Do Immigrant Patients Differ From Native Swedish Patients With Back Pain When Entering Rehabilitation?

Abstract

Back pain affects up to 80% of all people at some time during life. With the increasing migration between countries, there is a need for rehabilitation suitable also for immigrant patients. Most studies on rehabilitation for patients with back pain exclude immigrants. Back pain occurs in all societies, but cultural groups differ in how they perceive symptoms and react to them. In order to plan rehabilitation for patients with back pain, it is important to know whether immigrants have particular needs that should be addressed. The aim of this study was to compare immigrant and Swedish patients with back pain before starting a rehabilitation programme. Nine hundred and forty-three consecutively patients entered an outpatient-based, multidisciplinary, behavioural and cognitive rehabilitation programme including graded return to work in Sweden. Five hundred and sixty-six were Swedes and 377 were immigrants. The patients were sick-listed for at least 6 weeks. Self-administered questionnaires were used to assess demographics, education, occupation, work, pain, pain behaviour, health, disability, psychosomatic symptoms, distress, etc. An abdominal muscle test, a back muscle test, a lifting test, a fitness test and a circuit test examined the patients' physical performance. Immigrant patients differed from Swedish patients with back pain when entering an outpatient-based, multidisciplinary, behavioural and cognitive rehabilitation programme for sick-listed patients. Reported health, pain, pain behaviour, disability, psychosomatic symptoms, distress and performance in physical tests were poorer in immigrant patients than in Swedish patients, but most work factors, sick-leave, duration of pain and background factors were not different from Swedish patients. Immigrant patients with back pain might have particular needs that should be addressed when planning treatment and rehabilitation programmes.