Abstract
BackgroundLow back pain (LBP) is a major cause of disability throughout the world. However, longitudinal evidence to relate low back pain and functional limitations is mostly confined to Western countries. In this study, we investigate the associations between low back pain and functional limitations in a prospective cohort of Thai adults.MethodsWe analysed information from the Thai Cohort Study of adult Open University adults which included 42,785 participants in both 2009 and 2013, with the majority aged 30 to 65 years and residing nationwide. We used multivariate logistic regression to explore the longitudinal associations between LBP in 2009 and 2013 (‘never’: no LBP in 2009 or 2013; ‘reverting’: LBP in 2009 but not in 2013; ‘incident’: no LBP in 2009 but LBP in 2013; and ‘chronic’: reporting LBP at both time points) and the outcome of functional limitations relating to Activities of Daily Living (ADL) in 2013.ResultsLow back pain was common with 30% of cohort members reporting low back pain in both 2009 and 2013 (‘chronic LBP’). The ‘chronic LBP’ group was more likely than the ‘never’ back pain group to report functional limitations in 2013: adjusted odds ratios 1.60 [95% Confidence Interval: 1.38–1.85] for difficulties getting dressed; 1.98 [1.71–2.30] for walking; 2.02 [1.71–2.39] for climbing stairs; and 3.80 [3.38–4.27] for bending/kneeling. Those with ‘incident LBP’ or ‘reverting LBP’ both had increased odds of functional limitations in 2013 but the odds were not generally as high.ConclusionsOur nationwide data from Thailand suggests that LBP is a frequent public health problem among economically productive age groups with adverse effects on the activities of daily living. This study adds to the limited longitudinal evidence on the substantial impact of low back pain in Southeast Asia.
Highlights
Low back pain (LBP) is a major cause of disability throughout the world
We focus on LBP in a large nationwide prospective cohort of Thai adults
We provide an estimate of the magnitude of LBP in working adults and its consequences 4 years later, adding to the evidence base of low back pain globally, and in middle-income countries such as Thailand
Summary
Longitudinal evidence to relate low back pain and functional limitations is mostly confined to Western countries. We investigate the associations between low back pain and functional limitations in a prospective cohort of Thai adults. With its impact on productivity and activities of daily living, LBP has gained increasing attention in developing countries worldwide [2, 7]. These include, for example, a study among rural Tibetans noted LBP prevalence of 34% [8] and another study across occupation groups in Shanghai reported LBP prevalence ranging from 40% among teachers to 74% among garment workers [9]. Longitudinal evidence relating to causes and consequences of LBP remains limited, especially in low and middle-income countries
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