para correspondencia
jbanos@imim.es

Correspondencia: Dr. J.E. Baños. Departament de Ciències Experimentals i de la Salut. Universitat Pompeu Fabra. Dr. Aiguader, 80. 08003 Barcelona. España
a Departamento de Farmacología, Terapéutica y Toxicología. Facultad de Medicina. Universitat Autònoma de Barcelona. Bellaterra (Barcelona)
b Laboratorio de Medicina Computacional. Unidad de Bioestadística. Facultad de Medicina. Universitat Autònoma de Barcelona. Bellaterra (Barcelona). España
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Resumen
Objetivo

El dolor de espalda es un motivo frecuente de asistencia sanitaria en los países occidentales. El presente estudio se dirigió a establecer la prevalencia del dolor de espalda en la población adulta de Cataluña, así como sus características, su vinculación a las variables sociodemográficas, la conducta terapéutica seguida y las consecuencias para quienes lo sufren.

Métodos

Estudio descriptivo realizado en 1994 a partir de una muestra de 1.964 personas, representativa de la población mayor de 18 años y obtenida a partir del censo de 1991. Los datos se obtuvieron mediante una entrevista telefónica. Se determinó la prevalencia de dolor en general durante los últimos 6 meses. En aquellos entrevistados que refirieron haber sufrido dolor de espalda, se analizaron sus características, se investigó su relación con las variables sociodemográficas, y se determinaron las conductas terapéuticas empleadas para aliviarlo y las consecuencias personales, sociales y laborales.

Resultados

El dolor de espalda presentó una elevada prevalencia (50,9%), apareció en todas las edades (media [DE], 47,6 [17] años), predominó en mujeres (60,7%), en trabajadores manuales (54,9%) y en personas con menos años de escolarización (71,1%). Era de larga evolución (el 69,2%, más de 3 años), frecuente (el 49,7%, más de la mitad de días), de duración variable (el 27,3%, más de 1 semana) e intensidad elevada (el 51,4%, intenso-insoportable). Las opciones terapéuticas más empleadas fueron la consulta médica (71,9%), terapias no convencionales (24,7%), fisioterapia (el 22,7%, sobre todo ejercicios físicos y electroterapia) y automedicación (14,6%). En general, la duración y el grado de alivio obtenido con los diversos tratamientos fue variable. El dolor de espalda limitó la actividad habitual (36,7%), obligó a guardar cama (22,7%), generó baja laboral (17%) y fue motivo de invalidez profesional (6,5%).

Conclusiones

El dolor de espalda constituye una situación clínica de elevada frecuencia en la población catalana y un motivo muy importante de utilización de atención médica y de limitación de la actividad personal y profesional.

Palabras clave:
Dolor de espalda
Epidemiología
Discapacidad por dolor
Tratamiento analgésico
Abstract
Background

Back pain is a common symptom of health assistance in Western countries. The goal of the present survey was to establish the prevalence of back pain in the general population in Catalonia, as well as to establish its characteristics, its relationship to sociodemographic variables, the therapeutic behavior followed by those affected and the associated-impairment and disabilities for the sufferers.

Methods

The survey was a descriptive study including a sample of 1,964 people, obtained from the census (1991) and representative of the population older than 18 years. The study was done in 1994 and data were obtained by means of a telephone interview. The prevalence of pain in the last six months was determined. Among those suffering back pain, additional information was obtained concerning its characteristics, the relationship with socio-demographic variables, the therapeutic behaviors used by patients, and the personal, social and work impairment and disabilities.

Results

Back pain was highly prevalent (50.9%), appeared in all ages (mean age of 47.6 years), was the highest in women (60.7%), in manual workers (54.9%) and in those less educated (71.1%). Back pain was long lasting (69.2% more than 3 years), frequent (49.7% more than the half of the days), and highly painful (severe-unbearable in 51.4%). The therapeutic behaviors most commonly used were the visit to the physician (71.9%), the use of alternative medical treatments (24.7%), physical therapy (22.7%, physical exercises and electrotherapy) and self-medication (14.6%, being acetylsalicylic acid the most employed). In general, the duration and degree of improvement was variable. Back pain limited the daily activities (36.7%) and forced to bed rest (22.7%). It was also a significant reason for time off work (17%) and disability pension (6.5%).

Conclusions

Back pain has a very high prevalence in the Catalonian population and is an important reason to seek medical attention. It greatly limits the daily personal and professional activities.

Key words:
Back pain
Epidemiology
Pain-associated disabilities
Analgesic treatment
El Texto completo está disponible en PDF
Biblografía
[1.]
R.A. Deyo, J.N. Weinstein.
Low back pain.
N Engl J Med, 344 (2001), pp. 363-370
[2.]
Andersson GBJ.
Epidemiologic features of chronic low-back pain.
[3.]
L.G. Hart, R.A. Deyo, D.C. Cherkin.
Physician office visits for low back pain: frequency, clinical evaluation, and treatment patterns from a U.S. national survey.
Spine, 20 (1995), pp. 11-19
[4.]
S.J. Linton, M. Ryberg.
Do epidemiological results replicate?.
The prevalence and health-economic consequences of neck and back pain in the general population. Eur J Pain, 4 (2000), pp. 347-354
[5.]
J.W. Frymoyer, W.L. Cats-Baril.
An overview of the incidence and costs of low back pain.
Orthop Clin North Am, 22 (1991), pp. 263-271
[6.]
M.A. González, M.A. Condón.
Incapacidad por dolor lumbar en España.
Med Clin (Barc), 114 (2000), pp. 491-492
[7.]
H. Taylor, N. Morency.
The Nuprin pain report Report N.° 851017.
[8.]
F.R. James, R.G. Large, J.A. Bushnell, J.E. Wells.
Epidemiology of pain in New Zealand.
Pain, 44 (1991), pp. 279-283
[9.]
K. Walsh, M. Cruddas, D. Coggon.
Low back pain in eight areas of Britain.
J Epidemiol Community Health, 46 (1992), pp. 227-230
[10.]
A.C. Papageorgiou, P.R. Croft, S. Ferry, M. Jayson, A. Silman.
Estimating the prevalence of low back pain in the general population.
Spine, 20 (1995), pp. 1889-1894
[11.]
M. von Korff, S.F. Dworkin, L. Le Resche, A. Kruger.
An epidemiologic comparison of pain complaints.
Pain, 32 (1988), pp. 173-183
[12.]
G. Brattberg, M. Thorslund, A. Wikman.
The prevalence of pain in a general population. The results of a postal survey in a county of Sweden.
Pain, 37 (1989), pp. 215-222
[13.]
A. Bassols, F. Bosch, M. Campillo, M. Cañellas, J.E. Baños.
An epidemiological comparison of pain complaints in the general population of Catalonia (Spain).
Pain, 83 (1999), pp. 9-16
[14.]
K.T. Palmer, K. Walsh, H. Bendall, C. Cooper, D. Coggon.
Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years.
BMJ, 320 (2000), pp. 1577-1578
[15.]
C. Engel, M. von Korff, W.J. Katon.
Back pain in primary care: Predictors of high health-care costs.
Pain, 65 (1996), pp. 197-204
[16.]
B. Santos-Eggimann, V. Wietlisbach, M. Rickenbach, F. Paccaud, F. Gutzwiller.
One-year prevalence of low back pain in two Swiss regions.
Spine, 25 (2000), pp. 2473-2479
[17.]
M. von Korff, R.A. Deyo, D. Cherkin, W. Barlow.
Back pain in primary care. Outcome at 1 year.
Spine, 18 (1993), pp. 855-862
[18.]
L. Shi.
A cost-benefit analysis of a California county's back injury prevention program.
Public Health Rep, 108 (1993), pp. 204-211
[19.]
N. Maniadakis, A. Gray.
The economic burden of back pain in the U.K. Pain, 84 (2000), pp. 95-103
[20.]
M.W. van Tulder, B.W. Koes, L.M. Bouter.
A cost-of-illness study of back pain in The Netherlands.
Pain, 62 (1995), pp. 233-240
[21.]
P.J. Watson, C.J. Main, G. Waddell, T.F. Gales, G. Purcell-Jones.
Medically certified work loss, recurrence and cost of wage compensation for back pain: a follow-up study working population of Jersey.
Br J Rheumatol, 37 (1998), pp. 82-86
[22.]
H. Miedema, A. Chorus, C. Wevers, S. van der Linden.
Chronicity of back problems during working life.
Spine, 23 (1998), pp. 2021-2029
[23.]
D. Wright, S. Barrow, A.D. Fisher, S.D. Horsley.
Jayson MIV. Influence of physical, psychological and behavioural factors on consultations for back pain.
Br J Rheumatol, 34 (1995), pp. 156-161
[24.]
A. Bassols, F. Bosch, J.E. Baños.
How does general population treat their pain?.
A survey in Catalonia (Spain). J Pain Symptom Manage, 23 (2000), pp. 318-328
[25.]
M.J. Izquierdo, F. Miquélez, M. Subirats.
Condicions de vida i hàbits de la població de l'Àrea Metropolitana de Barcelona.
Bellaterra: Universitat Autònoma de Barcelona, (1988),
[26.]
Compañía Telefónica Nacional de España.
IBLET 1989,
[27.]
B. Gros, V. Bertol, A. Fernández, M. Mallén, C. García, C. Ginés.
Las lumbalgias y su impacto en atención primaria.
Aten Primaria, 9 (1992), pp. 319-321
[28.]
P. Sabaté, J. Bestraten, J.L. Llor, J. Santigosa, M.J. Murria, A. Milá, et al.
Estudio de las lumbalgias atendidas en un centro de salud.
Aten Primaria, 9 (1992), pp. 208-211
[29.]
I. Failde, J.L. González, L.P. Novalbos, F. Casais, J. Marín, J. Elorza.
Psychological and occupational predictive factors for back pain among employees of a university hospital in Southern Spain.
Occup Med, 50 (2000), pp. 591-596
[30.]
T.L. Olsen, R.L. Anderson, S.R. Dearwater, A.M. Kirska, J.A. Cauley, D.J. Aaron, et al.
The epidemiology of low back pain in an adolescent population.
Am J Public Health, 82-4 (1992), pp. 606-608
[31.]
G. Brattberg.
Back pain and headache in Swedish schoolchildren: a longitudinal study.
Pain Clinic, 6 (1993), pp. 157-162
[32.]
I. Niedhammer, F. Lert, M.J. Marne.
Back pain and associated factors in French nurses.
Int Arch Occup Environ Health, 66 (1994), pp. 349-357
[33.]
D.M. Eisenberg, M.D. Ronald, R. Kessler, C. Foster, F. Norlock, D. Calkins, et al.
Unconventional medicine in the United States.
N Engl J Med, 28 (1993), pp. 246-252
[34.]
L.C. Paramore.
Use of alternative therapies: estimates from the 1994 Robert Wood Johnson Foundation of National Access to Care Survey.
J Pain Symptom Manage, 13 (1997), pp. 83-89
[35.]
T.J. Kaptchuk, D.M. Eisenberg.
The persuasive appeal of alternative medicine.
Ann Intern Med, 129 (1998), pp. 1061-1065
[36.]
J.C. Holland.
Use of alternative medicine. A marker for distress?.
N Engl J Med, 340 (1999), pp. 1758-1759
Copyright © 2003. Sociedad Española de Salud Pública y Administración Sanitaria
Descargar PDF
Idiomas
Gaceta Sanitaria
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?