Background
Chronic and acute back pain
Risk factors
Methods
Aim and objectives
Study design
Outcomes
Covariates
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Demographic: Age (age bands 16–24, 25–44, 45–64, 65+); Gender.
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Socioeconomic: Educational attainment (No qualification, other qualification, degree equivalent or above); Occupational status (Managerial and professional, intermediate, routine and manual, never worked/long term unemployed); Welsh index of multiple deprivation 2014 (WIMD) (Deprivation quintiles).
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Clinical: Mental health measured by the SF-36 (< 50 vs. > 50); BMI (less than 18.5, 18.5–25, 25–30, 30 and over); Depression (treated vs. untreated); Anxiety (treated vs. untreated); Physical activity (PA) (meeting the UK PA guidelines vs. not meeting them and number of days of light, moderate or vigorous exercise per week).
Data analysis
Results
Acute back pain | Chronic back pain | All back pain | ||||
---|---|---|---|---|---|---|
Total | Pain (%) | Total | Pain (%) | Total | Pain (%) | |
Total | 14,359 | 4519 (31.5%) | 14,351 | 1772 (13.4%) | 14,100 | 5520 (39.1%) |
Deprivation (WIMD quintile) | 14,359 | 14,351 | 14,100 | |||
Least deprived | 2839 | 892 (31.42) | 2859 | 248 (8.67) | 1029 | 1029, (36.65) |
2 | 3065 | 994 (32.43) | 3053 | 347 (11.37) | 1207 | 1207, (40.07) |
3 | 3275 | 1053 (32.15) | 3309 | 409 (12.36) | 1275 | 1275, (47.05) |
4 | 2762 | 866 (31.35) | 2745 | 381 (13.88) | 1072 | 1072, (45.79) |
Most deprived | 2418 | 714 (29.53) | 2385 | 387 (16,23) | 2529 | 2529, (108.03) |
Age (years) | 14,359 | 14,351 | ||||
16–24 | 1718 | 387 (22.53) | 1752 | 46 (2.63) | 410 | 410, (24.05) |
25–44 | 3830 | 1264 (33.84) | 3879 | 275 (7.09) | 1421 | 1421, (37.25) |
45–64 | 4963 | 1731 (34.88) | 4974 | 709 (14.25) | 2144 | 2144, (43.76) |
65+ | 3848 | 1137 (29.55) | 3746 | 742 (19.81) | 1545 | 1545, (41.97) |
Gender | 14,359 | 14,351 | ||||
Female | 7699 | 2480 (32.21) | 7667 | 1084 (14.14) | 3098 | 3098, (41.05) |
Male | 6660 | 2039 (30.62) | 6684 | 688 (10.29) | 2422 | 2422, (36.96) |
Educational attainment | 13,398 | 13,424 | ||||
No qualification | 2643 | 752 (28.45) | 2573 | 573 (22.27) | 1077 | 1077, (42.27) |
Other qualification | 8367 | 2731 (32.64) | 8443 | 883 (10.46) | 3231 | 3231, (39.01) |
Degree Equivalent and above | 2388 | 774 (32.41) | 2408 | 136 (5.65) | 856 | 856, (36.03) |
Occupational status (NS-SEC) | 13,959 | 13,936 | ||||
Managerial and Professional occupations | 5170 | 1605 (31.04) | 5228 | 461 (8.82) | 1868 | 1868, (36.52) |
Intermediate occupations | 2853 | 964 (33.79) | 2834 | 330 (11.64) | 1143 | 1143, (40.88) |
Routine and manual occupations | 5569 | 1718 (30.85) | 5524 | 883 (15.98) | 2217 | 2217, (40.74) |
Never worked and long-term unemployed | 357 | 104 (29.13) | 350 | 65 (18.57) | 143 | 143, (41.81) |
BMIa | 13,387 | 13,391 | ||||
Less than 18.5 | 281 | 59 (21.00) | 284 | 21 (7.39) | 71 | 71, (26.01) |
18.5 to under 25 | 5176 | 1498 (28.94) | 5213 | 490 (9.40) | 1778 | 1778, (34.88) |
25 to under 30 | 4878 | 1604 (32.88) | 4873 | 594 (12.19) | 1943 | 1943, (40.45) |
30 and over | 3052 | 1073 (35.16) | 3021 | 550 (18.21) | 1386 | 1386, (46.31) |
Mental Health (SF-36 mental health score) | 14,359 | 14,351 | ||||
Higher than average (> 50)b | 8803 | 2421 (27.50) | 8862 | 632 (7.13) | 2783 | 2783, (32.15) |
Lower than average (< 50)c | 5556 | 2098 (37.76) | 5489 | 1140 (20.77) | 2737 | 2737, (50.28) |
Depression | 13,840 | 14,165 | ||||
Yes | 1257 | 488 (38.82) | 1183 | 403 (34.07) | 717 | 717, (59.7) |
No | 12,583 | 3832 (30.45) | 12,982 | 1204 (9.27) | 4519 | 4519, (35.85) |
Anxiety | 13,776 | 14,124 | ||||
Yes | 1025 | 392 (38.24) | 959 | 315 (32.85) | 568 | 568, (58.32) |
No | 12,751 | 3904 (30.62) | 13,156 | 1252 (9.52) | 4624 | 4624, (36.16) |
Exercise | 14,136 | 14,139 | ||||
Meeting PA guidelinesd | 4106 | 1291 (31.44) | 4156 | 269 (6.47) | 1432 | 1432, (35.33) |
Not meeting guidelines | 10,030 | 3164 (31.55) | 9983 | 1451 (14.53) | 4001 | 4001, (40.64) |
Acute back pain
Univariable analysis | Multivariable analysis | ||||
---|---|---|---|---|---|
N | Crude OR (95% CI) | P value | Adjusted OR (95% CI) | P value | |
WIMD 2014 quintile | 14,359 | ||||
Least deprived | Reference category | ||||
2 | 1.05 (0.94, 1.17) | 0.405 | 1.03 (0.92, 1.16) | 0.611 | |
3 | 1.03 (0.93, 1.15) | 0.539 | 1.00 (0.89, 1.13) | 0.940 | |
4 | 1.00 (0.89, 1.12) | 0.958 | 0.93 (0.82, 1.05) | 0.261 | |
Most deprived | 0.91 (0.81, 1.03) | 0.138 | 0.86 (0.76, 0.98) | 0.029 | |
Age | 14,359 | ||||
16–24 | Reference category | ||||
25–44 | 1.69 (1.49, 1.93) | < 0.001 | 1.64 (1.42, 1.90) | < 0.001 | |
45–64 | 1.84 (1.62, 2.09) | < 0.001 | 1.73 (1.50, 1.99) | < 0.001 | |
65+ | 1.44 (1.26, 1.65) | < 0.001 | 1.49 (1.27, 1.73) | < 0.001 | |
Gender | 14,359 | ||||
Male | Reference category | ||||
Female | 1.08 (1.00, 1.16) | 0.040 | 1.01 (0.94, 1.10) | 0.761 | |
Educational attainment | 13,398 | ||||
No qualification | Reference category | ||||
Degree equivalent or higher | 1.21 (1.07, 1.36) | 0.002 | 1.28 (1.12, 1.47) | < 0.001 | |
Other qualifications | 1.22 (1.11, 1.34) | < 0.001 | 1.32 (1.18, 1.47) | < 0.001 | |
BMIa | 13,387 | ||||
Less than 18.5 | 0.65 (0.49, 0.87) | 0.004 | 0.79 (0.58, 1.07) | 0.127 | |
18.5 to under 25 | Reference category | ||||
25 to under 30 | 1.20 (1.11, 1.31) | < 0.001 | 1.14 (1.04, 1.25) | 0.004 | |
30 and over | 1.33 (1.21, 1.46) | < 0.001 | 1.20 (1.08, 1.33) | 0.001 | |
Mental health (SF-36) | 14,359 | ||||
Above averageb | Reference category | ||||
Below averagec | 1.60 (1.49, 1.72) | < 0.001 | 1.59 (1.47, 1.72) | < 0.001 | |
Vigorous exercise | 13,757 | ||||
0–2 days per week | Reference category | ||||
3–5 days | 0.83 (0.73, 0.94) | 0.03 | 0.91 (0.80, 1.03) | 0.156 | |
6–7 days | 0.83 (0.68, 1.02) | 0.077 | 0.91 (0.74, 1.13) | 0.406 |
Chronic back pain
Univariable analysis | Multivariable analysis | ||||
---|---|---|---|---|---|
N | Crude OR (95% CI) | P value | Adjusted OR (95% CI) | P value | |
WIMD 2014 quintile | 14,351 | ||||
Least deprived | – | – | – | – | |
2 | 1.35 (1.14, 1.60) | 0.001 | 1.32 (1.09, 1.60) | 0.005 | |
3 | 1.48 (1.26, 1.75) | < 0.001 | 1.33 (1.10, 1.61) | 0.003 | |
4 | 1.70 (1.43, 2.01) | < 0.001 | 1.42 (1.16, 1.72) | < 0.001 | |
Most deprived | 2.04 (1.72, 2.42) | < 0.001 | 1.61 (1.32, 1.96) | < 0.001 | |
Age | 14,351 | ||||
16–24 | – | – | – | – | |
25–44 | 2.83 (2.06, 3.89) | < 0.001 | 2.42 (1.71, 3.42) | < 0.001 | |
45–64 | 6.17 (4.55, 8.35) | < 0.001 | 5.14 (3.69, 7.15) | < 0.001 | |
65+ | 9.16 (6.76, 12.41) | < 0.001 | 7.34 (5.25, 10.26) | < 0.001 | |
Gender | 14,351 | ||||
Male | – | – | – | – | |
Female | 1.44 (1.30, 1.59) | < 0.001 | 1.43 (1.27, 1.61) | < 0.001 | |
Educational attainment | 13,424 | ||||
No qualification | – | – | – | – | |
Degree equivalent or higher | 0.21 (0.17, 0.25) | < 0.001 | 0.44 (0.36, 0.55) | < 0.001 | |
Other qualifications | 0.41 (0.36, 0.46) | < 0.001 | 0.75 (0.65, 0.86) | < 0.001 | |
BMIa | 13,391 | ||||
Less than 18.5- Underweight | 0.77 (0.49, 1.21) | 0.258 | 0.91 (0.55,1.48) | 0.699 | |
18.5 to under 25- Normal weight | – | – | – | – | |
25 to under 30- Overweight | 1.34 (1.18, 1.52) | < 0.001 | 1.20 (1.04, 1.38) | 0.013 | |
30 and over- Obese | 2.15 (1.88, 2.45) | < 0.001 | 1.60 (1.38, 1.85) | < 0.001 | |
Mental health (SF-36) | 14,351 | ||||
Above averageb | – | – | – | – | |
Below averagec | 3.41 (3.08, 3.79) | < 0.001 | 3.11 (2.76, 3.51) | < 0.001 | |
Light exercise | 14,014 | ||||
0–2 days per week | – | – | – | – | |
3–5 days | 0.43 (0.37, 0.49) | < 0.001 | 0.58 (0.49, 0.69) | < 0.001 | |
6–7 days | 0.39 (0.35, 0.43) | < 0.001 | 0.55 (0.48, 0.63) | < 0.001 |