Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population
Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population
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DOI：
10.1097/00007632-200306010-00021
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发表时间：
2003-06-01
期刊：
影响因子：
3
通讯作者：
Symmons, D
中科院分区：
文献类型：
--
作者：
Webb, R;Brammah, T;Symmons, D
研究设计.肌肉骨骼疼痛的多阶段横断面调查。估计所有报告的临床显著脊柱疼痛的患病率。确定脊柱疼痛的独立预测因子。从三个全科诊所登记处抽样的5752名成年人共邮寄了一份筛选问卷。向报告脊柱为主要疼痛部位的受试者发送部位特异性问卷（即，（背或脖子）问严重性。计算患病率估计值并外推至一般人群。采用logistic回归分析确定脊柱疼痛的预测因子，并对混杂因素（包括其他解剖部位的疼痛）进行综合调整。所有报告的脊柱疼痛的1个月患病率为29%（95%置信区间为27-31%），其中约一半为剧烈疼痛，一半为慢性疼痛，40%为致残性疼痛，20%为剧烈、致残性和慢性疼痛。大多数背部（75%）或颈部（89%）疼痛的人也报告其他部位疼痛。年龄、女性（仅颈部疼痛）、高体重指数、生活在物质匮乏的地区以及南亚种族是脊柱疼痛伴残疾的重要预测因素。体重指数与剥夺和颈部疼痛之间的关联在调整其他部位的疼痛后消失。然而，即使在完全校正后，肥胖（OR，1.7; 95%置信区间，1.1-2.5）和高度剥夺（OR，1.7; 95%置信区间，1.1-2.7）仍是背痛伴残疾的预测因子。调整其他部位的疼痛，可以评估观察到的相关性是否与脊柱疼痛本身或其他疼痛部位有关。肥胖是背痛及其严重程度的重要独立预测因素。这对初级预防有影响。残疾脊柱疼痛的患病率持续上升到老年。这对医疗保健规划有影响。
Study Design. Multiphase cross-sectional survey of musculoskeletal pain.Objectives. To estimate the prevalence of all reported and clinically significant spinal pain. To identify independent predictors of spinal pain.Methods. A total of 5752 adults sampled from three general practice registers were mailed a screening questionnaire. Subjects who reported the spine as a predominant site of pain were sent a site-specific questionnaire (i.e., back or neck) that asked about severity. Prevalence estimates were calculated and extrapolated to the general population. Predictors of spinal pain were identified using logistic regression with comprehensive adjustment for confounders (including pain at other anatomic sites).Results. The 1-month-period prevalence of all reported spinal pain was 29% (95% confidence interval 27-31%), of which about half was intense, half was chronic, 40% was disabling, and 20% was intense, disabling, and chronic. Most people with back (75%) or neck (89%) pain also reported pain at other sites. Age, female gender (neck pain only), high body mass index, living in an area of raised material deprivation, and south Asian ethnicity were significant predictors of spinal pain with disability. The association between body mass index and deprivation and neck pain was lost after adjustment for pain at other sites. However, even after full adjustment, obesity (OR, 1.7; 95% confidence interval, 1.1-2.5) and high deprivation (OR, 1.7; 95% confidence interval, 1.1-2.7) were predictors of back pain with disability.Conclusions. Adjustment for pain at other sites enabled assessment of whether observed associations were with spinal pain itself or with the other sites of pain. Obesity is an important independent predictor of back pain and its severity. This has implications for primary prevention. The prevalence of spinal pain with disability continues to rise into old age. This has implications for healthcare planning.