Association of low back pain on physical, sociodemographic and lifestyle factors across a general population sample within Greece

Article type: Research Article

Authors: Billis, E.^{a; *} | Koutsojannis, C.^a | Matzaroglou, C.^a | Gliatis, J.^b | Fousekis, K.^a | Gioftsos, G.^c | Papandreou, M.^d | McCarthy, C.^e | Oldham, J.A.^f | Tsepis, E.^a

Affiliations: [a] Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece | [b] Orthopaedic Department, University Hospital of Patras, Greece | [c] Department of Physiotherapy, Technological Educational Institute (T.E.I) of Sterea Ellada, Greece | [d] Department of Physiotherapy, Technological Educational Institute (T.E.I.) of Athens, Greece | [e] Imperial College Healthcare NHS Trust, London, UK | [f] University of Manchester, Manchester, UK

Correspondence: [*] Corresponding author: E. Billis, Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Psaron 6, Aigion 25100, Greece. Tel.: +30 2691061150, +30 2691061150 (secr), +30 26910 22058 (off); E-mail:ebillis@teiwest.gr

Abstract: BACKGROUND: Although low back pain (LBP) is a debilitating problem internationally, there is not a lot of research on its impact on physical, psychosocial and lifestyle factors. Especially in mediterranean countries, such as Greece, it is not sufficiently explored whether physical (pain location, activity limitation etc.), sociodemographic (education, smoking etc.) or lifestyle factors (i.e. quality of life or anxiety) are influenced by LBP. OBJECTIVE: To estimate LBP prevalence in the Greek general population and explore its association with particular sociodemographic, physical and lifestyle factors. METHOD: A sample of 3125 people of the Greek adult population was randomly selected by stratified sampling encompassing rural and urban representation within the Greek mainland. An extended survey form was developed entailing three sections; personal (sociodemographic) information, questions on symptomatology and physical factors (i.e. pain characteristics, recurrence, physical disability etc.) and 3 self-administered questionnaires (including mostly lifestyle factors); Hospital Anxiety and Depression (HAD) scale for anxiety and depression, SF-12 for quality of life (QoL) and Roland-Morris for disability. RESULTS: A total of 471 (15%) people reported LBP (210 males, mean age: 47.04 ± 15.03). Amongst them 60% reported sciatica, 76% suffered recurrent LBP and 70% received specialist care. Low disability levels, moderate to high pain intensity, gender differences and good self-reported QoL and psychosocial status were reported. Sociodemographic characteristics (income, smoking, marital status etc.) were not associated with LBP physical factors, apart from age which correlated with physical disability and wellness (r being 0.446 and 0.405, respectively, p< 0.001). Physical factors (particularly pain intensity and location) correlated with lifestyle factors (QoL) and disability (r ranging between 0.396 and 0.543, p< 0.001). Mental wellness, anxiety and depression (as lifestyle factors) were not associated with sociodemographic or physical factors. CONCLUSIONS: Physical parameters were amongst the most prevalent characteristics of the Greek sample, thus offering a direction towards a more targeted treatment and rehabilitation planning. Unlike previous literature, most sociodemographic characteristics were not correlated with any LBP physical or lifestyle factors, thus possibly indicating a different socioeconomic background and aetiology domain to that of the usual non-specific LBP spectrum.

Keywords: Low back pain, prevalence, physical, sociodemographic, lifestyle, Greece

DOI: 10.3233/BMR-150484

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 2, pp. 279-290, 2017