title: Rising prevalence of back pain in Austria: considering regional disparities.
abstract: BACKGROUND
  Back pain is the most common form of musculoskeletal conditions and leads to high health care costs. Information about geographic variations in highly prevalent diseases/disorders represents important implications for public health planning to face structural challenges. The present study aims to investigate regional trends in the prevalence of back pain and the role of obesity and social inequalities among Austrian adults.
  
  
  METHODS
  A secondary data analysis based on five nationally representative cross-sectional surveys (1973-2007) was carried out (N = 178,818). Back pain was measured as self-reported presence. Obesity (BMI ≥ 30 kg/m²) was adjusted for self-report bias. For the regional analyses, Austria was divided into Western, Central and Eastern Austria. A relative index of inequality (RII) was computed to quantify the extent of social inequality.
  
  
  RESULTS
  A continuous rise in back pain prevalence was observed in the three regions and among all investigated subgroups. In 2007 the age-standardised prevalence was similar in Central (36.9 %), Western (35.2 %) and Eastern Austria (34.3 %). The absolute change in back pain prevalence was highest among obese subjects in Central Austria (women: + 29.8 %, men: + 32.5 %). RIIs were unstable during the study period and in 2007 highest in Eastern Austria.
  
  
  CONCLUSIONS
  Variation and trends in back pain are not attributable to geographic variation in Austria: an assumed East-West gradient in Austria has not been confirmed. Nevertheless our study confirms that back pain dramatically increased in all Austrian regions and investigated subgroups. This worrying trend should be further monitored and public health interventions should be implemented increasingly, especially among obese women and men.
authors.affiliation: Institute of Nursing Science, Medical University of Graz, Billrothgasse 6, 8010, Graz, Austria. franziska.grossschaedl@medunigraz.at.
authors.forename: Franziska
authors.initials: F
authors.lastname: Großschädl
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria.
authors.forename: Erwin
authors.initials: E
authors.lastname: Stolz
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria.
authors.forename: Hannes
authors.initials: H
authors.lastname: Mayerl
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria.
authors.forename: Éva
authors.initials: É
authors.lastname: Rásky
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Freidl
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria. willibald.stronegger@medunigraz.at.
authors.forename: Willibald J
authors.initials: WJ
authors.lastname: Stronegger
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D017678:Sex Distribution; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Back pain; Geographic variation; Long-term trend; Obesity; Social inequality