Abstract
BackgroundChronic low back pain (CLBP) is the leading cause of disability and has been extensively investigated in high-income countries (HICs), with little done in low-and middle-income countries. Biomechanical stressors do not have a major pathogenic role, but psychosocial predisposition is important. The occurrence and progression of CLBP are significantly affected by psychosocial risk factors. Guidelines recommend the early identification of psychosocial factors that could predict CLBP.AimTo determine the prevalence and psychosocial risk factors for CLBP amongst adults in KwaZulu-Natal, South Africa.SettingThe study was conducted at five randomly selected public hospitals in KwaZulu-Natal.MethodsAnalytical cross-sectional hospital-based study utilising a self-administered questionnaire to collect data on (1) sociodemographic, (2) disability, (3) fear-avoidance beliefs and (4) illness behaviour. The Statistical Package for the Social Sciences (SPSS) 24.0 was used for data cleaning and descriptive statistics. Chi-square test was used for categorical variables. Standard Edition of the Statistical Software for Data Science version 17.0 (STATA 17.0 SE) was used to identify risk factors using the logistic regression analysis. A p-value of ≤ 0.05 was deemed statistically significant.ResultsOverall prevalence of CLBP was 22.2% (95% confidence interval [CI]: 18.8–25.9). Females had a higher prevalence of CLBP than males, 23.9% (95% CI: 19.4–28.9) and 19.7% (95% CI: 14.8–25.5), respectively; however, the difference was not significant p = 0.243. The multivariate regression analysis identified the following risk factors: female gender, middle-aged adults 38–47 years, obesity, disease conviction, affective disturbance, denial and fear-avoidance behaviour-work subscale.ConclusionThere is a high prevalence of CLBP amongst the study participants. Psychosocial factors (disease conviction, affective disturbance and fear-avoidance behaviour about work) are significant predictors of CLBP.
Highlights
Chronic low back pain (CLBP) is the leading cause of disability and has been extensively investigated in high-income countries (HICs), with little done in low-and middleincome countries
The current study shows that the prevalence of chronic low back pain (CLBP) increased with increasing age, which is in line with other similar cross-sectional studies.[42,43,44]
This study concluded that the prevalence of CLBP is high and is comparable to the prevalence in other HICs
Summary
Chronic low back pain (CLBP) is the leading cause of disability and has been extensively investigated in high-income countries (HICs), with little done in low-and middleincome countries. Guidelines recommend the early identification of psychosocial factors that could predict CLBP. Low back pain (LBP) is a leading cause of disability and the most prevalent musculoskeletal condition globally.[1]. About 10% – 40% of all LBP patients will have recurrent episodes and develop chronic low back pain (CLBP).[5]. The majority of disability and financial burden associated with LBP is attributed to this minority of the population who develop CLBP.[6]. The prevalence of CLBP is estimated at 19.1%7 and is expected to increase in low- and middle-income countries (LMICs), where healthcare systems are mostly focussed on communicable disease control and insufficiently equipped to deal with the increasing burden of non-communicable diseases.[8,9]. The prevalence of CLBP is estimated at 19.1%7 and is expected to increase in low- and middle-income countries (LMICs), where healthcare systems are mostly focussed on communicable disease control and insufficiently equipped to deal with the increasing burden of non-communicable diseases.[8,9] In Africa, the prevalence of LBP is 47%.10
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