Aug 2026· British Journal of Healthcare and Medical Research· Vol 13, pp. 295-303· 0 citations
TL;DR
Low back pain at MTRH affects middle-aged females with high BMI, was chronic and mechanically aggravated, and high index of suspicion is required to make accurate clinical diagnosis.
Abstract
Background: Low back pain (LBP) is a common musculoskeletal condition and a leading cause of disability worldwide, contributing to reduced quality of life and economic burden. Despite its high prevalence, there remains variability in its clinical presentation across different populations, particularly in low- and middle-income countries. Objective: To describe the clinical findings in patients presenting with low back pain at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Methods: A hospital-based cross-sectional study at MTRH (September 2024–August 2025) included 218 adults with low back pain who underwent lumbosacral X-ray and MRI. Consecutive sampling was used. Socio-demographic and clinical data were collected using structured tools and analyzed using STATA version 18 and summarized using descriptive statistics. Results: The mean age of participants was 51.2 years, with a female predominance (60.6%). Majority were overweight (32.1%) or obese (58.3%). A total of 74.8% of the participants presented with gradual onset pain with 45.4% presenting with symptoms lasting more than 12 weeks. Pain was sharp or aching in nature, with moderate intensity pain being most frequently reported. Aggravating factors included prolonged standing, sitting, and physical activity. Exercise and postural changes provided relief. Sciatic pain affected 31.7% of patients, and over one-third were unable to work due to functional limitation. Conclusion: Low back pain at MTRH affects middle-aged females with high BMI, was chronic and mechanically aggravated. Recommendation: High index of suspicion is required to make accurate clinical diagnosis. Further research on LBP is required as there is paucity of publications in developing countries.
The findings highlight the importance of routine use of validated SIJ provocation test clusters together with pain and hip/lumbar ROM assessment to facilitate timely diagnosis and targeted management in patients with LBP.
Nouman Khan, Sadia, Iqra Asad et al.· The Healer Journal of Physio...· 0 citations
BACKGROUND
Chronic lower back pain (CLBP) is a common health problem affecting individuals worldwide. However, studies concerning the prevalence of CLBP among undergraduates are scarce. University students represent a unique population because they are at a formative stage of life with academic demands, prolonged sitting during lectures and study sessions, and lifestyle factors that may increase risk. Additionally, CLBP in this population can impact performance, career trajectory, and long-term health outcomes, making early identification and intervention valuable. This study aimed to determine the prevalence and factors associated with CLBP and its impact on health-related quality of life (HRQoL) among undergraduates at Gulu University, Uganda.
METHODS
Between November 1 and November 30, 2023, a cross-sectional study was conducted using self-administered questionnaires. CLBP was defined as non-specific lower back pain lasting 12 weeks or more. The Oswestry Disability Index was used to evaluate disability associated with CLBP, and the EuroQoL-5D-5 L was used to evaluate HRQoL (higher scores indicate better HRQoL). Data were analysed using Mann-Whitney U test for non-normally distributed continuous variables and chi-square test for categorical variables.
RESULTS
We enrolled 394 participants, 79.2% (n = 312) were males, with a median age of 23 (IQR: 22-24) years. The prevalence of CLBP was 20.6% (n = 81). With respect to HRQoL scores (median (IQR)), both overall health (0.83 (0.75-0.9) versus 0.67 (0.61-0.78), p < 0.001) and self-reported health (80 (65-90) versus 65 (50-80), p < 0.001) were worse in participants with CLBP than in those without CLBP. Among participants with CLBP, 45.7% (n = 37) reported minimal disability, 34.6% (n = 28) reported moderate disability, and 19.7% (n = 16) reported severe disability on the Oswestry Disability Index.
CONCLUSIONS
CLBP affects one in five (20.6%) undergraduates at Gulu University, with 54.3% experiencing moderate to severe disability. Both overall health scores (median 0.67 vs. 0.83, p < 0.001) and self-reported health (median 65 vs. 80, p < 0.001) were significantly worse in those with CLBP. These findings highlight the urgent need for university-based screening programmes, ergonomic interventions, and accessible rehabilitation services to address this highly prevalent condition and its substantial impact on students' quality of life and academic performance.
Martha Lucky Tino, I. Pitua, Monica Lillian Nakyeyune et al.· BMC Musculoskeletal Disorder...· 0 citations
BACKGROUND
Nonspecific back pain is increasingly encountered in pediatric orthopaedic clinics. These visits are often complex and time-intensive, yet surgical intervention is rarely indicated. This study describes the characteristics of patients presenting with back pain at a single pediatric institution and examines associated biopsychosocial factors.
METHODS
An IRB-approved retrospective review was conducted of patients aged 7 to 22 years presenting with back pain to pediatric orthopaedic and sports medicine clinics in 2021. Demographic, clinical, imaging, and behavioral health data were extracted from the electronic medical record. Patients were categorized based on the presence or absence of structural spine diagnoses. Comparative analyses were performed between groups. Multivariable logistic regression was used to identify independent predictors of persistent symptoms at follow-up.
RESULTS
A total of 869 patients were included [mean age: 15.0±2.6 y; 537 (61.8%) female]. Chronic back pain was present in 631 patients (72.6%), and structural diagnoses were identified in 327 patients (37.6%), most commonly spondylolysis (14.6%) and scoliosis (14.3%). Behavioral health diagnoses were documented in 328 patients (37.7%). Pain severity did not differ significantly between patients with and without structural diagnoses (5.6±2.3 vs. 5.5±2.2; P=0.07). However, patients without structural diagnoses demonstrated significantly higher rates of behavioral health conditions (41.2% vs. 32.1%; P<0.001), including depression, ADHD, behavioral concerns, and suicidal ideation. On multivariable analysis, behavioral health diagnoses were independently associated with persistent symptoms (adjusted OR: 1.78, 95% CI: 1.32-2.41; P<0.001), whereas structural diagnosis was not (adjusted OR: 0.89, 95% CI: 0.65-1.23; P=0.48). Higher pain severity was also associated with symptom persistence (adjusted OR: 1.12 per point increase, 95% CI: 1.05-1.20; P=0.001).
CONCLUSIONS
In pediatric back pain, structural pathology was not independently associated with symptom persistence. Behavioral health factors demonstrated stronger associations with symptom burden and clinical outcomes, supporting a biopsychosocial model of care. Routine integration of behavioral health assessment may improve management and reduce persistent symptoms in this population.
LEVELS OF EVIDENCE
Level III-retrospective cohort study.
Heather M Richard, M. Shobode, Asahi Murata et al.· Journal of pediatric orthope...· 0 citations
Background Chronic low back pain (CLBP) is a leading cause of disability worldwide and is increasingly recognized as a condition influenced by altered central pain processing. Central Sensitization (CS), characterized by amplified nociceptive signaling within the Central Nervous System (CNS), may contribute to persistent pain, disability and poor treatment response in patients with CLBP. Despite the high burden of CLBP in Uganda, there is lack of local epidemiological data on CS. This study determined the prevalence and associated factors of CS among patients with CLBP attending Mbarara Regional Referral Hospital (MRRH). Methods A hospital-based cross-sectional study was conducted among 304 consecutively recruited adults with CLBP attending MRRH between October 2025 and January 2026. CS was assessed using the Central Sensitization Inventory (CSI), with a score ≥40 defining CS. Sociodemographic, clinical, psychological, and lifestyle data were collected using interviewer-administered questionnaires. Modified Poisson regression identified factors independently associated with CS. Results The mean age of participants was 56.5 ± 16.2 years, and 55.9% were female. The prevalence of CS was 33.9% (n=103; 95% CI: 28.9–39.4). Moderate to severe anxiety (aPR=3.24, 95% CI: 2.27–4.63), depression (aPR=1.63, 95% CI: 1.24–2.16), smoking (aPR=1.41, 95% CI: 1.04–1.91), opioid use (aPR=1.36, 95% CI: 1.02–1.81) and topical analgesics (aPR=1.43, 95% CI: 1.004–2.04) were independently associated with CS. Conclusion Approximately one-third of patients with CLBP at MRRH exhibited features of CS. CS was associated with psychological distress, smoking, and certain analgesic use patterns. These findings reinforce the need for a biopsychosocial model of care in the assessment and management of CLBP, incorporating evaluation of central pain mechanisms, psychological distress, and other social factors that contribute to pain and disability, while prospective longitudinal studies are needed to clarify temporal relationships and causal pathways.
Marven Robert Ruyonga, Derrick Asiimwe, D. Agaba et al.· Journal of Pain Research· 0 citations
Background/Objectives: Chronic low back pain (CLBP) is the leading global cause of years lived with disability, but long-term real-world evidence for non-surgical management remains scarce, particularly in low- and middle-income countries. This study aimed to describe 5-year trajectories of pain, disability, healthcare utilization, patient satisfaction, and surgical conversion among patients with non-specific CLBP initially managed non-surgically at a tertiary spine center in Northwest China. We also compared long-term outcomes between unimodal therapy and multidisciplinary biopsychosocial care and examined baseline demographic, clinical, and psychosocial predictors of treatment success and conversion to surgery. Methods: We conducted a 5-year retrospective cohort study of consecutive patients with non-specific CLBP at a tertiary spine center in Northwest China. Of 485 consecutive patients screened for eligibility, 420 were enrolled and were compared on the basis of unimodal therapy with multidisciplinary biopsychosocial care. Primary outcomes were pain (Numerical Pain Rating Scale, NPRS) and disability (Oswestry Disability Index, ODI), analyzed using linear mixed-effects models; predictors of surgical conversion were identified via multivariable Cox regression. Results: Of the 420 patients, 352 (83.8% retention) completed the 5-year follow-up. Both pain and disability improved substantially during the first 12 months. Thereafter, pain intensity increased slightly (NPRS from 4.8 to 5.4), whereas functional disability continued to improve (ODI from 31.7 to 26.5). Early multidisciplinary care was associated with sustained superior outcomes (adjusted functional disability (ODI) difference: −8.2 points at 5 years) and a 42% lower observed risk of surgery (HR = 0.58). The cumulative 5-year surgical rate was 14.2%, with high pain catastrophizing as the strongest independent predictor (HR = 3.10). Conclusions: In patients with non-specific CLBP, non-surgical management yields substantial 12-month gains; function continues to improve through 5 years, while pain shows partial recurrence. Early multidisciplinary biopsychosocial care was associated with more durable outcomes and lower surgical conversion; because treatment was not randomized, these associations warrant confirmation in pragmatic trials and support routine psychosocial screening and stratified care.
Bolong Zheng, H. Hui, Liang Yan et al.· Journal of Clinical Medicine· 0 citations
Chronic low back pain (CLBP) is a frequent clinical complaint in people with multiple sclerosis (pwMS); however, its prevalence is inconsistently reported, and its impact remains poorly characterized. This cross-sectional nationwide survey aimed to determine the proportion of pwMS who report CLBP and examine its association with self-reported disability and health-related quality of life (HRQoL) outcomes. A total of 1,106 pwMS completed surveys assessing disability (Patient Determined Disease Steps; PDDS), and HRQoL outcomes. Pain location was assessed using the Michigan Body Map, which asks participants to indicate all body regions where they have experienced persistent or recurrent pain for at least last three months. Based on selection of the lower back region, 49.5% (95% CI: 46.5%-52.4%) were classified as having CLBP. Greater disability was associated with higher odds of CLBP in pwMS (OR=1.21, 95% CI [1.02-1.44], p=0.02). Compared to those without CLBP, pwMS with CLBP had significantly higher pain intensity (B=2.9 [2.08-3.8], p<0.001), pain interference (B=3.9 [2.9-4.9], p<0.001), anxiety (B=.08[0.9-3.2], p<0.001), depression (B=1.9 [0.7- 3.1], p=0.001) and fatigue (B=2.4 [1.4-3.5], p<0.001), as well as lower perceived cognitive function (B= -1.79[-2.8- -0.7], p=0.001). There were no significant associations between presence of CLBP and sleep disturbance (B=0.26, p=0.38), physical activity level indexed by Godin-Shephard leisure-time physical activity questionnaire (OR=0.81, p=0.13) or sedentary behavior indexed by one-day sitting time duration (B=0.09, p=0.95). These findings highlight the high proportion and significance of CLBP in pwMS. PERSPECTIVE: The high proportion and substantial burden of chronic low back pain among pwMS warrant a comprehensive and systematic evaluation of existing management strategies to optimize care and improve patient outcomes.
Abbas Tabatabaei, Jacob J Sosnoff, Anna L. Kratz· Journal of Pain· 0 citations
