Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study

Mohammad Ghafouri; Azin Teymourzadeh; Amin Nakhostin-Ansari; Sadaf G Sepanlou; Sahar Dalvand; Farhad Moradpour; Amir Hooshang Bavarsad; Shahrokh Sadeghi Boogar; Morteza Dehghan; Alireza Ostadrahimi; Javad Aghazadeh-Attari; Mahmood Kahnooji; Ali Hosseinipour; Ali Gohari; Seyed Vahid Hosseini; Masoud Mirzaei; Alireza Khorram; Mehdi Shahmoradi; Farhad Pourfarzi; Mahmood Moosazadeh; Fariborz Mansour-Ghanaei; Hossein Marioryad; Farid Najafi; Stephane Genevay; Navid Moghadam; Ramin Kordi

doi:10.1016/j.amsu.2022.103243

Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study

Ann Med Surg (Lond). 2022 Jan 10:74:103243. doi: 10.1016/j.amsu.2022.103243. eCollection 2022 Feb.

Authors

Mohammad Ghafouri¹, Azin Teymourzadeh², Amin Nakhostin-Ansari^{1

3}, Sadaf G Sepanlou⁴, Sahar Dalvand^{5

6}, Farhad Moradpour⁷, Amir Hooshang Bavarsad⁸, Shahrokh Sadeghi Boogar⁹, Morteza Dehghan¹⁰, Alireza Ostadrahimi¹¹, Javad Aghazadeh-Attari¹², Mahmood Kahnooji¹³, Ali Hosseinipour¹⁴, Ali Gohari¹⁵, Seyed Vahid Hosseini¹⁶, Masoud Mirzaei¹⁷, Alireza Khorram¹⁸, Mehdi Shahmoradi¹⁹, Farhad Pourfarzi²⁰, Mahmood Moosazadeh²¹, Fariborz Mansour-Ghanaei²², Hossein Marioryad²³, Farid Najafi²⁴, Stephane Genevay²⁵, Navid Moghadam¹, Ramin Kordi¹

Affiliations

¹ Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
³ Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
⁸ Department of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁹ Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
¹⁰ Department of Orthopedics, School of Medicine, And Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
¹¹ Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
¹² Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.
¹³ Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
¹⁴ Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
¹⁵ Department of Clinical Biochemistry and Nutrition, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
¹⁶ Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
¹⁷ Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
¹⁸ Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
¹⁹ Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
²⁰ Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
²¹ Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
²² Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
²³ Yasuj University of Medical Sciences, Yasuj, Iran.
²⁴ Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
²⁵ Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.

Abstract

Background and objectives: Low back pain (LBP) is a common health condition in populations. Limited large-scale population-based studies evaluated the prevalence and predictors of LBP in developing countries. This study aimed to evaluate the prevalence and factors associated with LBP among the Iranian population.

Methods: We used baseline information from the Prospective Epidemiological Research Studies in Iran (PERSIAN), including individuals from 16 provinces of Iran. LBP was defined as the history of back pain interfering with daily activities for more than one week during an individual's lifetime. Various factors hypothesized to affect LBP, such as age, sex, marital status, educational status, ethnicity, living area, employment status, history of smoking, body mass index (BMI), physical activity, sleep duration, wealth score, history of joint pain, and history of morning stiffness in the joints were evaluated.

Results: In total, 163770 Iranians with a mean age of 49.37 (SD = 9.15) were included in this study, 44.8% of whom were male. The prevalence of LBP was 25.2% among participants. After adjusting for confounders, the female gender [OR:1.244(1.02-1.50)], middle and older ages [OR:1.23(1.10-1.33) and OR:1.13(1.07-1.42), respectively], being overweight or obese [OR:1.13(1.07-1.19) and OR:1.21(1.16-1.27), respectively], former and current smokers (OR:1.25(1.16-1.36) and OR:1.28(1.17-1.39), respectively], low physical activity [OR:1.07(1.01-1.14)], and short sleep duration [OR: 1.09(1.02-1.17)] were significantly associated with LBP.

Conclusion: In this large-scale study, we found the lifetime prevalence of LBP to be lower among the Iranian population in comparison to the global prevalence of LBP; further studies are warranted to evaluate the causality of risk factors on LBP.

Keywords: BMI, body mass index; Iran; LBP, low back pain; Low back pain; PERSIAN; Prevalence; YLD, years of healthy life lost due to disability.