Epidemiology of low back pain: An experience from patients attending physiotherapy sessions at a national hospital in Tanzania

Abstract

Background: Lower Back Pain (LBP) is a common health condition affecting a large portion of the world population, often leading to considerable disability and significant healthcare costs, particularly in low-resource settings like Tanzania. Various factors have been implicated such as socio-demographic, occupation and lifestyle related. Previously, LBP was seen in the elderly; however, there is a significant rise in the number of patients in the working age group which resulted in functional disability and reduction of productivity necessitating the need for early interventions.

Objective: We aimed at studying the epidemiology of lower back pain among patients attending physiotherapy sessions at Muhimbili Orthopaedic Institute (MOI), Tanzania. To investigate the sociodemographic factors; disease duration, severity and level of disability; and factors associated with functional disability due to low back pain among patients attending physiotherapy sessions at MOI, Tanzania.

Methods: A hospital based descriptive cross-sectional study was conducted among patients with lower back pain attending physiotherapy sessions at MOI. A Swahili version structured questionnaire was used to collect data on social demographic characteristics, duration of pain, pain severity and functional disability using Oswestry Disability Index (ODI) Score by convenient sampling method.

Results: Two hundred and twelve participants were enrolled with the mean age of 52.67± 13.69 years, with the majority of them (50.9%) between the ages of 40-60 years. Females comprised 70.3% of the participants and 59.4% of them reported prolonged sitting (>4 hours) at work. Chronic LBP was reported in 95.8% of participants, most of which had moderate pain level (53.3%). Based on the Oswestry Disability Index, 48.1% had mild disability, 39.6% moderate, 7.1% severe, and 5.2% had no disability. Significant factors associated with disability included prolonged driving (AOR=3.592, 95% CI: 1.171–10.875, p=0.025), lifting heavy objects (AOR=0.502, 95% CI: 0.255–0.994, p =0.046), employed (AOR = 3.096, 95% CI: 1.354–7.148, p = 0.007), marital status (married/cohabiting) (AOR = 0.392, 95% CI: 0.210–0.738, p = 0.021) and educational level (AOR=45.33 for no schooling, 95% CI: 3.563–574.650, p=0.003).

Conclusion: There were a significant number of patients with chronic low back pain in our setting most of which were associated with prolonged sitting, heavy lifting, being employed, married or cohabiting and low education as predictors of functional disability among them. These findings highlight the need for targeted occupational and educational interventions to mitigate disability risks.