Epidemiology of chronic low back pain in US adults: The National Health and Nutrition Examination Survey 2009-2010

University of Minnesota M.S. thesis. May 2016. Major: Clinical Research. Advisor: Robert Foley. 1 computer file (PDF); v, 22 pages.Abstract Objective: To describe epidemiologic characteristics and associations with increased healthcare utilization in US adults with chronic low back pain (cLBP). Methods: NHANES back pain survey 2009-2010, administered to adults aged 20- 69 (N = 5103). cLBP was defined as pain in the area between the lower posterior margin of the rib cage and the horizontal gluteal fold, with a history of pain lasting almost every day for at least 3 months. Demographic and behavioral characteristics were compared between those with cLBP and without. Factors, associated with ≥10 healthcare visits/year were evaluated in the cLBP subgroup (N=700). Results: cLBP associations with adjusted odds ratios (aORs) ≥2 included age 50-69, education less than high school, annual household income <$20 000, income from disability, depression, sleep disturbances, and medical comorbidities. Subjects with cLBP were more likely to be covered by government-sponsored insurance plans: aOR 3.23 ([95% CI] 2.19-4.75) for Medicaid, aOR 2.25 (1.57-3.22) for Medicare (p < 0.0001), and visited healthcare providers more frequently: aOR 3.35 (2.40-4.67) for ≥10 healthcare visits in the past year (p < 0.0001). In the cLBP subgroup aORs ≥2 were found for associations between ≥10 visits per year and unemployment, income from disability, depression, and sleep disturbances. Conclusion: US adults with cLBP are socio-economically disadvantaged, make frequent healthcare visits and are often covered by government-sponsored health insurance. The clustering of behavioral, psychosocial, and medical issues should be considered in the care of Americans with cLBP