Background Back pain is a major public health issue, causing greater disability worldwide than any other condition. Given the limited treatment options available, an understanding of the predictors of back pain is vital to optimize preventive strategies. Women are not only more likely to suffer from back pain, they are also more likely to utilise health care services to a greater extent than men. However, few studies to date have examined modifiable predictors of back pain in middle-aged women, with exposure and outcome measures assessed at multiple time points and major inconsistency and knowledge gaps persist in this area.
Objectives Our aim was to identify modifiable risk factors for back pain in middle-aged women.
Methods Women born between 1946 and 1951 were randomly selected from the Australian national health insurance scheme database to participate in The Australian Longitudinal Study of Women's Health. Self-reported data on back pain in the last 12 months, weight, height, age, physical activity, depression, menopause status and other socio-demographic factors were collected in 1998, 2001, 2004, 2007, 2010 and 2013. In 1998, 12,338 women completed the survey and 10,011 (74%) completed the 2013 survey 15 years later.
Results At baseline, median (range) age was 49.5 (44.6 – 53.5) years and 54% reported back pain. In longitudinal multivariate analysis, baseline weight (per 5kg increments) and depression were independent predictors of back pain over each 3 year survey interval and over the following 15 year period, whereas participation in vigorous physical activity was protective. Mean weight gain over the first three years of 1.4kg was associated with an increased risk of back pain over the following 12 years (multivariate OR 1.01, 95% CI 1.01–1.02). The effects of weight on back pain were not affected by participation in vigorous physical activity, being menopausal, or depression status, but the association between weight and back pain tended to be more consistent in those who were overweight or obese.
Conclusions Back pain is common in middle-aged women. Increased weight, weight gain and depression were independent predictors of back pain over 15 years, whereas participation in vigorous physical activity was protective. Targeting these lifestyle factors is an important area for future research on reducing the burden of back pain in middle-aged women.
Disclosure of Interest None declared
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