Prevalence of claims-based recurrent low back pain in a Canadian population: a secondary analysis of an administrative database

Abstract

Background: There is a vast literature reporting that the point prevalence of low back pain (LBP) is high and increasing. It is also known that a large proportion of acute LBP episodes are recurrent within 12 months. However, few studies report the annual trends in the prevalence of recurrent LBP or describe these trends according to age and sex categories.

Methods: We conducted a retrospective cohort study involving 401 264 adults selected from the administrative database of physician claims for the province of Quebec, Canada. These adults, aged 18 years and over, met the criteria of having consulted a physician three times within a 365-day period between 2000 and 2007 for a LBP condition corresponding to ICD-9 codes 721, 722, 724 or 739. All data were analyzed by sex and clustered according to specific age categories.

Results: We observed a decrease from 1.64% to 1.33% in the annual prevalence between 2000 and 2007 for men. This decrease in prevalence was mostly observed between 35 and 59 years of age. Older (≥ 65 years) women were 1.35 times more at risk to consult a physician for LBP in a recurrent manner than older men. The most frequently reported diagnosis was non-specific LBP between 2000 to 2007. During the same period, sequelae of previous back surgery and spinal stenosis were the categories with the largest increases.

Conclusion: The annual prevalence of claims-based recurrent LBP progressively decreased between 2000 and 2007 for younger adults (<65 years) while older adults (≥ 65 years) showed an increase. Given the aging Canadian population, recurrent low back pain could have an increasing impact on the quality of life of the elderly as well as on the healthcare system.

Figure 1

Bars represent the annual prevalence of claims-based recurrent low back pain in the Canadian province of Quebec for men (black bars) and women (shaded bars). The 8-year mean prevalence for men (solid line) and women (dotted line) shows the difference between the sexes (shaded area). Both distributions display a progressive and significant decrease from 2000 to 2007.

Figure 2

Annual prevalence of claims-based recurrent low back pain in 2000 and 2007 by age categories and sex. A) Profile of the male cohort prevalence. The mean prevalence in 2000 (solid line) is higher than in 2007 (dotted line). B) Profile of the female cohort prevalence. The mean prevalence in 2000 (solid line) is slightly lower than in 2007 (dotted line).