Aims: Chronic back pain (CBP) is a global health problem and a leading cause of disability. Evidence suggests a co-occurrence of CBP and other chronic conditions. The types of comorbidities linked to disabling symptoms remain unclear. This study aimed to compare the prevalence of non-communicable chronic conditions between adults with and without CBP, estimate the prevalence of multimorbidity among adults with chronic back pain, and identify comorbidities associated with activity limitation in adults with CBP.
Methods: Cross-sectional study with data from Brazilian adults (aged ≥18 years) who participated in the 2019 National Health Survey (n=87,678). This survey is representative of Brazilian adults living in private households in urban andrural areas. CBP was determined by a self-reported yes or no question. Similarly, participants were asked whether theyhave ever received a diagnosis of non-communicable chronic conditions. Activity limitation was measured on a 5- point Likert scale (from no limitation to very severe). Multimorbidity was defined as the presence of ≥1 comorbidities in addition to CBP. Proportional differences and ordinal logistic regression were calculated.
Results: Of the 87,678 participants, 21.6% (n=18,930) reported having CBP. The prevalence of all non-communicable chronic conditions was higher in people with CBP compared to those without CBP. Multimorbidity was reported by 62.1% (95%CI: 61.1, 63.6) of the adults with CBP. Comorbidities significantly associated with worse activity limitation level included Arthritis/ rheumatism (OR=2.1;95%CI:1.9, 2.4), lung disease (OR=1.8;95%IC 1.3, 2.5), Depression (OR=1.6; 95%CI:1.4, 1.8), and cardiovascular disease (OR=1.5; 95%CI: 1.3, 1.6).
Conclusion: Chronic conditions and multimorbidity affected more than half of adults with CBP, contributing to greater activity limitations. Healthcare professionals should consider the presence of other non-communicable chronic conditions when assessing and managing patients with CBP.