Drivers of international variation in prevalence of disabling low back pain

Findings from the Cultural and Psychosocial Influences on Disability study

D. Coggon, G. Ntani, K. T. Palmer, V. E. Felli, F. Harari, L. A. Quintana, S. A. Felknor, M. Rojas, A. Cattrell, S. Vargas-Prada, M. Bonzini, E. Solidaki, E. Merisalu, R. R. Habib, F. Sadeghian, M. M. Kadir, S. S.P. Warnakulasuriya, K. Matsudaira, B. Nyantumbu-Mkhize, H. L. Kelsall & 1 others H. Harcombe

Research output: Contribution to journalArticleResearchpeer-review

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Abstract

Background: Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. Methods: Baseline information about musculoskeletal pain and risk factors was elicited from 11 710 participants aged 20–59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in the 12 months before baseline (‘pain propensity index’). After a mean interval of 14 months, 9055 participants (77.3%) provided follow-up data on disabling LBP in the past month. Baseline risk factors for disabling LBP at follow-up were assessed by random intercept Poisson regression. Results: After allowance for other known and suspected risk factors, pain propensity showed the strongest association with disabling LBP (prevalence rate ratios up to 2.6, 95% CI: 2.2–3.1; population attributable fraction 39.8%). Across the 45 occupational groups, the prevalence of disabling LBP varied sevenfold (much more than within-country differences between nurses and office workers), and correlated with mean pain propensity index (r = 0.58). Conclusions: Within our study, major international variation in the prevalence of disabling LBP appeared to be driven largely by factors predisposing to musculoskeletal pain at multiple anatomical sites rather than by risk factors specific to the spine. Significance: Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age.

Original languageEnglish
Pages (from-to)35-45
Number of pages11
JournalEuropean Journal of Pain
Volume23
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Low Back Pain
  • risk factors
  • international
  • Disability

Cite this

Coggon, D. ; Ntani, G. ; Palmer, K. T. ; Felli, V. E. ; Harari, F. ; Quintana, L. A. ; Felknor, S. A. ; Rojas, M. ; Cattrell, A. ; Vargas-Prada, S. ; Bonzini, M. ; Solidaki, E. ; Merisalu, E. ; Habib, R. R. ; Sadeghian, F. ; Kadir, M. M. ; Warnakulasuriya, S. S.P. ; Matsudaira, K. ; Nyantumbu-Mkhize, B. ; Kelsall, H. L. ; Harcombe, H. / Drivers of international variation in prevalence of disabling low back pain : Findings from the Cultural and Psychosocial Influences on Disability study. In: European Journal of Pain. 2019 ; Vol. 23, No. 1. pp. 35-45.
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title = "Drivers of international variation in prevalence of disabling low back pain: Findings from the Cultural and Psychosocial Influences on Disability study",
abstract = "Background: Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. Methods: Baseline information about musculoskeletal pain and risk factors was elicited from 11 710 participants aged 20–59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in the 12 months before baseline (‘pain propensity index’). After a mean interval of 14 months, 9055 participants (77.3{\%}) provided follow-up data on disabling LBP in the past month. Baseline risk factors for disabling LBP at follow-up were assessed by random intercept Poisson regression. Results: After allowance for other known and suspected risk factors, pain propensity showed the strongest association with disabling LBP (prevalence rate ratios up to 2.6, 95{\%} CI: 2.2–3.1; population attributable fraction 39.8{\%}). Across the 45 occupational groups, the prevalence of disabling LBP varied sevenfold (much more than within-country differences between nurses and office workers), and correlated with mean pain propensity index (r = 0.58). Conclusions: Within our study, major international variation in the prevalence of disabling LBP appeared to be driven largely by factors predisposing to musculoskeletal pain at multiple anatomical sites rather than by risk factors specific to the spine. Significance: Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age.",
keywords = "Low Back Pain, risk factors, international, Disability",
author = "D. Coggon and G. Ntani and Palmer, {K. T.} and Felli, {V. E.} and F. Harari and Quintana, {L. A.} and Felknor, {S. A.} and M. Rojas and A. Cattrell and S. Vargas-Prada and M. Bonzini and E. Solidaki and E. Merisalu and Habib, {R. R.} and F. Sadeghian and Kadir, {M. M.} and Warnakulasuriya, {S. S.P.} and K. Matsudaira and B. Nyantumbu-Mkhize and Kelsall, {H. L.} and H. Harcombe",
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Coggon, D, Ntani, G, Palmer, KT, Felli, VE, Harari, F, Quintana, LA, Felknor, SA, Rojas, M, Cattrell, A, Vargas-Prada, S, Bonzini, M, Solidaki, E, Merisalu, E, Habib, RR, Sadeghian, F, Kadir, MM, Warnakulasuriya, SSP, Matsudaira, K, Nyantumbu-Mkhize, B, Kelsall, HL & Harcombe, H 2019, 'Drivers of international variation in prevalence of disabling low back pain: Findings from the Cultural and Psychosocial Influences on Disability study', European Journal of Pain, vol. 23, no. 1, pp. 35-45. https://doi.org/10.1002/ejp.1255

Drivers of international variation in prevalence of disabling low back pain : Findings from the Cultural and Psychosocial Influences on Disability study. / Coggon, D.; Ntani, G.; Palmer, K. T.; Felli, V. E.; Harari, F.; Quintana, L. A.; Felknor, S. A.; Rojas, M.; Cattrell, A.; Vargas-Prada, S.; Bonzini, M.; Solidaki, E.; Merisalu, E.; Habib, R. R.; Sadeghian, F.; Kadir, M. M.; Warnakulasuriya, S. S.P.; Matsudaira, K.; Nyantumbu-Mkhize, B.; Kelsall, H. L.; Harcombe, H.

In: European Journal of Pain, Vol. 23, No. 1, 01.01.2019, p. 35-45.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Drivers of international variation in prevalence of disabling low back pain

T2 - Findings from the Cultural and Psychosocial Influences on Disability study

AU - Coggon, D.

AU - Ntani, G.

AU - Palmer, K. T.

AU - Felli, V. E.

AU - Harari, F.

AU - Quintana, L. A.

AU - Felknor, S. A.

AU - Rojas, M.

AU - Cattrell, A.

AU - Vargas-Prada, S.

AU - Bonzini, M.

AU - Solidaki, E.

AU - Merisalu, E.

AU - Habib, R. R.

AU - Sadeghian, F.

AU - Kadir, M. M.

AU - Warnakulasuriya, S. S.P.

AU - Matsudaira, K.

AU - Nyantumbu-Mkhize, B.

AU - Kelsall, H. L.

AU - Harcombe, H.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. Methods: Baseline information about musculoskeletal pain and risk factors was elicited from 11 710 participants aged 20–59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in the 12 months before baseline (‘pain propensity index’). After a mean interval of 14 months, 9055 participants (77.3%) provided follow-up data on disabling LBP in the past month. Baseline risk factors for disabling LBP at follow-up were assessed by random intercept Poisson regression. Results: After allowance for other known and suspected risk factors, pain propensity showed the strongest association with disabling LBP (prevalence rate ratios up to 2.6, 95% CI: 2.2–3.1; population attributable fraction 39.8%). Across the 45 occupational groups, the prevalence of disabling LBP varied sevenfold (much more than within-country differences between nurses and office workers), and correlated with mean pain propensity index (r = 0.58). Conclusions: Within our study, major international variation in the prevalence of disabling LBP appeared to be driven largely by factors predisposing to musculoskeletal pain at multiple anatomical sites rather than by risk factors specific to the spine. Significance: Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age.

AB - Background: Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. Methods: Baseline information about musculoskeletal pain and risk factors was elicited from 11 710 participants aged 20–59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in the 12 months before baseline (‘pain propensity index’). After a mean interval of 14 months, 9055 participants (77.3%) provided follow-up data on disabling LBP in the past month. Baseline risk factors for disabling LBP at follow-up were assessed by random intercept Poisson regression. Results: After allowance for other known and suspected risk factors, pain propensity showed the strongest association with disabling LBP (prevalence rate ratios up to 2.6, 95% CI: 2.2–3.1; population attributable fraction 39.8%). Across the 45 occupational groups, the prevalence of disabling LBP varied sevenfold (much more than within-country differences between nurses and office workers), and correlated with mean pain propensity index (r = 0.58). Conclusions: Within our study, major international variation in the prevalence of disabling LBP appeared to be driven largely by factors predisposing to musculoskeletal pain at multiple anatomical sites rather than by risk factors specific to the spine. Significance: Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age.

KW - Low Back Pain

KW - risk factors

KW - international

KW - Disability

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U2 - 10.1002/ejp.1255

DO - 10.1002/ejp.1255

M3 - Article

VL - 23

SP - 35

EP - 45

JO - European Journal of Pain

JF - European Journal of Pain

SN - 1090-3801

IS - 1

ER -