Low back pain and its risk indicators: a survey of 7,040 Finnish male conscripts

Studies describing risk indicators of low back pain (LBP) have focused on adults, although the roots of LBP lie in adolescence and early adulthood. The objective of the present study was to assess the lifetime occurrence and risk indicators of LBP in young adult males. The survey sample comprised 7,333 male conscripts (median age 19), of which 7,040 (96%) answered a questionnaire during the first days of their conscription. The outcome was lifetime LBP prompting at least one visit to a physician. Associations between 18 background variables and LBP were analysed by logistic regression. Altogether 894 (12.7%) respondents reported LBP. Health status was a strong determinant of LBP. The strongest individual risk indicators for LBP were having two or more other than back-related diseases diagnosed by a physician during past year (OR 2.0; 95% CI 1.6-2.5), below-average self-perceived health (OR 1.6; 95% CI 1.3-2.0) and use of smokeless tobacco (OR 1.4; 95% CI 1.2-1.7). Socioeconomic status was not associated with LBP and health behaviours only weakly. The strongest risk indicators for LBP were related to health problems. Of the socioeconomic background factors, none were associated with LBP. It is evident that LBP is associated with other health problems as well, indicating that its background may be multifactorial. This presents challenges for prevention programme planning and implementation. Longitudinal cohort studies are urgently needed to enhance understanding of adolescent risk indicators of LBP.