Differences in physical and psychological health in patients with chronic low back pain: a national survey in general Sp
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Differences in physical and psychological health in patients with chronic low back pain: a national survey in general Spanish population María Dueñas1,2,3 · Jose A. Moral‑Munoz1,2,4 · Jenifer Palomo‑Osuna1,2,5 · Alejandro Salazar1,2,3 · Helena De Sola1,2,5 · Inmaculada Failde1,2,5 Accepted: 8 June 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose To estimate the prevalence of diagnosed and undiagnosed chronic low back pain (CLBP-D and CLBP-UD, respectively) in the general adult population in Spain and to compare the characteristics of these two groups with subjects without CLBP symptoms (No-CLBP). To establish CLBP-D patient sub-groups according to their self-perceived health status, mental health, level of pain and the impact of their pain on daily activities. Methods Data were obtained from the National Health Survey of Spain 2017 with a sample of 23,089 adults. Three groups were defined: CLBP-D, CLBP-UD and No-CLBP. In the CLBP-D group, a cluster analysis was performed to identify subgroups. A multinomial regression model was constructed to determine the factors associated with each of the sub-groups identified. Results The prevalence of CLBP-D was 22% (95% CI 21.5–22.5) and that of CLBP-UD was 1.4% (95% CI 1.2–1.5). CLBP-D was more common in middle-aged females with a low educational level. They have a worse perceived health status, report more comorbidities, have worse mental health and more limitations in comparison with the populations without CLBP and with CLBP-UD. Three sub-groups of CLBP-D subjects were identified. Women and older subjects with a lower educational level, more occupational stress, less social support and with more physical limitations were the most likely subjects to be included in the group worst-affected. Conclusions There is a high prevalence of CLBP among the adult population in Spain. Occupational stress and a lack of social support are common factors among subjects’ worst-affected of CLBP-D and identifying the subjects with these risks is therefore a recommended strategy for improving the healthcare provided to CLBP patients. Keywords Low back pain · Mental health · Chronic pain · Stress · Social support
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-020-02553-y) contains supplementary material, which is available to authorized users. * Jose A. Moral‑Munoz [email protected] 1
2
Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cadiz, Spain Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cadiz, Spain
Low back pain (LBP) is a common condition that, according to the data of the Global Burden of Diseases Study 2018, was considered the main cause of years lost to disability (YLD), with a growing burden described in recent years 3
Department of Statistics and Operational Research, University of Cadiz, Puerto Real, Spain
4
Department of Nursing and Physiotherapy, Uni
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