Prevalence of low back pain and concurrent psychological distress over a 16-year period.
OBJECTIVE
To investigate time trends of low back pain (LBP) and concurrent psychological distress in the general population.


METHODS
Every 4 years between 1990 and 2006, a self-administered questionnaire including the General Health Questionnaire (GHQ-12) and a question on LBP were sent to a random sample of the population in the county of Stockholm (response rate 61-69%). All individuals aged 21-64 years in the five samples (n = 1976-26,611) were included in the study.


RESULTS
Among women, the prevalence of self-reported LBP rose rather moderately during the 16-year period, from 12.5% to 16.4% (prevalence rate ratio (PRR) 1.31; 95% CI 1.11 to 1.55). The prevalence did not change at all among men (PRR 1.02; 95% CI 0.85 to 1.23). In contrast, the prevalence of LBP with concurrent psychological distress rose more substantially, from 2.6% to 5.9% among women (PRR 2.23; 95% CI 1.53 to 3.24) and from 1.9% to 3.5% among men (PRR 1.82; 95% CI 1.14 to 2.90). The prevalence of both LBP and LBP with concurrent psychological distress seemed to fluctuate somewhat over the period.


CONCLUSIONS
Between 1990 and 2006, the focus of discussion of the high societal costs for sickness absence and disability pensions gradually shifted from musculoskeletal disorders to psychological well-being. As a result, the general population's awareness and perception of pain and psychological distress may have changed and, in turn, affected individuals' willingness to report these symptoms. Further research is necessary to investigate the impact of cultural changes on subjective symptom reporting.
Leijon
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O
Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Norrbacka, 4th floor, SE 171 76 Stockholm, Sweden. ola.leijon@ki.se
Mulder
M
M
D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult