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

doi:10.1002/acr.22890

Table 1

Demographic and behavioral characteristics of US adults, ages 20–69, with and without chronic low back pain (N = 5103).

% Total (SE%)
N = 5103 % with cLBP (SE%)
N=700 % w/o cLBP (SE%)
N=4403 Chi-Sq P-value Adjusted OR (95% CI) AOR P-value
Age
20–29 21.7 (0.8) 15.1 (1.4) 22.7 (0.9) <0.0001 1 (Ref.) <0.0001
30–39 20.4 (0.7) 18.3 (2.2) 20.7 (0.8) 1.39 (0.97–1.98)
40–49 22.6 (0.8) 19.3 (2.3) 23.1 (0.8) 1.27 (0.86–1.86)
50–59 20.9 (0.9) 27.4 (2.5) 19.9 (0.9) 2.03 (1.48–2.78)
60–69 14.5 (0.5) 20.0 (1.5) 13.6 (0.5) 2.07 (1.59–2.71)

Female gender 50.8 (0.7) 55.8 (2.6) 50.1 (0.7) 0.036 1.28 (1.03–1.58) 0.027

Race
African American 11.8 (0.9) 10.1 (1.4) 12.1 (0.9) <0.0001 1 (Ref.) 0.0001
Caucasian 66.2 (3.5) 74.9 (3.7) 64.9 (3.5) 1.52 (1.14–2.04)
Hispanic 14.5 (3.0) 11.9 (3.1) 14.9 (3.0) 0.98 (0.73–1.32)
Other 7.5 (1.2) 3.1 (0.8) 8.1 (1.3) 0.58 (0.34–0.97)

Education
College and higher 28.6 (1.3) 18.6 (2.6) 30.2 (1.5) 0.0001 1 (Ref.) 0.0002
GED/AA degree 53.6 (1.1) 60.9 (2.1) 52.5 (1.4) 1.99 (1.33–2.98)
Less than High school 17.7 (0.8) 20.6 (1.2) 17.3 (0.9) 2.27 (1.53–3.38)

Marital status
Married/living w partner 64.2 (1.0) 62.9 (2.4) 64.3 (1.0) 0.004 1 (Ref.) 0.370
Separated 15.4 (0.6) 20.6 (2.3) 14.6 (0.7) 1.22 (0.92–1.62)
Never married 18.3 (0.9) 16.5 (2.2) 21.0 (1.1) 1.02 (0.76–1.37)

Employment status
Working 69.0 (0.7) 56.3 (1.9) 71.0 (0.8) <0.0001 1 (Ref.) <0.0001
Not working 27.4 (0.6) 40.7 (1.9) 25.4 (0.6) 1.79 (1.52–2.12)
Looking for work 3.6 (0.4) 3.0 (0.7) 3.7 (0.4) 1.17 (0.76–1.79)

Annual HH income $
>100 000 23.8 (1.3) 17.4 (1.8) 24.7 (1.3) 0.0001 1 (Ref.) 0.0064
65–99 000 18.6 (1.1) 16.8 (2.0) 18.8 (1.3) 1.18 (0.75–1.86)
45–64 000 15.9 (1.3) 16.2 (2.0) 15.8 (1.3) 1.36 (0.93–1.99)
20–44 000 28.2 (1.0) 29.0 (1.6) 28.0 (1.1) 1.42 (1.05–1.93)
<20 000 13.6 (1.0) 20.6 (2.9) 12.6 (1.0) 2.29 (1.46–3.58)

Income from disability 5.7 (0.6) 12.8 (2.2) 4.6 (0.4) <0.0001 2.62 (2.01–3.41) <0.0001

BMI
<25 31.7 (1.4) 25.0 (2.4) 32.7 (1.5) 0.0004 1 (Ref.) 0.034
25–30 32.6 (1.0) 30.8 (2.1) 32.9 (1.1) 1.14 (0.92–1.42)
>30 35.7 (1.0) 44.2 (2.6) 34.4 (1.2) 1.46 (1.10–1.96)

Smoking status
Never 56.0 (1.9) 42.5 (2.6) 58.0 (2.0) <0.0001 1 (Ref.) 0.0001
Former 21.7 (1.4) 27.1 (1.8) 20.9 (1.6) 1.44 (1.12–1.86)
Current 22.3 (0.9) 30.4 (2.2) 21.1 (0.9) 1.77 (1.37–2.30)

Alcohol use, past year 70.9 (1.3) 74.4 (1.7) 70.3 (1.5) 0.04 1.21 (0.96–1.52) 0.114

Modified AUDIT-C ≥4 21.1 (1.0) 20.3 (1.5) 21.2 (1.0) 0.473 1.06 (0.86–1.30) 0.568

PHQ9 score (depression)
1–4 (none) 75.4 (1.2) 56.8 (2.9) 78.3 (1.2) <0.0001 1 (Ref.) <0.0001
5–9 (mild) 16.5 (1.0) 21.3 (2.1) 15.7 (1.1) 1.86 (1.38–2.52)
10–14 (moderate) 5.0 (0.3) 10.0 (1.3) 4.2 (0.3) 3.30 (2.46–4.44)
15–19 (moderate-severe) 2.5 (0.3) 8.7 (1.7) 1.5 (0.2) 8.29 (5.19–13.24)
20–27 (severe) 0.8 (0.2) 3.1 (0.8) 0.4 (0.1) 10.62 (5.42–20.80)

Sleep disturbances 25.2 (1.3) 52.7 (2.8) 21.0 (1.0) <0.0001 3.90 (3.22–4.73) <0.0001

Medical comorbidities
0–1 79.7 (0.9) 57.9 (2.3) 83.0 (0.7) <0.0001 1 (Ref.) <0.0001
2–3 15.7 (0.6) 27.4 (1.4) 13.9 (0.6) 2.49 (2.10–2.95)
>3 4.6 (0.5) 14.8 (2.2) 3.1 (0.3) 6.09 (4.12–9.00)

SE – standard error.
cLBP – chronic low back pain.
Chi-Sq – Chi-square.
AOR – adjusted odds ratio, adjusted for age, race, gender, education.
CI – confidence interval.
GED – general educational development.
AA – associate’s.
HH – household.
BMI – body mass index.
PHQ9 – patient health questionnaire 9.
Reference category not displayed for binary variables.

	% Total (SE%) N = 5103	% with cLBP (SE%) N=700	% w/o cLBP (SE%) N=4403	Chi-Sq P-value	Adjusted OR (95% CI)	AOR P-value
Age
20–29	21.7 (0.8)	15.1 (1.4)	22.7 (0.9)	<0.0001	1 (Ref.)	<0.0001
30–39	20.4 (0.7)	18.3 (2.2)	20.7 (0.8)		1.39 (0.97–1.98)
40–49	22.6 (0.8)	19.3 (2.3)	23.1 (0.8)		1.27 (0.86–1.86)
50–59	20.9 (0.9)	27.4 (2.5)	19.9 (0.9)		2.03 (1.48–2.78)
60–69	14.5 (0.5)	20.0 (1.5)	13.6 (0.5)		2.07 (1.59–2.71)

Female gender	50.8 (0.7)	55.8 (2.6)	50.1 (0.7)	0.036	1.28 (1.03–1.58)	0.027

Race
African American	11.8 (0.9)	10.1 (1.4)	12.1 (0.9)	<0.0001	1 (Ref.)	0.0001
Caucasian	66.2 (3.5)	74.9 (3.7)	64.9 (3.5)		1.52 (1.14–2.04)
Hispanic	14.5 (3.0)	11.9 (3.1)	14.9 (3.0)		0.98 (0.73–1.32)
Other	7.5 (1.2)	3.1 (0.8)	8.1 (1.3)		0.58 (0.34–0.97)

Education
College and higher	28.6 (1.3)	18.6 (2.6)	30.2 (1.5)	0.0001	1 (Ref.)	0.0002
GED/AA degree	53.6 (1.1)	60.9 (2.1)	52.5 (1.4)		1.99 (1.33–2.98)
Less than High school	17.7 (0.8)	20.6 (1.2)	17.3 (0.9)		2.27 (1.53–3.38)

Marital status
Married/living w partner	64.2 (1.0)	62.9 (2.4)	64.3 (1.0)	0.004	1 (Ref.)	0.370
Separated	15.4 (0.6)	20.6 (2.3)	14.6 (0.7)		1.22 (0.92–1.62)
Never married	18.3 (0.9)	16.5 (2.2)	21.0 (1.1)		1.02 (0.76–1.37)

Employment status
Working	69.0 (0.7)	56.3 (1.9)	71.0 (0.8)	<0.0001	1 (Ref.)	<0.0001
Not working	27.4 (0.6)	40.7 (1.9)	25.4 (0.6)		1.79 (1.52–2.12)
Looking for work	3.6 (0.4)	3.0 (0.7)	3.7 (0.4)		1.17 (0.76–1.79)

Annual HH income $
>100 000	23.8 (1.3)	17.4 (1.8)	24.7 (1.3)	0.0001	1 (Ref.)	0.0064
65–99 000	18.6 (1.1)	16.8 (2.0)	18.8 (1.3)		1.18 (0.75–1.86)
45–64 000	15.9 (1.3)	16.2 (2.0)	15.8 (1.3)		1.36 (0.93–1.99)
20–44 000	28.2 (1.0)	29.0 (1.6)	28.0 (1.1)		1.42 (1.05–1.93)
<20 000	13.6 (1.0)	20.6 (2.9)	12.6 (1.0)		2.29 (1.46–3.58)

Income from disability	5.7 (0.6)	12.8 (2.2)	4.6 (0.4)	<0.0001	2.62 (2.01–3.41)	<0.0001

BMI
<25	31.7 (1.4)	25.0 (2.4)	32.7 (1.5)	0.0004	1 (Ref.)	0.034
25–30	32.6 (1.0)	30.8 (2.1)	32.9 (1.1)		1.14 (0.92–1.42)
>30	35.7 (1.0)	44.2 (2.6)	34.4 (1.2)		1.46 (1.10–1.96)

Smoking status
Never	56.0 (1.9)	42.5 (2.6)	58.0 (2.0)	<0.0001	1 (Ref.)	0.0001
Former	21.7 (1.4)	27.1 (1.8)	20.9 (1.6)		1.44 (1.12–1.86)
Current	22.3 (0.9)	30.4 (2.2)	21.1 (0.9)		1.77 (1.37–2.30)

Alcohol use, past year	70.9 (1.3)	74.4 (1.7)	70.3 (1.5)	0.04	1.21 (0.96–1.52)	0.114

Modified AUDIT-C ≥4	21.1 (1.0)	20.3 (1.5)	21.2 (1.0)	0.473	1.06 (0.86–1.30)	0.568

PHQ9 score (depression)
1–4 (none)	75.4 (1.2)	56.8 (2.9)	78.3 (1.2)	<0.0001	1 (Ref.)	<0.0001
5–9 (mild)	16.5 (1.0)	21.3 (2.1)	15.7 (1.1)		1.86 (1.38–2.52)
10–14 (moderate)	5.0 (0.3)	10.0 (1.3)	4.2 (0.3)		3.30 (2.46–4.44)
15–19 (moderate-severe)	2.5 (0.3)	8.7 (1.7)	1.5 (0.2)		8.29 (5.19–13.24)
20–27 (severe)	0.8 (0.2)	3.1 (0.8)	0.4 (0.1)		10.62 (5.42–20.80)

Sleep disturbances	25.2 (1.3)	52.7 (2.8)	21.0 (1.0)	<0.0001	3.90 (3.22–4.73)	<0.0001

Medical comorbidities
0–1	79.7 (0.9)	57.9 (2.3)	83.0 (0.7)	<0.0001	1 (Ref.)	<0.0001
2–3	15.7 (0.6)	27.4 (1.4)	13.9 (0.6)		2.49 (2.10–2.95)
>3	4.6 (0.5)	14.8 (2.2)	3.1 (0.3)		6.09 (4.12–9.00)