title: Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women.
abstract: OBJECTIVE
  This study aims to explore the relationship between socio-psychological stress and low back pain (LBP) prevalence among Chinese middle-aged women.
  
  
  BACKGROUND
  Women in mid-life experience increasing socio-psychological stress because of midlife transitions, stressful life events and housework or work factors. Encountering socio-psychological stress itself may result in the manifestation of LBP.
  
  
  METHODS
  A case-control study of Hong Kong community-based middle-aged women was conducted. The study subjects were either from the University Family Medicine Clinic or from a previous population-based cross-sectional study of middle-aged women conducted by Department of Community and Family Medicine. Among the 928 potential eligible subjects from both sources, a total of 182 cases and 235 controls participated in this study. Data were collected from face-to-face interviews and included demographic factors, menopausal status, socio-psychological stress and occurrence of LBP. Socio-psychological stress covered social factors, self-reported nature of housework/work, housework/work stress and stressful life events.
  
  
  RESULTS
  Among the 182 cases who entered this study, 83 women (45.6%) had experienced 1-<14 days of LBP, and 99 women (54.4%) had at least 14 days of LBP in the previous 12 months. Those who reported that 'their family members, relatives or friends were very sick, died, needed her to take care of them or who they worried about in the past 12 months' had an increased risk of LBP of 67% (95% confidence interval (CI) 1.09-2.55). In addition women with a bad or ordinary relationship with cohabitants had an increased risk of LBP of 70% (95% CI 1.00-3.04). Lastly, women with a high housework or work stress had an increased risk of suffering both types of LBP of nearly two- and half-fold (95% CI 1.61-3.85).
  
  
  CONCLUSIONS
  The results indicate that an association exists between high socio-psychological stress and LBP prevalence. Alleviating the impact of housework or work related factors would, however, involve improving both the work and home environment.
authors.affiliation: Department of Nursing and Health Sciences, Faculty of Health and Social Studies, Hong Kong Polytechnic University, Hong Kong, China. hsvyip@inet.polyu.edu.hk
authors.forename: Y B
authors.initials: YB
authors.lastname: Yip
authors.forename: S C
authors.initials: SC
authors.lastname: Ho
authors.forename: S G
authors.initials: SG
authors.lastname: Chan
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002681:China / Q000208:ethnology; D005260:Female; D005783:Gender Identity; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D017116:Low Back Pain / Q000208:ethnology* / Q000209:etiology*; D008593:Menopause / Q000208:ethnology / Q000502:physiology / Q000523:psychology; D008875:Middle Aged; D008960:Models, Psychological; D015404:Nursing Methodology Research; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000208:ethnology*; D011795:Surveys and Questionnaires; D016387:Women's Health; D014937:Work