PUBLIC HEALTH / CLINICAL RESEARCH
Low back pain among medical students: a cross-sectional study from Poland
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1
Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland
2
Department of General Orthopedics, Orthopedic Oncology and Traumatology, Poznan University of Medical Sciences, Poznan, Poland
3
Department of Public Health, Poznan University of Medical Sciences, Poznan, Poland
Submission date: 2024-07-09
Final revision date: 2024-11-25
Acceptance date: 2024-12-06
Online publication date: 2025-02-22
Corresponding author
Andrzej Bałoniak
Faculty of Medicine
Poznan University of
Medical Sciences
Poznan, Poland
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Low back pain (LBP) is a common condition and the leading cause of disability worldwide. Medical students may be at higher risk due to prolonged sitting and stress. The aim of this study was to examine the prevalence of LBP and disability among Polish medical students and identify associated risk factors.
Material and methods:
In this study, 533 medical students, predominantly female (66.4%), with a median age of 22, were surveyed via an online questionnaire. The survey used the Oswestry Disability Index (ODI) and Patient Health Questionnaire (PHQ-9) to evaluate LBP and depression symptoms. Demographic data and information on smoking, exercise, sitting duration, spine posture, past and present LBP, pain duration, intensity, and analgesic use were also collected.
Results:
Point prevalence LBP was 70.95%, while 78.26% of participants reported past history of LBP. The median LBP intensity measured with the Numeric Rating Scale (NRS) was 3, and the median ODI score was 10%. Overall, female medical students suffered more from LBP than males (66.4% vs. 33.6%). The following LBP risk factors were identified in the studied group: past episodes of LBP (OR = 2.92), sitting 8 h/day (OR = 2.44), as well as 10 h or more (OR = 2.95), moderate and severe depression symptoms (OR = 2.51, OR = 7.33 respectively).
Conclusions:
Prevalence of low back pain among medical students in the studied group is high, resulting in mild disability, with females experiencing more severe symptoms than males. Past LBP episodes, sitting 8 h or more, and depression symptoms are independent risk factors for development of LBP among Polish medical students.
REFERENCES (37)
1.
Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012; 64: 2028-37.
2.
Fatoye F, Gebrye T, Ryan CG, Useh U, Mbada C. Global and regional estimates of clinical and economic burden of low back pain in high-income countries: a systematic review and meta-analysis. Front Public Health 2023; 11: 1098100.
3.
Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2017; 166: 514-30.
4.
Kędra A, Kolwicz-Gańko A, Sitarski D, Kędra P, Czaprowski D. Prevalence of back pain and the knowledge of preventive measures in a cohort of 11619 Polish school-age children and youth – an epidemiological study. Medicine 2019; 98: e15729.
5.
Kędra A, Kolwicz-Gańko A, Sitarski D, Ewertowska P, Czaprowski D. Low back pain and everyday functioning of students. Ortop Traumatol Rehabil 2016; 18: 31-9.
6.
Kozak-Szkopek E, Broczek K, Slusarczyk P, et al. Prevalence of chronic pain in the elderly Polish population – results of the PolSenior study. Arch Med Sci 2017; 13: 1197-206.
7.
Sany SA, Tanjim T, Hossain MI. Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study. F1000Res 2021; 10: 698.
8.
Vujcic I, Stojilovic N, Dubljanin E, Ladjevic N, Ladjevic I, Sipetic-Grujicic S. Low back pain among medical students in Belgrade (Serbia): a cross-sectional study. Pain Res Manag 2018; 2018: 8317906.
9.
Taha YA, Al Swaidan HA, Alyami HS, et al. The prevalence of low back pain among medical students: a cross-sectional study from Saudi Arabia. Cureus 2023; 15: e38997.
10.
Baradaran Mahdavi S, Riahi R, Vahdatpour B, Kelishadi R. Association between sedentary behavior and low back pain: a systematic review and meta-analysis. Health Promot Perspect 2021; 11: 393-410.
11.
Aggarwal N, Anand T, Kishore J, Ingle GK. Low back pain and associated risk factors among undergraduate students of a medical college in Delhi. Educ Health (Abingdon) 2013; 26: 103-8.
12.
Sirbu E, Onofrei R, Szasz S, Susan M. Predictors of disability in patients with chronic low back pain. Arch Med Sci 2020; 16: 94-100.
13.
Pinheiro MB, Ferreira ML, Refshauge K, et al. Symptoms of depression as a prognostic factor for low back pain: a systematic review. Spine J 2016; 16: 105-16.
14.
Pinheiro MB, Ferreira ML, Refshauge K, et al. Symptoms of depression and risk of new episodes of low back pain: a systematic review and meta-analysis. Arthritis Care Res 2015; 67: 1591-603.
15.
Drożak P, Duda P, Bryliński Ł, et al. Depression among Polish medical students and its lifestyle-linked predictors. J Educ Health Sport 2021; 11: 156-66.
16.
Pawlaczyk M, Siembida J, Balaj K, Rajewska-Rager A. The assessment of stress level, anxiety, depressive symptoms, and defense mechanisms among Polish and English medical students. Ann Gen Psychiatry 2020; 19: 29.
17.
Miekisiak G, Kollataj M, Dobrogowski J, et al. Validation and cross-cultural adaptation of the Polish version of the Oswestry Disability Index. Spine 2013; 38: E237-43.
18.
Kokoszka A, Jastrzębski A, Obrębski M. Psychometric properties of the polish version of Patient Health Questionnaire-9. Psychiatria 2016; 13: 187-93.
19.
Moroder P, Runer A, Resch H, Tauber M. Low back pain among medical students. Acta Orthop Belg 2011; 77: 88-92.
20.
Algarni AD, Al-Saran Y, Al-Moawi A, Bin Dous A, Al-Ahaideb A, Kachanathu SJ. The prevalence of and factors associated with neck, shoulder, and low-back pains among medical students at University Hospitals in Central Saudi Arabia. Pain Res Treat 2017; 2017: 1235706.
21.
Alshagga MA, Nimer AR, Yan LP, Ibrahim IAA, Al-Ghamdi SS, Radman Al-Dubai SA. Prevalence and factors associated with neck, shoulder and low back pains among medical students in a Malaysian Medical College. BMC Res Notes 2013; 6: 244.
22.
Ahmed SSEKA, Bahar RKM, Ahmed LAM, et al. Prevalence and associated factors of back pain among medical students in Sudan. Health N Hav 2022; 14: 931-8.
23.
Alshehri MM, Alqhtani AM, Gharawi SH, et al. Prevalence of lower back pain and its associations with lifestyle behaviors among college students in Saudi Arabia. BMC Musculoskelet Disord 2023; 24: 646.
24.
Papalia GF, Petrucci G, Russo F, et al. COVID-19 pandemic increases the impact of low back pain: a systematic review and metanalysis. Int J Environ Res Public Health 2022; 19: 4599.
25.
Wong JJ, Tricco AC, Côté P, et al. Association between depressive symptoms or depression and health outcomes for low back pain: a systematic review and meta-analysis. J Gen Intern Med 2022; 37: 1233-46.
26.
de Goes Salvetti M, de Mattos Pimenta CA, Braga PE, Corrêa CF. Incapacidade relacionada à dor lombar crônica: prevalência e fatores associados. Rev Escola Enfermagem da USP 2012; 46: 16-23.
27.
Oliveira DS, Vélia Ferreira Mendonça L, Sofia Monteiro Sampaio R, Manuel Pereira Dias de Castro-Lopes J, Ribeiro de Azevedo LF. The impact of anxiety and depression on the outcomes of chronic low back pain multidisciplinary pain management – a multicenter prospective cohort study in pain clinics with one-year follow-up. Pain Med 2019; 20: 736-46.
28.
Pinheiro MB, Ferreira ML, Refshauge K, et al. Symptoms of depression and risk of low back pain. Clin J Pain 2017; 33: 777-85.
29.
Dighriri Y, Akkur M, Alharbi S, Madkhali N, Matabi K, Mahfouz M. Prevalence and associated factors of neck, shoulder, and low-back pains among medical students at Jazan University, Saudi Arabia: a cross-sectional study. J Fam Med Prim Care 2019; 8: 3826.
30.
Tavares C, Salvi CS, Nisihara R, Skare T. Low back pain in Brazilian medical students: a cross-sectional study in 629 individuals. Clin Rheumatol 2019; 38: 939-42.
31.
Lin Y, Zhang X, Li H, Huang Y, Zhang W, Zhang C. Musculoskeletal pain is prevalent in Chinese medical and dental students: a cross-sectional study. Front Public Health 2022; 10: 1046466.
32.
Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol 2010; 171: 135-54.
33.
Hayden JA, van Tulder MW, Malmivaara AV, Koes BW. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med 2005; 142: 765.
34.
Amelot A, Mathon B, Haddad R, Renault MC, Duguet A, Steichen O. Low back pain among medical students: a burden and an impact to consider! Spine (Phila Pa 1976) 2019; 44: 1390-5.
35.
Falavigna A, Teles AR, Mazzocchin T, et al. Increased prevalence of low back pain among physiotherapy students compared to medical students. Eur Spine J 2011; 20: 500-5.
36.
Ilic I, Milicic V, Grujicic S, Zivanovic Macuzic I, Kocic S, Ilic MD. Prevalence and correlates of low back pain among undergraduate medical students in Serbia, a cross-sectional study. PeerJ 2021; 9: e11055.
37.
Rezaei B, Mousavi E, Heshmati B, Asadi S. Low back pain and its related risk factors in health care providers at hospitals: a systematic review. Ann Med Surg 2021; 70: 102903.