Chronic lower back pain and its impact on health-related quality of life among undergraduates of Gulu University, Uganda: a cross-sectional study

Abstract

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. 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. 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. 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.