Low back pain and associated factors among users of community health centres in South Africa : a prevalence study
Background: Low back pain (LBP) has a high prevalence worldwide. LBP is significantly associated with a range of poor socio-demographic circumstances which should be addressed in preventive programs. Despite this there is a dearth of information about the prevalence and associated factors among low-income communities in South Africa. It is speculated that the burden of LBP may be most significant in these underprivileged communities. Objective: The objective of this study was to assess the prevalence of LBP among the lowincome communities in the Cape Town Metropole and to establish associated factors in order to make recommendations for management. Study design: A cross-sectional study was conducted among the visitors of eight community health centres (CHCs) in the Cape Town Metropole. Methodology: A new measurement tool was developed based on existing validated outcome measures and initial testing of the psychometric properties of the questionnaire was conducted. The questionnaire was administered to 489 eligible subjects. Descriptive analysis was used to describe the sample and logistic regression analytical techniques were applied to determine associated factors. Main findings: Lifetime prevalence for LBP was 76.49% (n=358). About 37% (n=133) suffered from chronic LBP. LBP was significantly associated with belonging to the black ethnic group, any co-morbidity, poor perceived general health, and any type of pain medication. Lifting weights > 20 kg and kneeling and squatting were physical factors significantly associated with LBP. Severe psychological distress was significantly associated with acute and chronic LBP. Having a better or same perceived general health compared to a year ago, was protective for LBP. Conclusion: LBP has a high prevalence among the low income communities, visiting the CHCs, in the Cape Town Metropole. Multiple factors were associated with LBP, which imply that a tailormade multidisciplinary program addressing lifestyle issues, self management strategies, medication use, chronic diseases and psychosocial factors may be required for this population to combat LBP.