Prevalence of Chronic Nonspecific Low Back Pain and Its Associated Factors among Middle-Aged and Elderly People: An Analysis Based on Data from a Musculoskeletal Examination in Japan

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Abstract

Study Design

A cross-sectional study.

Purpose

To clarify the prevalence of chronic nonspecific low back pain (CNSLBP) and its associated factors among middle-aged and elderly Japanese individuals using data from a musculoskeletal examination conducted in general Japanese populations.

Overview of Literature

Most studies evaluating low back pain-associated factors have been conducted in Western countries, but they have not always evaluated CNSLBP.

Methods

We obtained data on 213 subjects aged >50 years who responded to a survey regarding age, gender, body mass index, lifestyle-related diseases (diabetes mellitus, hypertension, and hyperlipidemia), glucocorticoid use, smoking and alcohol-drinking habits, labor intensity, and chronic low back pain (CLBP) and underwent screening for lumbar spinal stenosis, evaluation for quality of life (QOL), and evaluation for specific spinal pathology via thoracolumbar spine X-rays. We investigated the prevalence of CNSLBP and association between CNSLBP and measured variables.

Results

The prevalence of CNSLBP and chronic specific low back pain (CSLBP) was 15.4% and 9.3%, respectively. Among the subjects with CLBP, 62.2% had CNSLBP. In age-adjusted logistic models, smoking habits ( p=0.049, odds ratio [OR]=2.594), low back pain ( p<0.001, OR=0.974), lumbar function ( p=0.001, OR=0.967), and social function ( p=0.023, OR=0.976) in the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were significantly associated with CNSLBP, whereas EQ-5D utility score ( p=0.024, OR=0.068), low back pain ( p=0.007, OR=0.981), lumbar function ( p=0.001, OR=0.963), walking ability ( p=0.001, OR=0.968), and social function ( p=0.002, OR=0.966) in JOABPEQ were significantly associated with CSLBP.

Conclusions

CNSLBP among middle-aged and elderly individuals was associated with smoking habits and decreased QOL; however, CSLBP was considered to be more multilaterally associated decreased QOL.

Related collections

Most cited references 24

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Prevalence and characteristics of chronic musculoskeletal pain in Japan

Masaya Nakamura, Yuji Nishiwaki, Takahiro Ushida … (2011)

Background This cross-sectional study was conducted to obtain epidemiologic data on chronic musculoskeletal pain in the Japanese people, and with it a better understanding of the actual conditions and problems involved. Methods A questionnaire covering basic information, chronic musculoskeletal pain, daily life, quality of life, and social loss was prepared and mailed to 11507 individuals aged 18 years or older. Subjects were selected randomly nationwide in accordance with the demographic composition of Japan. Results The prevalence of chronic musculoskeletal pain was 15.4%. The prevalence was highest in people in their 30s to 50s. Pain occurred most frequently in the low back, neck, shoulder, and knee. Among symptomatic subjects, 42% sought treatment, by visiting a medical institution (19%), taking folk remedies (20%), or both (3%). Treatment was generally prolonged, with 70% of those treated reporting treatment durations of more than a year. Although 69% reported that their symptoms had improved, 30% reported unchanged or aggravated symptoms and dissatisfaction with treatment. Among symptomatic subjects, a high percentage of both men and women had lost jobs, left school, been absent from work or school, or had changed jobs. Basic activities of daily living (ADL) were disturbed in men, and the instrumental ADL (IADL) score was low in women. SF-36 scale scores were significantly lower in every area for subjects with chronic pain. Conclusions Chronic musculoskeletal pain does not necessarily improve even with prolonged treatment. It adversely affects daily life and both physical and mental health. Because those suffering pain often increasingly need assistance in daily activities, people around them are also affected. The therapeutic system and treatment procedures for chronic musculoskeletal pain merit prompt review.

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The prevalence of low back pain in the elderly. A systematic review of the literature.

H Bressler, P. Rochon, E Badley … (1999)

The prevalence of low back pain in the older population (> = or 65 years) was reviewed in an analysis of the literature from 1966 to the present. To determine the prevalence of low back pain in the geriatric population. Back pain is one of the most frequently reported conditions affecting the adult population. However, the prevalence of low back pain in the older age population is not accurately known. A methodologic search of five computerized bibliographic databases was performed to identify citations on the prevalence of low back pain in the elderly. Data were summarized, and prevalence studies were critically appraised in detail for their quality. There is wide variability in the reported prevalence of back pain. Many factors have been proposed to explain these findings including sample source, study design, definitions of back pain, and use of patient-reported data. Comorbidity among older patients also contributes to the variability in the reporting of prevalence of back pain. There is an under-representation of the older population in the back pain literature. The data in the current study suggest that the prevalence of low back pain in this population is not known with certainty and is not comparable with that in the younger population. The authors stress the need for future studies to improve the reporting of age information to make prevalence studies more informative and applicable.

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A review of the association between cigarette smoking and the development of nonspecific back pain and related outcomes.

N Mayo, Hamish Scott, Richard Goldberg (2000)

A structured review of the epidemiologic literature was performed. Thirty-eight studies published in peer-reviewed journals were reviewed. The methodologic strengths and weaknesses of the studies were described and assessed qualitatively. Four studies were excluded because of difficulties in design or interpretation. To provide a systematic analysis of the literature to assess the evidence as to whether smoking is associated with the prevalence and incidence of nonspecific back pain and related outcomes. Evidence has been gathering regarding the association of smoking with nonspecific back pain and other back disorders, but a comprehensive summary and evaluation of the data have not been published. Positive associations between current smoking and nonspecific back pain were found in 18 of 26 studies in men and 18 of 20 studies in women. For sciatica and herniated discs, there were four of eight and one of five positive studies in men and women, respectively. The majority of these studies were cross-sectional (18 in men and 16 in women), with only a handful of prospective studies. Positive associations between past smoking and nonspecific back pain were reported in five of nine studies in men and five of six studies in women. In addition, increases in the prevalence and/or incidence of nonspecific back pain were found in the majority of studies in which level of consumption was analyzed and reported. An attempt was made to assess whether these results could be artifactual arising from selection bias, confounding bias, publication bias, or errors in measurement. As well, the biologic mechanisms were summarized that have been suggested by various investigators. The available data are consistent with the notion that smoking is associated with the incidenceand prevalence of nonspecific back pain, but there are too few studies to make any conclusions for the other end points (e.g., sciatica, herniated discs). It cannot be ruled out that the association is a statistical artifact arising from either selection or confounding factors, because the evidence for nonspecific low back pain derives mostly from cross-sectional studies. In addition, it cannot be stated unequivocally that smoking preceded back pain. Long-term follow-up studies are needed to eliminate the possibility that chronic back pain preceded smoking, to better estimate dose-response correlations, and to perform biologic measurements to elucidate possible mechanisms.

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Author and article information

Journal

Journal ID (nlm-ta): Asian Spine J

Journal ID (iso-abbrev): Asian Spine J

Journal ID (publisher-id): ASJ

Title: Asian Spine Journal

Publisher: Korean Society of Spine Surgery

ISSN (Print): 1976-1902

ISSN (Electronic): 1976-7846

Publication date (Print): December 2017

Publication date (Electronic): 07 December 2017

Volume: 11

Issue: 6

Pages: 989-997

Affiliations

Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.

Author notes

Corresponding author: Yoichi Iizuka. Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan. Tel: +81-27-220-8269, Fax: +81-27-220-8275, yoiizuka@ 123456gunma-u.ac.jp

Article

DOI: 10.4184/asj.2017.11.6.989

PMC ID: 5738322

PubMed ID: 29279756

SO-VID: 70609ce9-9e26-4e7a-bd0f-5d41039a70b8

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 31 January 2017

Date revision received : 23 March 2017

Date accepted : 31 March 2017

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Prevalence of Chronic Nonspecific Low Back Pain and Its Associated Factors among Middle-Aged and Elderly People: An Analysis Based on Data from a Musculoskeletal Examination in Japan

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Abstract

Study Design

Purpose

Overview of Literature

Methods

Results

Conclusions

Related collections

Orthopedics

Most cited references 24

Prevalence and characteristics of chronic musculoskeletal pain in Japan

The prevalence of low back pain in the elderly. A systematic review of the literature.

A review of the association between cigarette smoking and the development of nonspecific back pain and related outcomes.

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Cited by 29

Most referenced authors 332