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


METHODS
This is a cross-sectional study.


METHODS
Two thousand five hundred ten subjects aged 14-90 years were randomly selected from the German general population in 2012.


METHODS
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/m(2) ) 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.


CONCLUSIONS
BMI and depression are modifiable risk indicators for chronic disabling LBP.
Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany; Department of Psychosomatic Medicine, Technische Universität München, München, Germany.
Winfried
W
Häuser
Gabriele
G
Schmutzer
Elmar
E
Brähler
Marcus
M
Schiltenwolf
Anja
A
Hilbert
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
Back Pain; Depression; Obesity