Abstract
BackgroundThere is a vast literature reporting that the point prevalence of low back pain (LBP) is high and increasing. It is also known that a large proportion of acute LBP episodes are recurrent within 12 months. However, few studies report the annual trends in the prevalence of recurrent LBP or describe these trends according to age and sex categories.MethodsWe conducted a retrospective cohort study involving 401 264 adults selected from the administrative database of physician claims for the province of Quebec, Canada. These adults, aged 18 years and over, met the criteria of having consulted a physician three times within a 365-day period between 2000 and 2007 for a LBP condition corresponding to ICD-9 codes 721, 722, 724 or 739. All data were analyzed by sex and clustered according to specific age categories.ResultsWe observed a decrease from 1.64% to 1.33% in the annual prevalence between 2000 and 2007 for men. This decrease in prevalence was mostly observed between 35 and 59 years of age. Older (≥65 years) women were 1.35 times more at risk to consult a physician for LBP in a recurrent manner than older men. The most frequently reported diagnosis was non-specific LBP between 2000 to 2007. During the same period, sequelae of previous back surgery and spinal stenosis were the categories with the largest increases.ConclusionThe annual prevalence of claims-based recurrent LBP progressively decreased between 2000 and 2007 for younger adults (<65 years) while older adults (≥65 years) showed an increase. Given the aging Canadian population, recurrent low back pain could have an increasing impact on the quality of life of the elderly as well as on the healthcare system.
Highlights
There is a vast literature reporting that the point prevalence of low back pain (LBP) is high and increasing
An overview of the extensive literature on low back pain led us to the following observations: 1) only 38% of prevalence studies that were reviewed provide definitions for recurrent LBP, making comparisons difficult [11]; 2) LBP is often reported as a point prevalence but its longitudinal progression is seldom investigated [12,13,14]; 3) sex and age variables are often aggregated, which limits descriptive and categorical analyses of the data
By performing secondary analyses on this extensive administrative database, we provide a descriptive portrait of the longitudinal progression of the annual prevalence of recurrent LBP cases in specific age and sex categories
Summary
There is a vast literature reporting that the point prevalence of low back pain (LBP) is high and increasing. An overview of the extensive literature on low back pain led us to the following observations: 1) only 38% of prevalence studies that were reviewed provide definitions for recurrent LBP, making comparisons difficult [11]; 2) LBP is often reported as a point prevalence but its longitudinal progression is seldom investigated [12,13,14]; 3) sex and age variables are often aggregated, which limits descriptive and categorical analyses of the data. While national surveys allow repeated measurements of the prevalence over time, definitions regarding low back pain are not always specific [17], and the accuracy of LBP estimates generated with large population surveys remains debatable with regards to the variations reported [18]. In a universal healthcare system based on a centralized fee-for-service, the specificity of the administrative databases is high, in part because physicians promptly submit claims for the services provided to patients [24]
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