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Rückenschmerz und Sozialschicht bei Berufstätigen

Ergebnisse einer deutschen Bevölkerungsstichprobe

Back pain and social status among the working population

What is the association? Results from a German general population survey

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Zusammenfassung

Hintergrund

Wenig Evidenz besteht in Deutschland für den differenziellen Einfluss von Sozialschichtindikatoren auf Rückenschmerzen. Diese Arbeit geht daher der Frage nach, welche Sozialschichtindikatoren bei Berufstätigen mit welchen Rückenschmerzindikatoren am engsten assoziiert sind.

Material und Methoden

Insgesamt 4412 berufstätige Erwachsene aus 5 deutschen Städten im Alter zwischen 18 und 65 Jahren nahmen an einem postalischen Rückenschmerzsurvey teil. Erfasst wurden die Punkt- und Jahresprävalenz der Rückenschmerzen sowie deren Schweregrad. Als Sozialschichtindikatoren wurden das Bildungsniveau, die berufliche Position und das Äquivalenzeinkommen herangezogen. Assoziationen wurden mittels Poisson-Regression im Querschnitt untersucht.

Ergebnisse

Das Bildungsniveau war der beste Prädiktor für Rückenschmerzen. Personen mit Hauptschulabschluss hatten im Vergleich zu Teilnehmern mit Fachabitur oder Abitur ein fast 4-fach erhöhtes Risiko, schwergradige Rückenschmerzen aufzuweisen. Vom Rückenschmerzschweregrad über die Punkt- hin zur Jahresprävalenz nahm der Grad der Assoziation mit den Sozialschichtindikatoren erheblich ab.

Schlussfolgerung

Rückenschmerz kann nicht generell als Symptom eines niedrigen Sozialstatus aufgefasst werden. Soziale Ungleichheit spielt jedoch eine große Rolle bei der Vorhersage starker und beeinträchtigender Rückenschmerzen. Die zukünftige Analyse zugrundeliegender Wirkmechanismen ist für präventive und therapeutische Ansätze von großer Relevanz.

Abstract

Background

Little empirical evidence is available on differential associations between social status indicators and back pain in Germany. This study therefore systematically evaluated associations between different indicators of social status and back pain.

Methods

In total 4,412 employed adults, aged 18 to 65 years participated in a postal survey in 5 regions of Germany. The point prevalence and 1-year prevalence of back pain were assessed as well as the level of disabling back pain. Educational level, professional category and household income served as measures of social status. Associations between social status and back pain have been assessed cross-sectionally using Poisson regression.

Results

Educational level was the best predictor for back pain among the assessed social status indicators. Adults with a low educational level had almost a 4-fold risk of reporting disabling back pain compared to subjects with a high educational level. Associations were highest for disabling back pain and attenuated strongly over the point prevalence towards the 1-year prevalence.

Discussion

Back pain cannot generally be regarded as a symptom of a low social status. However, social inequality is of major importance regarding the prediction of severe back problems. A better understanding of mediating factors is essential for the prevention and therapy.

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Danksagung

Diese Studie wurde durchgeführt in Zusammenarbeit mit Prof. Dr. Michael Pfingsten, Prof. Dr. Monika Hasenbring, Prof. Dr. Heinz Dieter Basler sowie Prof. Dr. Wolfgang Eich und Mitarbeiter. Sie wurde gefördert durch das BMBF (Förderkennzeichen: 01 EM 011).

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  1. Institut für Community Medicine, Universität Greifswald, Walther Rathenau Str. 48, 17487, Greifswald, Deutschland

    C.O. Schmidt, J. Moock, R.A. Fahland, Y.Y.-S. Feng & T. Kohlmann

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  1. C.O. Schmidt
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  2. J. Moock
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  3. R.A. Fahland
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Correspondence to C.O. Schmidt.

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Schmidt, C., Moock, J., Fahland, R. et al. Rückenschmerz und Sozialschicht bei Berufstätigen. Schmerz 25, 306–314 (2011). https://doi.org/10.1007/s00482-011-1050-3

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