Assessment of risk factors for non-specific chronic disabling low back pain in Japanese workers—findings from the CUPID (Cultural and Psychosocial Influences on Disability) study

The majority of patients with non-specific low back pain (LBP) suffer from chronic pain. Psychosocial factors play an important role in the chronicity of LBP. To explore the risk factors for chronic disabling LBP in detail, we assessed its various risk factors in Japanese workers, using data from the Cultural and Psychosocial Influences on Disability (CUPID) study. Data were drawn from a 1 yr follow-up of 20‒59 yr-old workers who participated in the CUPID study. A self-administered questionnaire assessed various factors, including individual characteristics, ergonomic work demands, and work-related or other psychosocial factors. Logistic regression analyses were performed to assess the associations between these factors and chronic disabling LBP. Of 198 participants, 35 (17.7%) had chronic disabling LBP during the 1 yr follow-up. Multivariate logistic regression analysis revealed that the interaction effect of the two factors, expectation of LBP problems and excessive working hours (≥ 60 h per week), was associated with chronic disabling LBP. Chronic disabling LBP was present in 42.5% of participants with both of these two risk factors, whereas it was present in 11.8% of participants without these risk factors. In conclusion, among various factors, the combination of two psychosocial factors was particularly associated with chronic disabling LBP.