Benz T1, Angst J2, Ajdacic-Gross V3, Aeschlimann A4, Rössler W5,6, Angst F4
1RehaClinic, Research Department and Pain Center, Bad Zurzach, Switzerland, 2Psychiatric Hospital Burghölzli, University of Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland, 3Psychiatric Hospital Burghölzli, University of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland, 4RehaClinic, Research Department, Bad Zurzach, Switzerland, 5Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil, 6Collegium Helveticum, a Joint Research Institute of the University of Zurich & ETH Zurich, Zurich, Switzerland
Background: Back pain is extremely common and a huge burden for both individuals and public health care services.
Purpose: The aim of this study was to determine prevalences and incidences of lumbar and cervical back pain over a period of 23 years and to quantify associations with concomitant disorders.
Methods: Data on lumbar and cervical back pain, and mental disorders from the well-known Zurich study, collected between 1986 (age m: 27/f: 28 years) and 2008 (age 49/50) were analysed. Epidemiological parameters were representative rates for the general population. Associations were quantified by odds ratios (ORs).
Results: Of n=499 subjects, 68.9% ever experienced lumbar and 60.7% cervical back pain. The 23-year prevalences were 66.9% (men: 58.9%, women: 75.1%) and 54.9% (men: 44.6%, women: 65.2%) and the 23-year incidences 37.7% and 37.6% for lumbar and cervical back pain respectively. Annual prevalences varied between 28.4% and 47.2% for lumbar and 18.3% and 54.7% for cervical back pain; the corresponding annual incidences varied by 5.8%-13.3% (lumbar) and 7.8%-12.6% (cervical). Lumbar back pain was significantly associated with cardiovascular disease (OR=4.58, 99% confidence interval=1.10-19.02), obesity (OR=3.99, 2.25-7.07), asthma spectrum (OR=5.76, 4.05-8.19), tranquillizer dependence (OR=5.84, 2.70-12.66), and other comorbidities (ORs=1.47-3.27). Significant associations with cervical back pain were observed for specific phobia (OR=5.10, 99% confidence interval=2.49-10.43), panic attacks (OR=4.79, 2.64-8.69), and other comorbidities (ORs=1.61-2.62).
Conclusion(s): Lumbar back pain is highly associated with obesity and obesity-related syndromes, especially cardiovascular, anxiety, and headache disorders. Cervical back pain is highly associated with anxiety-related disorders. This study contributes to the refinement of epidemiological data on lumbar and cervical back pain in a sample representative of Switzerland's most populous canton.
Implications: Some associations with treatable concomitant disorders were high, which may contribute to the indirect management of lumbar and cervical back pain relief.
Keywords: Back pain, Prevalence, Comorbidity
Funding acknowledgements: Grant nos. 3200-050881.97/1 and 32-50881.97 of the Swiss National Science Foundation and Zurzach Rehabilitation Foundation SPA, Bad Zurzach, Switzerland.
Purpose: The aim of this study was to determine prevalences and incidences of lumbar and cervical back pain over a period of 23 years and to quantify associations with concomitant disorders.
Methods: Data on lumbar and cervical back pain, and mental disorders from the well-known Zurich study, collected between 1986 (age m: 27/f: 28 years) and 2008 (age 49/50) were analysed. Epidemiological parameters were representative rates for the general population. Associations were quantified by odds ratios (ORs).
Results: Of n=499 subjects, 68.9% ever experienced lumbar and 60.7% cervical back pain. The 23-year prevalences were 66.9% (men: 58.9%, women: 75.1%) and 54.9% (men: 44.6%, women: 65.2%) and the 23-year incidences 37.7% and 37.6% for lumbar and cervical back pain respectively. Annual prevalences varied between 28.4% and 47.2% for lumbar and 18.3% and 54.7% for cervical back pain; the corresponding annual incidences varied by 5.8%-13.3% (lumbar) and 7.8%-12.6% (cervical). Lumbar back pain was significantly associated with cardiovascular disease (OR=4.58, 99% confidence interval=1.10-19.02), obesity (OR=3.99, 2.25-7.07), asthma spectrum (OR=5.76, 4.05-8.19), tranquillizer dependence (OR=5.84, 2.70-12.66), and other comorbidities (ORs=1.47-3.27). Significant associations with cervical back pain were observed for specific phobia (OR=5.10, 99% confidence interval=2.49-10.43), panic attacks (OR=4.79, 2.64-8.69), and other comorbidities (ORs=1.61-2.62).
Conclusion(s): Lumbar back pain is highly associated with obesity and obesity-related syndromes, especially cardiovascular, anxiety, and headache disorders. Cervical back pain is highly associated with anxiety-related disorders. This study contributes to the refinement of epidemiological data on lumbar and cervical back pain in a sample representative of Switzerland's most populous canton.
Implications: Some associations with treatable concomitant disorders were high, which may contribute to the indirect management of lumbar and cervical back pain relief.
Keywords: Back pain, Prevalence, Comorbidity
Funding acknowledgements: Grant nos. 3200-050881.97/1 and 32-50881.97 of the Swiss National Science Foundation and Zurzach Rehabilitation Foundation SPA, Bad Zurzach, Switzerland.
Topic: Musculoskeletal: spine; Pain & pain management; Disability & rehabilitation
Ethics approval required: Yes
Institution: Zurich University Psychiatric Hospital, University of Zurich
Ethics committee: Ethical Committee of the Zurich University Psychiatric Hospital
Ethics number: N/A
All authors, affiliations and abstracts have been published as submitted.
