{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:14:17Z","timestamp":1792520057542,"version":"4.5.0"},"reference-count":63,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T00:00:00Z","timestamp":1574121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Dutch Arthritis Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Low back pain (LBP) is very common and is a main cause of limited activity and work absence. Patients with LBP may also report spinal morning stiffness; this symptom could be useful for identifying subgroups with signs and symptoms related to spinal osteoarthritis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study investigated whether an association exists between reported spinal morning stiffness and radiographic evidence of lumbar disk degeneration (LDD) in people with LBP and a history of pain of the hip and\/or knee.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This cross-sectional study used 8-year follow-up data from the Cohort Hip and Cohort Knee study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The association between spinal morning stiffness and radiographic LDD features was assessed with multivariable logistic regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The presence of osteophytes was significantly associated with spinal morning stiffness (odds ratio [OR]\u00a0=\u00a02.1 [95% confidence interval [CI]\u00a0=\u00a01.3\u20133.2]) as was the presence of grade 2 or 3 disk space narrowing (OR\u00a0=\u00a02.0 [95% CI\u00a0=\u00a01.1\u20133.5]). There was also a significant association between morning stiffness persisting for &amp;gt; 30\u00a0minutes and grade 2 osteophytes (OR\u00a0=\u00a02.6 [95% CI\u00a0=\u00a01.1\u20136.2]) and grade 1 disk space narrowing (OR\u00a0=\u00a02.0 [95% CI\u00a0=\u00a01.1\u20133.6]). Furthermore, there was a significant association between moderate spinal morning stiffness and the presence of osteophytes (OR\u00a0=\u00a02.0 [95% CI\u00a0=\u00a01.2\u20133.2]). Both the presence of osteophytes and disk space narrowing were significantly associated with severe spinal morning stiffness (for osteophytes: OR\u00a0=\u00a02.0 [95% CI\u00a0=\u00a01.2\u20133.7]; for narrowing at L1-S1: OR\u00a0=\u00a01.8 [95% CI\u00a0=\u00a01.1\u20133.1]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>Only lumbar lateral radiographs were available for each participant, implying that the LDD features could have been underestimated. The quality of the radiographs was not consistent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study showed an association between self-reported spinal morning stiffness and symptomatic LDD. When morning stiffness lasted &amp;gt; 30\u00a0minutes, there was a significant association with the features of LDD. The association was stronger when the severity of spinal morning stiffness increased.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzz170","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T14:05:00Z","timestamp":1574085900000},"page":"255-267","source":"Crossref","is-referenced-by-count":8,"title":["Association Between Self-Reported Spinal Morning Stiffness and Radiographic Evidence of Lumbar Disk Degeneration in Participants of the Cohort Hip and Cohort Knee (CHECK) Study"],"prefix":"10.1093","volume":"100","author":[{"given":"Roxanne","family":"van den Berg","sequence":"first","affiliation":[{"name":"Department of General Practice, Erasmus University Medical Center , PO Box 2040, 3000 CA Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth M","family":"Jongbloed","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia O","family":"Kuchuk","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, University Medical Center , Utrecht, the Netherlands; and Department of Rheumatology, Tergooi Hospital, Hilversum, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart W","family":"Koes","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin H G","family":"Oei","sequence":"additional","affiliation":[{"name":"Department of Radiology & Nuclear Medicine, Erasmus University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sita M A","family":"Bierma-Zeinstra","sequence":"additional","affiliation":[{"name":"Department of General Practice, and Department of Orthopedics, Erasmus University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim A J","family":"Luijsterburg","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus University Medical Center . * S.M.A. Bierma-Zeinstra and P.A.J. 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