Modifiable Risk Factors in Patients With Low Back Pain

Orthopedics. 2016 May 1;39(3):e413-6. doi: 10.3928/01477447-20160404-02. Epub 2016 Apr 12.


Low back pain is one of the most common reasons for physician visits in the United States and is a chief complaint frequently seen by orthopedic surgeons. Patients with chronic low back pain can experience recurring debilitating pain and disability, decreasing their quality of life. A commercially available software platform, Explorys (Explorys, Inc, Cleveland, Ohio), was used to mine a pooled electronic health care database consisting of the medical records of more than 26 million patients. According to the available medical history data, 1.2 million patients had a diagnosis of low back pain (4.54%). The information was used to determine the incidence of low back pain in patients with a history of nicotine dependence, obesity (body mass index, >30 kg/m(2)), depressive disorders, and alcohol abuse. Relative risk was then calculated for the defined modifiable risk factors. Patients with nicotine dependence, obesity, depressive disorders, and alcohol abuse had a relative risk of 4.489, 6.007, 5.511, and 3.326 for low back pain, respectively, compared with patients without the defined risk factor. A statistically significant difference was found in the incidence of low back pain between all 4 groups with the risk factors evaluated and the general population (P<.05). By determining treatable patient risk factors for low back pain, physicians can monitor at-risk patients and focus on prevention and control of debilitating disease. These approaches can decrease the number of patients with isolated low back pain who are seen by orthopedic surgeons. [Orthopedics. 2016; 39(3):e413-e416.].

MeSH terms

  • Alcoholism / complications*
  • Alcoholism / epidemiology
  • Depressive Disorder / complications*
  • Depressive Disorder / epidemiology
  • Female
  • Humans
  • Incidence
  • Low Back Pain / epidemiology
  • Low Back Pain / etiology*
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / epidemiology
  • Quality of Life
  • Risk Factors
  • Tobacco Use Disorder / complications*
  • Tobacco Use Disorder / epidemiology
  • United States / epidemiology