Personal Factors Associated with Low Back Pain Generated from a Large Population Analysis of the UK Biobank.

BACKGROUND

Low back pain (LBP) is a common musculoskeletal complaint and the leading cause of disability worldwide. Studies involving limited cohorts have investigated risk factors for LBP; however, few have examined a comprehensive range of variables including personal factors within a large population-level database. The purpose of this study was to investigate personal factors associated with LBP with the intent to understand how it could be more effectively treated.

METHODS

The UK Biobank is a large prospectively collected, population-level database, which contains numerous sociodemographic, clinical, lifestyle, and personal factors. Patients who reported LBP during a visit with their primary care provider between 2006 and 2010 were included. Continued/recurrent LBP was evaluated at follow-up in 2014. Bivariate and multivariable logistic regression analyses were done.

RESULTS

Of 501,509, there were 145,855 (29.1%) who reported LBP at initial visit. LBP was associated with being overweight/obese (OR, 1.17/1.45), identifying as Asian (OR, 1.5), driving to work (OR, 1.13), active job (OR, 1.15), salaries <30K/yr (OR, 1.15), >3 hr/d watching TV (OR, 1.2), decreased sleep (OR, 1.09), anxiety/depression (OR, 1.20/1.26), and opioid use (OR, 3.8). Of the 145,855 who reported LBP, 51,131 were seen at follow-up in 2014, 10,706 (21.0%) reported LBP again. Significant factors were being male (OR, 1.36), active job (OR, 1.16), thyroid disease (OR, 1.19), and being retired (OR, 1.20) (P < 0.05 for all variables).

CONCLUSIONS

Numerous personal factors are associated with LBP which present opportunities for the expansion of how care is provided for patients with this issue. A whole-person approach, focusing on activity modifications, sleep, nutrition, weight control, and mental/social health support, would be beneficial.

LEVEL OF EVIDENCE: Level III retrospective cohort study.