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Disability Among Persons With Chronic Severe Back Pain: Results From a Nationally Representative Population-based Sample

  • Debbie Ehrmann Feldman
    Correspondence
    Address reprint requests to Debbie Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, Pavillon 7077 du Parc, C.P. 6128, Succ. Centre-ville, Montréal, QC H3C3J7, Canada.
    Affiliations
    School of Rehabilitation, Faculty of Medicine, Physiotherapy Program and School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Centre for interdisciplinary research in rehabilitation, CReSP: Center for Research in Public Health, Université de Montréal, Montreal, Canada
    Search for articles by this author
  • Richard L. Nahin
    Affiliations
    National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
    Search for articles by this author
Published:September 08, 2022DOI:https://doi.org/10.1016/j.jpain.2022.07.016

      Highlights

      • Prevalence of chronic pain with severe back pain is 8.2% in US adults.
      • Many have disability related to mobility and work limitations.
      • A third are limited for social participation and a sixth have self-care limitations.
      • Unsuccessful pain management is associated with greater disability.

      Abstract

      We evaluated the association between the chronic severe back pain with disability and participation, in U.S. Adults using data from the US 2019 National Health Interview Survey. In our sample of 2,925 adults (weighted n: 20,468,134) who reported having chronic severe back pain, 60% reported mobility disability, 60% had work limitations, 34% were limited for social participation and 16% had self-care limitations. Older age (65+) was associated with mobility difficulties (OR 1.99, 95% CI 1.28,6.09) and work limitation (OR 2.21, 95% CI 1.61,3.05). Lower socioeconomic status was associated with increasing odds of disability across the 4 categories. Being obese was only associated with mobility difficulties (OR 1.95, 95% CI 1.41,2.71), while not working in the past week was associated with difficulties in mobility (OR 3.55, 95% CI 2.64,4.75), self-care (OR 3.34, 95% CI 2.20,5.08), and social participation (OR 3.20, 95% CI 2.13,4.80). Comorbidities were highly associated with limitations in all 4 categories. Those deeming their ability to manage their pain ineffective were twice as likely to have limitations in self-care, social and work participation but not mobility. Identifying factors associated with disability and limitation may help target appropriate management for persons with chronic pain at high risk for disability.

      Perspective

      We evaluated the association between the chronic severe back pain with disability and participation, in a representative sample of Americans. Identifying factors associated with a likelihood of disability may help target appropriate pain management for persons at high risk for disability due to chronic severe back pain.

      Key words

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