Low Back Pain Among Medical Students: A Meta-Analysis of a Growing Global Public Health Concern

Abstract Background Low back pain (LBP) is a significant public health issue. Recent literature highlights the substantial burden of low back pain among medical students due to academic demands; however, a comprehensive global perspective on this issue remains lacking. This meta-analysis aims to assess the global prevalence of LBP among medical students and examine the associations. Methods A systematic review and meta-analysis were conducted, with searches in five major databases up until February 2025. Studies assessing LBP prevalence using the modified Nordic questionnaire were included. The AXIS tool was used for quality assessment. Random-effects meta-analysis was performed to calculate pooled estimates of LBP prevalence and odds ratios, with subgroup analyses by training stage, gender, and BMI. Results Thirty-two studies representing 15,819 medical students, were included which demonstrated a high-quality reporting. Meta-analyses showed significant pooled 12-month (-0.401, 95% CI[-0.402 - -0.401], p < 0.001) and 7-day (-1.339, 95% CI[-1.339 - -1.338], p < 0.001) LBP prevalence, with low heterogeneity (I² = 0%, p = 1). Clinical students had higher odds of LBP compared to preclinical students (OR = 0.924, 95% CI[0.784-1.064], p < 0.001). Female students had significantly higher odds than males (OR = 0.719, 95% CI[0.494-0.944], p < 0.001). Overweight students had elevated odds of LBP (OR = 0.893, 95% CI[-0.379-1.408], p = 0.007), while normal BMI, underweight and obese showed no significant association. Discussion LBP is a global public health issue among medical students, with clinical-stage students, females, and those with abnormal BMI (obese, underweight) being at higher risk. These findings underscore the need for targeted interventions, including gender-sensitive strategies to address LBP and reduce its impact on future healthcare professionals. Key messages • This meta-analysis of 15,819 medical students revealed female gender, clinical stage of study and being overweight as significantly increasing the odds of back pain worldwide. • Low back pain among medical students is a global public health concern necessitating targeted interventions are needed to reduce the burden of this occupational hazard.