Epidemiology of chronic low back pain in US adults: National Health and Nutrition Examination Survey 2009–2010

Abstract

Objective

To describe epidemiologic characteristics and associations with increased healthcare utilization in US adults with chronic low back pain (cLBP).

Methods

NHANES back pain survey 2009–2010, administered to adults aged 20–69 (N = 5103). cLBP was defined as pain in the area between the lower posterior margin of the ribcage and the horizontal gluteal fold, with a history of pain lasting almost every day for at least 3 months. Demographic and behavioral characteristics were compared between those with cLBP and without. Factors, associated with ≥10 healthcare visits/year were evaluated in the cLBP subgroup (N=700).

Results

cLBP associations with adjusted odds ratios (aORs) ≥2 included age 50–69, education less than high school, annual household income <$20 000, income from disability, depression, sleep disturbances, and medical comorbidities. Subjects with cLBP were more likely to be covered by government-sponsored insurance plans: aOR 3.23 ([95% CI] 2.19–4.75) for Medicaid, aOR 2.25 (1.57–3.22) for Medicare (p < 0.0001), and visited healthcare providers more frequently: aOR 3.35 (2.40–4.67) for ≥10 healthcare visits in the past year (p < 0.0001). In the cLBP subgroup aORs ≥2 were found for associations between ≥10 visits per year and unemployment, income from disability, depression, and sleep disturbances.

Conclusion

US adults with cLBP are socioeconomically disadvantaged, make frequent healthcare visits and are often covered by government-sponsored health insurance. The clustering of behavioral, psychosocial, and medical issues should be considered in the care of Americans with cLBP.