Back Pain and Co-occurring Conditions: Findings From a Nationally Representative Sample

Area of Science:

• Epidemiology
• Public Health
• Chronic Disease Management

Background:

• Back pain is a prevalent condition with numerous identified risk factors.
• Existing research often overlooks the impact of co-occurring conditions on back pain etiology.
• Understanding these relationships is crucial for effective back pain management.

Purpose of the Study:

• To determine the prevalence of co-occurring conditions with back pain.
• To identify risk factors for back pain, accounting for co-occurring conditions.
• To analyze the association between back pain and specific co-occurring conditions.

Main Methods:

• Cross-sectional population-level health survey using the 2013 Canadian Community Health Survey (n=61,854).
• Back pain and co-occurring conditions identified via self-report of professionally diagnosed long-term conditions.
• Multivariable log-Poisson regression was employed to assess adjusted associations.

Main Results:

• Population prevalence of back pain was 19.3%, with 71% reporting at least one co-occurring condition.
• Arthritis, high blood pressure, migraine, and mood disorders were most frequent co-occurring conditions.
• After controlling for co-occurring conditions, traditional risk factors like female sex and overweight/obesity were no longer significant; associations with age, low income, smoking, and inactivity were attenuated. The strongest association was with 3+ co-occurring conditions (PR=3.32).

Conclusions:

• Established risk factors for back pain may represent shared risk factors with co-occurring conditions.
• The high frequency of co-occurring conditions suggests diverse underlying mechanisms for back pain.
• The significant association between co-occurring conditions and back pain has implications for clinical practice and future research into patient subgroups.