Personal Factors Associated with Low Back Pain Generated from a Large Population Analysis of the UK Biobank

BACKGROUND: Low back pain (LBP) is a common musculoskeletal complaint and the leading cause of disability worldwide. Studies involving limited cohorts have investigated risk factors for LBP; however, few have examined a comprehensive range of variables including personal factors within a large population-level database. The purpose of this study was to investigate personal factors associated with LBP with the intent to understand how it could be more effectively treated. METHODS: The UK Biobank is a large prospectively collected, population-level database, which contains numerous sociodemographic, clinical, lifestyle, and personal factors. Patients who reported LBP during a visit with their primary care provider between 2006 and 2010 were included. Continued/recurrent LBP was evaluated at follow-up in 2014. Bivariate and multivariable logistic regression analyses were done. RESULTS: Of 501,509, there were 145,855 (29.1%) who reported LBP at initial visit. LBP was associated with being overweight/obese (OR, 1.17/1.45), identifying as Asian (OR, 1.5), driving to work (OR, 1.13), active job (OR, 1.15), salaries <30K/yr (OR, 1.15), >3 hr/d watching TV (OR, 1.2), decreased sleep (OR, 1.09), anxiety/depression (OR, 1.20/1.26), and opioid use (OR, 3.8). Of the 145,855 who reported LBP, 51,131 were seen at follow-up in 2014, 10,706 (21.0%) reported LBP again. Significant factors were being male (OR, 1.36), active job (OR, 1.16), thyroid disease (OR, 1.19), and being retired (OR, 1.20) (P < 0.05 for all variables). CONCLUSIONS: Numerous personal factors are associated with LBP which present opportunities for the expansion of how care is provided for patients with this issue. A whole-person approach, focusing on activity modifications, sleep, nutrition, weight control, and mental/social health support, would be beneficial. LEVEL OF EVIDENCE: Level III retrospective cohort study.