THE RELATION OF SELF-REPORTED BACK PAIN TO PSYCHOSOCIAL, BEHAVIORAL, AND HEALTH-RELATED FACTORS IN A WORKING POPULATION IN SWITZERLAND

Back pain causes a considerable loss of working days as well as health care costs and therefore represents a major public health problem in industrialized countries. Psychosocial factors have received increasin g attention from researchers studying the causal factors of non-specif ic back pain. However, most studies focus on few dimensions, like indi vidual or work-related factors. We studied the simultaneous associatio n of various factors representing psychosocial, behavioral, and health -related dimensions to self-reported back pain. Data from the Berne Wo rkplace Health Project on 850 employed men and women was analyzed. Bac k pain was operationalized by a dichotomized variable (having suffered moderately to severely from back pain in the preceding four weeks). T he theoretical model guiding the underlying project was a general dema nd-resource model. Variables that-according to that model-were hypothe sized to be related to back pain as well as more specific factors-like physical work load-were analyzed by stepwise logistic regression anal ysis. in men, there was a statistical trend (P < 0.1) for several work -related factors (low job discretion, high job demands, low job satisf action). In women, dissatisfaction with salary was the only work-relat ed factor associated with back pain. There was no significant associat ion between private context factors, like poor social network or high demands/low control, and back pain. Only in men, the likelihood of bac k pain increased with age, while only in women, back pain was associat ed with emotional problems (individual factors). Among the behavioral factors, smoking was associated to back pain in men, while in women no ne of the behavioral factors was significant. In both men and women re porting more than two functional symptoms and a history of intestinal problems were associated to back pain. All of our findings were in the expected direction, i.e. it was invariably unfavorable categories of explanatory variables that were associated with higher prevalence of b ack pain. However, most associations seem to be quite unspecific. Ther e is a need for theoretically guided research aiming at the developmen t of a more complex process model of back pain. Copyright (C) 1996 Els evier Science Ltd