The impact of body weight and depression on low back pain in a representative population sample

Abstract

Objective: Low back pain (LBP), obesity, and depression are highly prevalent health conditions. We assessed the relative impact of body weight and depression on different types of LBP in a representative population sample. Design: This is a cross-sectional study. Setting and Patients: Two thousand five hundred ten subjects aged 14-90 years were randomly selected from the German general population in 2012. Measures: Pain sites and duration of pain were assessed by the Widespread Pain Index( WPI), depression by the Beck Depression Inventory Primary Care Questionnaire, disability by the European Organization for Research and Treatment of Cancer questionnaire, and current body mass index (BMI, kg/m2) by self-reported body weight and height. Widespread pain was defined by ≥7/19 pain sites in the WPI. Hierarchical logistic regression analyses were performed with different types of LBP as the dependent variable, and age, gender, lifetime employment status as a worker, number of pain sites, BMI, and depression as independent variables. Results: One thousand six hundred eighty-seven (67.1%) of participants reported no pain. Five hundred six (20.2%) reported chronic LBP and 84 (3.3%) reported disabling chronic LBP. Age (odds ratio [OR] 1.05 [95% confidence interval {CI} 1.04-1.06]), BMI (OR 1.08 [95% CI 1.05.-1.11]), and depression (OR 1.38 [95% CI 1.30-1.49]) independently predicted chronic LPB compared with persons without pain. Age (OR 1.07 [95% CI 1.05-1.09]), BMI (OR 1.07 [95% CI 1.03-1.13]), and depression (OR 1.71 [95% CI 1.55-1.88]) independently predicted disabling chronic LPB compared with persons without pain. Age (OR 1.03 [95% CI 1.01-1.05]), widespread pain (OR 5.23 [95% CI 3.04-9.00), and depression (OR 1.34 [95% CI 1.16-1.55]) independently predicted disabling chronic LPB compared with persons with nondisabling chronic LBP. Conclusion: BMI and depression are modifiable risk indicators for chronic disabling LBP. © 2014 American Academy of Pain Medicine.