Factors that influence low back pain in people with a stoma

Purpose: People with a stoma believe that there is a link between their surgery and low back pain (LBP). Aim: To explore factors relating to (i) core stability in people with a stoma and LBP and (ii) biopsychosocial factors related to LBP. Methods: Adults with an ileostomy and LBP (n = 17) completed (i) a range of standardised instruments, (ii) clinical tests and (iii) an ultrasound scan of right and left transversus abdominis (TrA). Results: The findings showed moderate pain and disability: RMDQ: median = 12 (IQR: 9.5-13), EQ-5D health state: mean = 6.9 (+/-1.75), BPI pain severity: median = 4.5 (IQR: 2.87-5.4). The TrA contraction was less on the operated than the unoperated side and this was linked to less control for BKFO to the operated side, and the presence of a parastomal hernia. Co-morbidities were associated with greater balance problems during the stork test (p < 0.05). Men had more fear avoidance (p < 0.05) on the FABQ regarding physical activity. Discussion: Abdominal function may be altered after stoma surgery leading to reduced ability to perform functional tasks and a possible increased risk of back pain. These results should be viewed with caution due to the small sample size.