Prevalence and Impact of Low Back Pain in a Community-Based Population in Northern India

Abstract

Background: Low back pain (LBP) ranks first for disability and sixth for overall burden on world health, with an annual approximate cost of $135 billion. There are limited data on the prevalence and risk factors for LBP in developing countries, such as India. Objectives: To assess the prevalence, pain intensity, and quality of life (QOL) associated with LBP in northern India. Study Design: Cross-sectional study. Settings: Northern states of India. Methods: Adult population of different strata of the community were interviewed. Lifetime, point, 1-year, and age standardized lifetime prevalence with 95% confidence intervals (CI) and QOL, and pain intensity using the Numeric Rating Scale (NRS-11) were determined. Binary logistic regression test was conducted to determine the predictors of LBP prevalence; odds ratio (OR) with 95% CI are presented. Significance level was set at P ≤ 0.05. Results: A total of 1,531 patients were interviewed of whom 48% were men and mean (standard deviation [SD]) age was 32 (10) years. Lifetime, point, 1-year, and age standardized lifetime prevalence (95% CI) were 57% (54%–59%), 32% (30%–34%), 48% (46%–51%), and 59% (56%–62%), respectively. Average (SD) NRS-11 was 4.2 (2.6). Significant impact of LBP on sleep (24%), depression/psychological problems (24%), and social life (28%) were observed. Women (OR, 2.23; 95% CI, 1.80–2.77; P < 0.05), walking/lifting activity (OR, 1.362; 95% CI, 1.097– 1.692; P < 0.05), and increasing age (OR, 1.03; 95% CI, 1.02–1.04; P < 0.05) were most significant positive predictors of LBP. Limitations: The progression of LBP could not be assessed in the enrolled patients. Conclusions: LBP is highly prevalent in India, adversely affecting QOL in respondents. This calls for action by health officials to plan prevention, education, and management programs in the society. Key words: Low back pain, pain intensity, prevalence, incidence, quality of life