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      Prevalence and Correlates of Low Back Pain in Primary Care: What Are the Contributing Factors in a Rapidly Developing Country

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          Abstract

          Study Design

          Cross-sectional.

          Purpose

          The purpose of the study was to determine the prevalence of low back pain (LBP) in the primary care setting with emphasis on the socio-demographic contributing factors and impact of LBP on lifestyle habits.

          Overview of Literature

          LBP is one of the most common medical conditions seen in the Primary Health Care Clinic.

          Methods

          A representative sample of 2,600 patients were approached and 1,829 subjects agreed to participate in this study (70.0%). Data on socio-demographic characteristics, life style habits and type of treatment were collected through a questionnaire.

          Results

          The prevalence of LBP in the study sample was 56.5% (95% confidence interval, 54.2-58.8). LBP was more prevalent among women (53.9%) compared to men (46.1%). There was significant difference between male and female patients of LBP in terms of ethnicity ( p<0.001), marital status ( p=0.010), occupation ( p<0.001), monthly household income ( p=0.004), and cigarette/sheesha smokers ( p<0.001). The percentages of different aspects of functional disabilities were statistically significantly higher among females compared to male patients with LBP. Almost a quarter of female patients with LBP (26%) and 18% male patients with LBP reported pain in the arms and legs ( p=0.002). In addition, gastrointestinal complaints such as abdominal pain and food intolerance were significantly higher among female patients with LBP as compared to males (31% vs. 24.6%, p=0.018; and 25% vs. 18%, p=0.008, respectively). Complaints about headache and fainting were also significantly higher among female patients as compared to male LBP patients (43% vs. 36%, p=0.029; and 26% vs. 20%, p=0.016, respectively). The multivariate logistic regression revealed that being female, prolonged standing, prolonged sitting, heavy weight lifting, weakness in the legs, regular exercise, and cigarette/sheesh a smoking had a significant effect on the presence of LBP.

          Conclusions

          LBP is highly prevalent among both genders and in older age. Also, weakness in the legs, smoking, prolonged standing and sitting had a significant effect on LBP. Furthermore, the current study findings support the fact that LBP continues to be an important clinical, social and economic, burden and a public health problem affecting the population of the entire world.

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          Most cited references26

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          The association between obesity and low back pain: a meta-analysis.

          This meta-analysis assessed the association between overweight/obesity and low back pain. The authors systematically searched the Medline (National Library of Medicine, Bethesda, Maryland) and Embase (Elsevier, Amsterdam, the Netherlands) databases until May 2009. Ninety-five studies were reviewed and 33 included in the meta-analyses. In cross-sectional studies, obesity was associated with increased prevalence of low back pain in the past 12 months (pooled odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14, 1.54), seeking care for low back pain (OR = 1.56, 95% CI: 1.46, 1.67), and chronic low back pain (OR = 1.43, 95% CI: 1.28, 1.60). Compared with non-overweight people, overweight people had a higher prevalence of low back pain but a lower prevalence of low back pain compared with obese people. In cohort studies, only obesity was associated with increased incidence of low back pain for > or =1 day in the past 12 months (OR = 1.53, 95% CI: 1.22, 1.92). Results remained consistent after adjusting for publication bias and limiting the analyses to studies that controlled for potential confounders. Findings indicate that overweight and obesity increase the risk of low back pain. Overweight and obesity have the strongest association with seeking care for low back pain and chronic low back pain.
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            Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey.

            This study is an analysis of national survey data from 5 sample years. The authors characterized the frequency of office visits for low back pain, the content of ambulatory care, and how these vary by physician specialty. Few recent data are available regarding ambulatory care for low back pain or how case mix and patient management vary by physician specialty. Data from the National Ambulatory Medical Care Survey were grouped into three time periods (1980-81, 1985, 1989-90). Frequency of visits for low back pain, referral status, tests, and treatments were tabulated by physician specialty. There were almost 15 million office visits for "mechanical" low back pain in 1990, ranking this problem fifth as a reason for all physician visits. Low back pain accounted for 2.8 percent of office visits in all three time periods. Nonspecific diagnostic labels were most common, and 56 percent of visits were to primary care physicians. Specialty variations were observed in caseload, diagnostic mix, and management. Back pain remains a major reason for all physician office visits. This study describes visit, referral, and management patterns among specialties providing the most care.
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              Low back pain in Australian adults. health provider utilization and care seeking.

              To determine the characteristics of Australian adults who seek care for low back pain (LBP), including the type of care they choose and any factors associated with making those choices. A population-based mailed survey. An age, gender, and state stratified random sample of 2768 Australian adults selected from the Electoral Roll. A self-administered, fully structured questionnaire included a series of questions relating to care seeking for LBP, choice of provider, and types of treatment received. In addition, a series of questions were asked relating to demographic characteristics, socioeconomic variables, severity of LBP, cigarette smoking, anthropometric variables, perceived cause of LBP, lifetime emotional distress, job satisfaction, lifetime physical fitness, past 5-year health status, and fear of LBP causing future impairment. The response rate was 69.1%. The sample proved to be similar to the Australian adult population. The majority of respondents with LBP in the past 6 months did not seek care for it (55.5%). Factors that increased care seeking were higher grades of pain and disability severity, fear of the impact of pain on future work and life, and female sex. Factors decreasing the likelihood for seeking care were identified as the cause of pain being an accident at home and also never being married. General medical practitioners and chiropractors are the most popular providers of care. This study shows that a majority of people did not seek care for their LBP. The reasons for care seeking proved to be independent of social or economic status.
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                Author and article information

                Journal
                Asian Spine J
                Asian Spine J
                ASJ
                Asian Spine Journal
                Korean Society of Spine Surgery
                1976-1902
                1976-7846
                June 2014
                09 June 2014
                : 8
                : 3
                : 227-236
                Affiliations
                [1 ]Department of Medical Statistics and Epidemiology, Hamad Medical Corporation and Department of Public Health, Weill Cornell Medical College, Doha, Qatar.
                [2 ]Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK.
                [3 ]Department of Psychiatry, Rumeilah Hospital, Hamad Medical Corporation, Doha, Qatar.
                [4 ]Institute of Medical Science, University of Toronto, Clinical Research Rheumatology and Spondyloarthritis Program, Arthritis Centre of Excellence, Toronto Western Hospital, Toronto, ON, Canada.
                Author notes
                Corresponding author: Abdulbari Bener. Department of Medical Statistics and Epidemiology, Hamad Medical Corporation and Department of Public Health, Weill Cornell Medical College, PO Box 3050, Doha, Qatars. Tel: +974-4439-3765, Fax: +974-4439-3769, abener@ 123456hmc.org.qa
                Article
                10.4184/asj.2014.8.3.227
                4068841
                24967035
                e5791041-ca5e-4c94-9a81-5c53a98a15d1
                Copyright © 2014 by Korean Society of Spine Surgery

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 January 2013
                : 15 April 2013
                : 04 July 2013
                Funding
                Funded by: the Qatar Foundation
                Award ID: 11-074-3-015
                Categories
                Clinical Study

                Orthopedics
                epidemiology,low back pain,roland-morris disability,risk factors,life-style habits,primary health care

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