Risk factors associated with low back pain among adults: A population based case control study

Background: Although numerous studies have explored factors associated with LBP, evidence from large population based case control studies in low and middle income countries remains limited. This study aimed to investigate demographic, lifestyle, occupational, psychological and clinical factors associated with chronic low back pain among adults. Methods: This population based case control study utilized data extracted from the SINA Electronic Health Record system, a nationwide health surveillance registry in Iran. Adults aged 18 years and older with complete data on low back pain status and key covariates were included. Cases were defined as individuals reporting chronic low back pain, while controls reported no low back pain at the time of assessment. Multivariable logistic regression models were applied to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Model 1 adjusted for demographic variables and Model 2 further included lifestyle, occupational, psychological and clinical factors. Interaction terms between sex and hard physical job and between sex and body mass index (BMI), were evaluated, followed by sex stratified analyses. Results: We managed to get 139,499 adults to take part in this study. When we looked at all the data, it turned out that being male (OR = 2.61, 95% CI: 2.53–2.70, p < 0.001), getting older (especially between 48 and 57 years, or 58 and above), underweight (OR = 1.42, p < 0.001), overweight (OR = 1.49, p < 0.001), and obese individuals (OR = 1.78, p < 0.001), Smoking (OR = 1.18, p < 0.001), hypertension (OR = 1.20, p < 0.001), diabetes (OR = 1.95, p < 0.001), musculoskeletal diseases (OR = 8.02, p < 0.001), anxiety (OR = 1.68, p < 0.001) depression (OR = 1.64, p < 0.001)and Hard physical work (OR = 2.34, p < 0.001) were independently associated with low back pain. Significant interactions were observed between sex and hard physical work (p < 0.001) and between sex and BMI (p < 0.001), with stronger associations observed among women. Conclusions: It seems low back pain is the result of a whole heap of different factors - demographic, lifestyle, work-related, psychological and clinical all interacting in a complicated way to produce its effects on each individual. And it's clear that girls are different from boys in this respect. We reckon that looking at how some of these factors affect certain groups of people, like women, is really important when studying low back pain. It also suggests that if we can get people to change some of the things that are putting them at risk, like working too hard or being obese, then that might help reduce the burden of low back pain.