Back pain for one in four

Back pain is likely to be underreported, say US researchers, despite findings that more than a quarter of working adults have some form of lower back pain

The researchers say that the employment of patients with back pain has implications for both the factors causing or contributing to the pain and its effects, but few estimates of the proportion of back pain that is related to work in the United States are available.

They set out to estimate the burden of lower back pain among US workers, its work-relatedness, and its effect on work.

In 2015 the National Health Interview Survey (a nationally representative survey) collected supplemental data about the work-relatedness and the effects on work of back pain—specifically, low back pain—among US workers for the first time in nearly three decades.

Researchers randomly surveyed more than 19,000 adults to estimate the burden of low back pain among US workers and whether the pain was related to work and/or had an effect on work.

“The prevalence of any LBP and work-related LBP was highest in construction and extraction occupations, whereas the prevalence of frequent and severe LBP was highest in building and grounds cleaning and maintenance occupations,” the authors write.

Workers who reported frequent exertion or standing were more likely than those who did not to report all three outcomes.

“Overall prevalence was 26.4% for any LBP, 8.1% for frequent and severe LBP, and 5.6% for work-related LBP.

“Approximately 21.4% of workers with any LBP and 23.7% of those with frequent and severe LBP reported being told by a health professional that their LBP was probably work-related.

“However, most workers with LBP did not recall ever discussing whether their LBP was work-related with a health professional.

“Overall, 6% of current workers with any LBP, 10.2% of those with frequent and severe LBP, and 18.4% of those with work-related LBP had ever filed a workers’ compensation claim.

“Regardless of the cause, 16.9% of workers with any LBP and 19.0% of those with frequent and severe LBP missed at least one full day of work in the past three months because of LBP.

“Furthermore, 6.1% of workers with any LBP and 10.7% of those with frequent and severe LBP had stopped working, changed jobs, or made a major change in work activities in the past three months because of LBP.”

The authors said the study has several limitations, including that the data were cross-sectional, and that the accuracy and reliability of assessing occupational causality of health conditions through respondent reports are unknown.

“Third, relying on reported attribution of LBP to work by a health professional likely underestimates work-relatedness,” they warned.

The study was published in the Annals of Internal Medicine.

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