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The association between social factors, employment status and self-reported back pain – A representative prevalence study on the German general population

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Abstract

Aim

The medical and economic impact of back pain in terms of health care costs, lost working days, and early retirement is on the increase in Western industrialised nations. This paper investigates the prevalence of back pain in the German general population and the relationship between social factors, employment status and back pain.

Subjects and methods

The first German Health Survey comprised a representative total sample of 6,235 persons between the ages of 18 and 79. The relationship between back pain and social, lifestyle and workplace-related factors was investigated using multivariable logistic regression analyses.

Results

The 7-day prevalence for back pain in Germany was found to be 36%, and the 1-year prevalence was 59%. The prevalence rates were significantly higher in women, lower socio-economic classes, non-athletes, smokers and those who are overweight. Depressed mood and allergies co-occurred with back pain more frequently than by chance.

Conclusion

This study reports the first representative prevalence data for back pain, and its correlates and associations for the German general population.

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References

  • Alexopoulos EC, Burdorf A, Kalokerinou A (2003) Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals. Int Arch Occup Environ Health 76:289–294

    PubMed  Google Scholar 

  • Bellach BM, Knopf H, Thefeld W (1998) Der Bundes-Gesundheitssurvey 1997/98. Gesundheitswesen 60:59–68

    Google Scholar 

  • Bellach BM, Ellert U, Radoschewski M (2000) Epidemiologie des Schmerzes—Ergebnisse des Bundes-Gesundheitssurveys 1998. Bundesgesundheitsblatt 6:424–431

    Article  Google Scholar 

  • Bortz J (1985) Lehrbuch der Statistik für Sozialwissenschaftler. Springer, Berlin

  • Bressler HB, Keyes WJ, Rochon PA, Badley E (1999) The prevalence of low back pain in the elderly. A systematic review of the literature. Spine 24:1813–1819

    Article  CAS  PubMed  Google Scholar 

  • Brown WJ, Mishra G, Lee C, Bauman A (2000) Leisure time physical activity in Australian women: relationship with well being and symptoms. Res Q Exerc Sport 71:206–216

    CAS  PubMed  Google Scholar 

  • Cassidy JD, Carroll LJ, Cote P (1998) The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine 23:1860–1866

    Article  CAS  PubMed  Google Scholar 

  • Chesterton LS, Barlas P, Foster NE, Baxter GD, Wright CC (2003) Gender differences in pressure pain threshold in healthy humans. Pain 101:259–266

    Article  PubMed  Google Scholar 

  • Davey-Smith G, Bartley M, Blane D (1990) The Black report on socioeconomic inequalities in health 10 years on. BMJ 301:373–377

    PubMed  Google Scholar 

  • Failde I, Gonzalez JL, Novalbos JP, Casais F, Marin J, Elorza J (2000) Psychological and occupational predictive factors for back pain among employees of a university hospital in southern Spain. Occup Med (Lond) 50:591–596

    Google Scholar 

  • Feinstein JS (1993) The relationship between socioeconomic status and health: a review of the literature. Milbank Q 71:279–322

    CAS  PubMed  Google Scholar 

  • Feyer AM, Herbison P, Williamson AM, Silva I de, Mandryk J, Hendrie L, Hely MC (2000) The role of physical and psychological factors in occupational low back pain: a prospective cohort study. Occup Environ Med 57:116–120

    Article  CAS  PubMed  Google Scholar 

  • Glendinning A, Hendry L, Shucksmith J (1995) Lifestyle, health and social class in adolescence. Soc Sci Med 41:235–248

    Article  CAS  PubMed  Google Scholar 

  • Göbel H (2001) Epidemiologie und Kosten chronischer Schmerzen. Spezifische und unspezifische Rückenschmerzen. Schmerz 15:92–98

    Article  PubMed  Google Scholar 

  • Hagen KB, Tambs K, Bjerkedal T (2002) A prospective cohort study of risk factors for disability retirement because of back pain in the general working population. Spine 27:1790–1796

    Article  PubMed  Google Scholar 

  • Hasenbring M (2001) Biopsychosoziale Grundlagen der Chronifizierung am Beispiel von Rückenschmerzen. In: Zenz M, Jurna I (eds) Lehrbuch der Schmerztherapie. Wissenschaftliche Verlagsgesellschaft, Stuttgart, pp 185–196

  • Hasenbring M, Hallner D, Klasen B (2001) Psychologische Mechanismen im Prozess der Schmerzchronifizierung: Unter- oder überbewertet? Schmerz 15:442–447

    Article  CAS  PubMed  Google Scholar 

  • Hildebrandt VH, Bongers PM, Dul J, Dijk FJ van, Kemper HC (2000) The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations. Int Arch Occup Environ Health 73:507–518

    Article  CAS  PubMed  Google Scholar 

  • Hoogendoorn WE, Bongers PM, Vet HC de et al. (2000) Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: results of a prospective cohort study. Spine 25:3087–3092

    Article  CAS  PubMed  Google Scholar 

  • Hurwitz EL, Morgenstern H (1999) Cross-sectional associations of asthma, hay fever, and other allergies with major depression and low-back pain among adults aged 20–39 years in the United States. Am J Epidemiol 150:1107–1116

    CAS  PubMed  Google Scholar 

  • Institut für Epidemiologie (1997) MONICA-Projekt Region Augsburg. Herz-Kreislaufstudie der Weltgesundheitsorganisation (WHO). Data-Book. Trends in cardiovascular risk factors from survey 1984/85 to survey 1994/95. München

  • Josephson M, Vingard E (1998) Workplace factors and care seeking for low-back pain among female nursing personnel. MUSIC-Norrtalje Study Group. Scand J Work Environ Health 24:465–472

    CAS  PubMed  Google Scholar 

  • Klein T (1996) Mortalität in Deutschland—Aktuelle Entwicklungen und soziale Unterschiede. In: Zapf W, Schupp J, Habich R, (eds) Lebenslagen im Wandel: Sozialberichterstattung im Längsschnitt. Campus, Frankfurt a.M. New York, pp 366–377

  • Klein T, Lowel H, Schneider S, Zimmermann M (2002) Social relationships, stress and mortality. Z Gerontol Geriatr 35:441–449

    Article  PubMed  Google Scholar 

  • Kohlmann T (2001) Bevölkerungsbezogene Epidemiologie am Beispiel chronischer Rückenschmerzen. In: Jurna I, Zenz M (eds) Lehrbuch der Schmerztherapie. Wissenschaftliche Verlagsgesellschaft, Stuttgart, pp 221–229

  • Krause N, Ragland DR, Fisher JM, Syme SL (1998) Psychosocial job factors, physical workload, and incidence of work-related spinal injury: a 5-year prospective study of urban transit operators. Spine 23:2507–2516

    Article  CAS  PubMed  Google Scholar 

  • Kristjansdottir G, Rhee H (2002) Risk factors of back pain frequency in schoolchildren: a search for explanations to a public health problem. Acta Paediatr 91:849–854

    Article  CAS  PubMed  Google Scholar 

  • Latza U, Kohlmann T, Deck R, Raspe H (2000) Influence of occupational factors on the relation between socioeconomic status and self-reported back pain in a population-based sample of German adults with back pain. Spine 25:1390–1397

    Article  PubMed  Google Scholar 

  • Leboeuf-Yde C (2000) Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine 25:226–237

    Article  CAS  PubMed  Google Scholar 

  • Leboeuf-Yde C, Kyvik KO (1998) At what age does low back pain become a common problem? A study of 29,424 individuals aged 12–41 years. Spine 23:228–234

    Article  CAS  PubMed  Google Scholar 

  • Linton SJ (2000) Psychological risk factors for neck and back pain. In: Nachemson AL, Jonsson E (eds) Neck and back pain: the scientific evidence of causes, diagnosis, and treatment. Lippincott Williams & Wilkins, Philadelphia, pp 57–78

  • Masset DF, Piette AG, Malchaire JB (1998) Relation between functional characteristics of the trunk and the occurrence of low back pain. Associated risk factors. Spine 23:359–365

    Article  CAS  PubMed  Google Scholar 

  • Miranda H, Viikari-Juntura E, Martikainen R, Takala EP, Riihimaki H (2002) Individual factors, occupational loading, and physical exercise as predictors of sciatic pain. Spine 27:1102–1109

    Article  PubMed  Google Scholar 

  • Nachemson A, Vingard E (2000) Influences of individual factors and smoking on neck and low back pain. In: Nachemson AL, Jonsson E (eds) Neck and back pain: the scientific evidence of causes, diagnosis, and treatment. Lippincott Williams & Wilkins, Philadelphia, pp 79–95

  • National Research Council, Institute of Medicine (2001) Musculoskeletal disorders and the workplace: low back pain and upper extremities. National Academy Press, Washington DC

    Google Scholar 

  • Neubauer E (2002) Entwicklung eines Kurzfragebogens zur Früherkennung des Chronifizierungsrisikos bei akuten Rückenschmerzen. Medizinische Fakultät der Ruprecht-Karls-Universität Heidelberg, Heidelberg

  • Pfingsten M, Hildebrandt J (2004) Rückenschmerzen. In: Basler H, Franz C, Kröner-Herwig B, Rehfisch H (eds) Psychologische Schmerztherapie. Springer, Berlin, pp 395–414

  • Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine 27:109–120

    Article  Google Scholar 

  • Potthoff P, Schroeder E, Reis U, Klamert A (1999) Ablauf und Ergebnisse der Feldarbeit beim Bundes-Gesundheitssurvey. Gesundheitswesen 61:62–67

    PubMed  Google Scholar 

  • Rutten A, Abel T, Kannas L et al. (2001) Self reported physical activity, public health, and perceived environment: results from a comparative European study. J Epidemiol Community Health 55:139–146

    Article  CAS  PubMed  Google Scholar 

  • Schneider S (2002) Lebensstil und Mortalität. Welche Faktoren bedingen ein langes Leben? Westdeutscher Verlag, Wiesbaden

  • Schneider S (2003) Schichtzugehörigkeit und Mortalität in der BRD: Empirische Überprüfung theoretischer Erklärungsansätze. Soz Fortsch 52:64–73

    Google Scholar 

  • Schroeder E, Potthoff P, Reis U, Klamert A (1998) Erhebungsarbeiten beim Bundes-Gesundheitssurvey. Gesundheitswesen 60:104–107

    Google Scholar 

  • Statistisches Bundesamt (1998) Gesundheitsbericht für Deutschland: Gesundheitsberichtserstattung des Bundes. Metzler-Poeschel, Wiesbaden

  • Svensson P, Cairns BE, Wang K, Hu JW, Graven-Nielsen T, Arendt-Nielsen L, Sessle BJ (2003) Glutamate-evoked pain and mechanical allodynia in the human masseter muscle. Pain 101:221–227

    Article  CAS  PubMed  Google Scholar 

  • Thefeld W, Stolzenberg H, Bellach BM (1999) Bundes-Gesundheitssurvey: Response, Zusammensetzung der Teilnehmer und Non-Responder-Analyse. Gesundheitswesen 61:S57–61

    PubMed  Google Scholar 

  • Thoren P, Floras JS, Hoffmann P, Seals DR (1990) Endorphins and exercise: physiological mechanisms and clinical implications. Med Sci Sports Exerc 22:417–428

    CAS  PubMed  Google Scholar 

  • Vezyroglou G, Mitropoulos A, Antoniadis C (1996) A metabolic syndrome in diffuse idiopathic skeletal hyperostosis. A controlled study. J Rheumatol 23:672–676

    CAS  PubMed  Google Scholar 

  • Vingard E, Nachemson A (2000) Work-related influences on neck and low back pain. In: Nachemson AL, Jonsson E (eds) Neck and back pain: the scientific evidence of causes, diagnosis, and treatment. Lippincott Williams & Wilkins, Philadelphia, pp 97–126

  • Vuori IM (2001) Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc 33:S551–586

    CAS  PubMed  Google Scholar 

  • Waddell G (1998) The back pain revolution. Churchill Livingstone, Edinburgh

  • Waddell G, Waddell H (2000) A review of social influences on neck and back pain and disability. In: Nachemson AL, Jonsson E (eds) Neck and back pain: the scientific evidence of causes, diagnosis, and treatment. Lippincott Williams & Wilkins, Philadelphia, pp 13–56

  • Winkler G, Filipiak B, Hense HW, Schwertner B (1998) Externe Qualitätskontrolle im Bundes-Gesundheitssurvey 1997/98: Konzept und erste Erfahrungen. Gesundheitswesen 60:108–112

    Google Scholar 

  • Winkler J, Stolzenberg H (1999) Der Sozialschichtindex im Bundes-Gesundheitssurvey 1997/98. Gesundheitswesen 61:178–183

    Google Scholar 

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Acknowledgements

Special thanks are due to Dr. Heribert Stolzenberg, Robert-Koch-Institut Berlin (Germany) for supplying the data sets. We also wish to thank Gwendolyn Schmitt and Christian Hauf for their assistance in data processing. This publication was supported by a grant from the research fund of the Department of Orthopaedic Surgery, University of Heidelberg (Germany).

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  1. Department of Orthopaedic Surgery, Research Department, University of Heidelberg, Schlierbacher Landstrasse 200, 69118 , Heidelberg, Germany

    Sven Schneider, Marcus Schiltenwolf, Silke M. Zoller & Holger Schmitt

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  1. Sven Schneider
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Correspondence to Sven Schneider.

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Schneider, S., Schiltenwolf, M., Zoller, S.M. et al. The association between social factors, employment status and self-reported back pain – A representative prevalence study on the German general population. J Public Health 13, 30–39 (2005). https://doi.org/10.1007/s10389-004-0085-7

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