Former US president John F Kennedy's debilitating back pain may have been a contributing factor in his assassination in 1963, researchers have suggested.
From the time he was a toddler until his assassination in November 1963, Kennedy suffered from a series of medical issues, but no condition seemed to cause him more distress than his chronic low back pain.
A Robert Wood Johnson Medical School rheumatologist and a clinical psychologist at the University of Michigan's Chronic Pain and Fatigue Research Center reviewed the impact back pain had on the life and death of the 35th US president.
"Tan and fit, JFK exuded strength and vitality despite the fact that his general health was quite poor and his back and gastrointestinal pain were almost incapacitating," said co-author Afton L Hassett, a psychologist and associate research scientist in the Department of Anesthesiology at the University of Michigan Health System.
In an article published in the journal Regional Anesthesia and Pain Medicine Back, authors wrote that back pain may even have been a contributing factor in JFK's assassination.
JFK's back pain had stabilised by 1962. He took every precaution to avoid trauma and was reluctant to discontinue use of his back brace and crutches when recommended by physicians.
"Several biographers have noted that his back pain consumed a great deal of his time and effort and may have been a contributing factor in his assassination in Dallas in 1963," the authors wrote.
Kennedy, aged just 46, was shot in the head as he was driven through Dallas in an open-top limousine.
"When the first bullet struck him in the back of the neck, his back brace held him erect, allowing the next and fatal bullet to strike the back of his head. JFK's aching back was with him until the bitter end," they wrote.
Chronic back pain co-existed for Kennedy with diagnosed Addison's Disease, "spastic colitis," which is now called irritable bowel syndrome, allergies and other medical issues.
He had low back pain almost constantly, perhaps starting with a minor sports injury in 1940. However a specific cause was never identified and a surgical cure not achieved, even after lumbosacral and left sacroiliac fusion surgery.
Few were aware in 1954 of a post-operative coma and septicemia JFK suffered, during which he received last rites of the church, according to the article.
His fifth and final surgical procedure was in September 1957 and this left him disenchanted with finding a surgical solution for his back pain, it said.
Later a conservative programme, including trigger point injections and exercises, provided modest relief. He wore a back brace and took hot baths several times a day; often using crutches while walking except when he was in public view.
