INFLUENCE OF PHYSICAL, PSYCHOLOGICAL AND BEHAVIORAL-FACTORS ON CONSULTATIONS FOR BACK PAIN

Over 34 000 questionnaires were used to study occurrence and consultat ions for back pain in the community. The 12-month period prevalence wa s 24% and 13% of the sample consulted a doctor. Elderly women were at greatest risk of back pain. The consultation rate increased in both se xes throughout middle age, but declined in men over the age of 55 yr. Back pain was associated with the Goldberg General Health Health Quest ionnaire score suggesting psychiatric morbidity [odds ratio (OR) = 2.0 5; confidence interval (CI) 1.89-2.23], obesity (OR = 1.59; CI 1.40-1. 79), and cigarette smoking (OR = 1.52; CI 1.36-1.70). Vigorous daily a ctivity was positively associated with back pain in men aged 18-39 yr (OR = 1.37; CI 1.02-1.85), and women aged 18-39 yr (OR = 1.50; CI 1.08 -2.09), but was negatively associated with back pain in women aged ove r 65 yr (OR = 0.35; CI 0.16-0.76). Alcohol consumption was also negati vely associated with back pain (OR = 0.72; CI 0.62-0.85). The prevalen ce of arthritis, constipation and respiratory disorders was increased in those who consulted for back pain corrected for the other variables . Thus back pain was substantially more common in women compared to me n over 55 yr, Psychiatric morbidity, cigarette smoking and obesity wer e associated with back pain at all ages, but the effect of physical ex ercise appeared to change with age. Further studies are required to ex plain the sex differences and nature of the associations.