Background
Materials and methods
Study participants and design
Definition of chronic low back pain
Demographic and health surveys
Statistical analysis
Ethics statement
Results
Participant demographics according to chronic low back pain
Variables | Without CLBP (n = 14,345) | CLBP (n = 2,693) | p value |
---|---|---|---|
Age, year | 47.3 (16.1) | 59.1 (16.0) | < .001 |
Age, n (%) | |||
10–19 | 174 (1.2%) | 4 (0.1%) | < .001 |
20–29 | 1932 (13.5%) | 142 (5.3%) | |
30–39 | 3143 (21.9%) | 269 (10.0%) | |
40–49 | 3052 (21.3%) | 310 (11.5%) | |
50–59 | 2423 (16.9%) | 439 (16.3%) | |
60–69 | 2038 (14.2%) | 698 (25.9%) | |
70–79 | 1296 (9.0%) | 665 (24.7%) | |
80–89 | 275 (1.9%) | 161 (6.0%) | |
≥ 90 | 12 (0.1%) | 5 (0.2%) | |
Gender, n (%) | |||
Male | 6444 (44.9%) | 758 (28.1%) | < .001 |
Female | 7901 (55.1%) | 1935 (71.9%) | |
Height, cm | 162.4 (9.1) | 157.3 (9.3) | < .001 |
Weight, kg | 62.5 (11.5) | 59.0 (10.3) | < .001 |
BMI, kg/m2 | 23.6 (3.4) | 23.8 (3.3) | .002 |
Obesity, n (%)a | |||
Underweight (< 18.5) | 683 (4.8%) | 106 (4.0%) | .001 |
Normal (18.5–24.9) | 9080 (64.1%) | 1644 (61.6%) | |
Obese (> 25) | 4403 (31.1%) | 918 (34.4%) | |
Smoking status, n (%) | |||
Non/Ex-smoker | 11,018 (76.9%) | 2304 (85.7%) | < .001 |
Current smoker | 3318 (23.1%) | 274 (14.3%) | |
Alcohol consumption, n (%) | |||
None | 6453 (45.0%) | 1688 (62.7%) | < .001 |
≥ 1 drink/month | 7892 (55.0%) | 1005 (37.3%) | |
Occupation, n (%) | |||
Unemployed (Student, housewife, etc.) | 5791 (40.4%) | 1375 (51.1%) | < .001 |
Office work | 2891 (20.2%) | 187 (6.9%) | |
Sales and services | 1893 (13.2%) | 221 (8.2%) | |
Agriculture, forestry and fishery | 1102 (7.7%) | 524 (19.5%) | |
Machine fitting and simple labor | 2668 (18.6%) | 386 (14.3%) | |
Household income, n (%)b | |||
Low | 2572 (18.4%) | 976 (36.9%) | < .001 |
Low-moderate | 3510 (25.1%) | 645 (24.4%) | |
Moderate-high | 3881 (27.8%) | 554 (20.9%) | |
High | 4008 (28.7%) | 471 (17.8%) | |
Education level, n (%)c | |||
≤ 6 years | 3462 (24.1%) | 1503 (55.8%) | < .001 |
7–9 years | 1594 (11.1%) | 316 (11.7%) | |
10–12 years | 5289 (36.9%) | 563 (20.9%) | |
≥ 13 years | 4000 (27.9%) | 311 (11.5%) | |
Physical activity, n (%)d | |||
Walk | 6570 (46.0%) | 1263 (47.1%) | .32 |
Middle PA | 1903 (13.3%) | 514 (19.1%) | < .001 |
High PA | 2276 (15.9%) | 408 (15.2%) | .34 |
Depressive symptom, n (%)e | 1987 (13.9%) | 698 (25.9%) | < .001 |
Vitamin Df | |||
Insufficiency (< 20 ng/ml) | < 0.001 | ||
Normal (≥ 20 ng/ml) | 3937 (68.4%) | 1059 (45.6%) | |
Comorbidities, n (%) | 6756 (63.2%) | 1263 (54.4%) | |
Hypertension | 2591 (18.1%) | 879 (32.6%) | < .001 |
Dyslipidemia | 968 (6.7%) | 305 (11.3%) | < .001 |
Stroke | 261 (1.8%) | 134 (5.0%) | < .001 |
Ischemic heart disease | 258 (1.8%) | 133 (4.9%) | < .001 |
Knee osteoarthritis | 2119 (14.8%) | 1052 (39.1%) | < .001 |
Asthma | 512 (3.6%) | 215 (8.0%) | < .001 |
COPD | 114 (0.8%) | 57 (2.1%) | < .001 |
Diabetes | 1004 (7.0%) | 310 (11.5%) | < .001 |
Chronic kidney disease | 48 (0.3%) | 17 (0.6%) | .022 |
Liver cirrhosis | 23 (0.2%) | 10 (0.4%) | .022 |
Cancerg | 356 (2.5%) | 145 (5.4%) | < .001 |
Unadjusted individual factors associated with chronic low back pain
Variables | Odds radio | 95% CI | p value | |
---|---|---|---|---|
Age group | ||||
10–19 | Reference | |||
20–29 | 3.197 | 1.169 | 8.741 | 0.024 |
30–39 | 3.723 | 1.371 | 10.110 | 0.01 |
40–49 | 4.418 | 1.629 | 11.987 | 0.004 |
50–59 | 7.881 | 2.910 | 21.346 | < 0.001 |
60–69 | 14.898 | 5.509 | 40.292 | < 0.001 |
70–79 | 22.321 | 8.248 | 60.406 | < 0.001 |
80–89 | 25.467 | 9.275 | 69.929 | < 0.001 |
≥ 90 | 18.125 | 4.298 | 76.427 | < 0.001 |
Gender | ||||
Male | Reference | |||
Female | 2.082 | 1.902 | 2.279 | < 0.001 |
Height | 0.940 | 0.935 | 0.944 | < 0.001 |
Weight | 0.972 | 0.968 | 0.976 | < 0.001 |
BMI | 1.020 | 1.008 | 1.032 | 0.002 |
Obesitya | ||||
Underweight (< 18.5) | Reference | |||
Normal (18.5–24.9) | 1.167 | 0.944 | 1.441 | 0.153 |
Obese (> 25) | 1.343 | 1.082 | 1.668 | 0.008 |
Smoking status | ||||
Non/Ex-smoker | Reference | |||
Current smoker | 0.555 | 0.495 | 0.622 | < 0.001 |
Alcohol consumption | ||||
None | Reference | |||
≥ 1 drink/month | 0.487 | 0.447 | 0.530 | < 0.001 |
Occupation | ||||
Unemployed (Student, housewife, etc.) | Reference | |||
Office work | 0.272 | 0.232 | 0.319 | < 0.001 |
Sales and services | 0.492 | 0.423 | 0.572 | < 0.001 |
Agriculture, forestry and fishery | 2.003 | 1.777 | 2.257 | < 0.001 |
Machine fitting and simple labor | 0.609 | 0.539 | 0.688 | < 0.001 |
Household incomeb | ||||
Low | ||||
Low-moderate | 0.484 | 0.433 | 0.541 | < 0.001 |
Moderate-high | 0.376 | 0.335 | 0.422 | < 0.001 |
High | 0.310 | 0.274 | 0.349 | < 0.001 |
Education levelc | ||||
≤ 6 years | Reference | |||
7–9 years | 0.457 | 0.399 | 0.523 | < 0.001 |
10–12 years | 0.245 | 0.221 | 0.273 | < 0.001 |
≥ 13 years | 0.179 | 0.157 | 0.204 | < 0.001 |
Physical activityd | ||||
Walk | 1.043 | 0.960 | 1.133 | 0.316 |
Middle PA | 1.542 | 1.385 | 1.717 | < 0.001 |
High PA | 0.946 | 0.844 | 1.061 | 0.341 |
Depressive symptome | 2.176 | 1.972 | 2.401 | < 0.001 |
Vitamin Df | ||||
Insufficiency (< 20 ng/ml) | Reference | |||
Normal (≥ 20 ng/ml) | 0.695 | 0.635 | 0.761 | < 0.001 |
Comorbidities | ||||
Hypertension | 2.198 | 2.007 | 2.408 | < 0.001 |
Dyslipidemia | 1.765 | 1.541 | 2.022 | < 0.001 |
Stroke | 2.826 | 2.285 | 3.495 | < 0.001 |
Ischemic heart disease | 2.837 | 2.292 | 3.512 | < 0.001 |
Knee osteoarthritis | 3.699 | 3.380 | 4.048 | < 0.001 |
Asthma | 2.344 | 1.988 | 2.764 | < 0.001 |
COPD | 2.699 | 1.959 | 3.720 | < 0.001 |
Diabetes | 1.729 | 1.511 | 1.978 | < 0.001 |
Chronic kidney disease | 1.892 | 1.087 | 3.295 | < 0.001 |
Liver cirrhosis | 2.321 | 1.103 | 4.882 | 0.026 |
Cancerg | 2.236 | 1.836 | 2.725 | < 0.001 |
Association between individual factors and chronic low back pain
Variables | Odds radio | 95% CI | p value | |
---|---|---|---|---|
Age group | ||||
10–19 | Reference | |||
20–29 | 3.113 | 1.127 | 8.593 | 0.028 |
30–39 | 3.454 | 1.259 | 9.474 | 0.016 |
40–49 | 3.136 | 1.144 | 8.594 | 0.026 |
50–59 | 4.090 | 1.490 | 11.230 | 0.006 |
60–69 | 6.104 | 2.220 | 16.787 | < 0.001 |
70–79 | 8.996 | 3.260 | 24.823 | < 0.001 |
80–89 | 8.778 | 3.103 | 24.838 | < 0.001 |
≥ 90 | 6.474 | 1.116 | 37.544 | 0.037 |
Gender | ||||
Male | Reference | |||
Female | 1.763 | 1.566 | 1.985 | < 0.001 |
Alcohol consumption | ||||
None | Reference | |||
≥ 1 drink/month | 0.864 | 0.774 | 0.964 | 0.009 |
Household incomea | ||||
Low | reference | |||
Low-moderate | 0.869 | 0.756 | 0.999 | 0.048 |
Moderate-high | 0.906 | 0.779 | 1.054 | 0.200 |
High | 0.889 | 0.757 | 1.044 | 0.152 |
Education levelb | ||||
≤ 6 years | reference | |||
7–9 years | 0.741 | 0.628 | 0.874 | < 0.001 |
10–12 years | 0.604 | 0.514 | 0.710 | < 0.001 |
≥ 13 years | 0.447 | 0.367 | 0.545 | < 0.001 |
Middle PAc | 1.520 | 1.339 | 1.726 | < 0.001 |
Depressive symptomd | 1.551 | 1.374 | 1.750 | < 0.001 |
Vitamin De | ||||
Insufficiency (< 20 ng/ml) | 0.767 | 0.693 | 0.850 | < 0.001 |
Normal (≥ 20 ng/ml) | Reference | |||
Comorbidities | ||||
Stroke | 1.532 | 1.169 | 2.007 | 0.002 |
Ischemic heart disease | 1.590 | 1.207 | 2.094 | 0.001 |
Knee osteoarthritis | 1.663 | 1.477 | 1.873 | < 0.001 |
Asthma | 1.434 | 1.164 | 1.767 | 0.001 |
COPD | 2.091 | 1.378 | 3.173 | 0.001 |
Cancerf | 1.416 | 1.104 | 1.816 | 0.006 |