Residents of Mountainous Areas Have a Higher Low Back Pain Prevalence Than Flat Areas of Chongqing, China: A Cross-Sectional Study

BACKGROUND AND PURPOSE: Epidemiological studies on low back pain in residents living in mountainous areas are scarce. The study was aimed at investigating the prevalence and associated factors of low back pain in Chongqing, relatively impoverished mountainous areas of China. MATERIALS AND METHODS: This was a cross-sectional study conducted at selected community or village health service centers in Chongqing over a 2-month period (May 2021 to June 2021), which included adults of Chongqing aged >18 years with or without low back pain (N=1820) chosen by stratified, cluster-sampling. Associated factors of low back pain including sociodemographic characteristics, lifestyle, and occupational features were collected, along with medical history, Oswestry Disability Questionnaire (ODI), and Numerical Rating Scale (NRS) of patients with low back pain, and carried out for at least 20 minutes per respondent. Univariate and multivariate logistic regression models were utilized for statistical analysis. RESULTS: Overall, 30.5% of 1704 respondents presented with low back pain, with 26.3% living in flat areas and 35.6% in mountainous areas. The associated factors of low back pain were mountainous area residence (OR 1.4, 95% CI 1.1–1.8), advanced age (OR 1.8, 95% CI 1.3–2.5 for those aged 45–59 years, OR 2.3, 95% CI 1.6–3.4 for those aged 60–74 years, and OR 2.1, 95% CI 1.2–3.6 for those aged ≥75 years), married or remarried (OR 1.9, 95% CI 1.1–3.2), divorced or widowed (OR 2.7, 95% CI 14–5.4), moderate labor intensity (OR 1.4, 95% CI 1.1–1.8), frequent stoop (OR 1.6, 95% CI 1.1–2.4), and depressed mood (OR 1.6, 95% CI 1.2–2.1). Residents in the mountainous areas had a higher score on Oswestry Disability Questionnaire (8.3 [SD 6.3] vs 6.2 [SD 4.3]) than those in flat areas. CONCLUSION: Mountainous areas in Chongqing had higher prevalence of low back pain as 35.6%, compared with 26.3% in flat areas, with more severe dysfunction in low back pain patients. Multifactorial analysis found that the factors associated with low back pain in Chongqing residents included mountain residence, labor intensity, stoop, psychological factors and frequency of exercise.