The prevalence and psychosocial risk factors of chronic low back pain in KwaZulu-Natal

Background: Chronic low back pain (CLBP) is the leading cause of disability and has been extensively investigated in high-income countries (HICs), with little done in low-and middle income countries. Biomechanical stressors do not have a major pathogenic role, but psychosocial predisposition is important. The occurrence and progression of CLBP are significantly affected by psychosocial risk factors. Guidelines recommend the early identification of psychosocial factors that could predict CLBP. Aim: To determine the prevalence and psychosocial risk factors for CLBP amongst adults in KwaZulu-Natal, South Africa. Setting: The study was conducted at five randomly selected public hospitals in KwaZulu-Natal. Methods: Analytical cross-sectional hospital-based study utilising a self-administered questionnaire to collect data on (1) sociodemographic, (2) disability, (3) fear-avoidance beliefs and (4) illness behaviour. The Statistical Package for the Social Sciences (SPSS) 24.0 was used for data cleaning and descriptive statistics. Chi-square test was used for categorical variables. Standard Edition of the Statistical Software for Data Science version 17.0 (STATA 17.0 SE) was used to identify risk factors using the logistic regression analysis. A p-value of <= 0.05 was deemed statistically significant. Results: Overall prevalence of CLBP was 22.2% (95% confidence interval [CI]: 18.8-25.9). Females had a higher prevalence of CLBP than males, 23.9% (95% CI: 19.4-28.9) and 19.7% (95% CI: 14.8-25.5), respectively; however, the difference was not significant p = 0.243. The multivariate regression analysis identified the following risk factors: female gender, middleaged adults 38-47 years, obesity, disease conviction, affective disturbance, denial and fear avoidance behaviour-work subscale. Conclusion: There is a high prevalence of CLBP amongst the study participants. Psychosocial factors (disease conviction, affective disturbance and fear-avoidance behaviour about work) are significant predictors of CLBP.