Quantifying the association between psychological distress and low back pain in urban Europe: a secondary analysis of a large cross-sectional study

Objectives This study aims to estimate the prevalence of low back pain (LBP) in Europe and to quantify its associated mental and physical health burdens among adults in European urban areas. 

Design: This research is a secondary analysis of data from a large multicountry population survey. Setting The population survey on which this analysis is based was conducted in 32 European urban areas across 11 countries. 

Participants: The dataset for this study was collected during the European Urban Health Indicators System 2 survey. There were a total of 19 441 adult respondents but data from 18 028, 50.2% female (9 050) and 49.8% male (8 978), were included in these analyses. Primary and secondary outcome measures Being a survey, data on the exposure (LBP) and outcomes were collected simultaneously. The primary outcomes for this study are psychological distress and poor physical health. 

Results: The overall European prevalence of LBP was 44.6% (43.9-45.3) widely ranging from 33.4% in Norway to 67.7% in Lithuania. After accounting for sex, age, socioeconomic status and formal education, adults in urban Europe suffering LBP had higher odds of psychological distress aOR 1.44 (1.32-1.58) and poor self-rated health aOR 3.54 (3.31-3.80). These associations varied widely between participating countries and cities. 

Conclusion: Prevalence of LBP, and its associations with poor physical and mental health, varies across European urban areas.