The prevalence of low back pain in the literature. A structured review of 26 Nordic studies from 1954 to 1993

Abstract

Study design: A systematic review was done for all prevalence studies on low back pain in the Nordic population between 1954 and 1992 that could be identified.

Objective: To investigate the homogeneity of data.

Summary of background data: Costs resulting from low back pain are steadily increasing, but it is not known whether this has been caused by changes in healthcare behavior or whether there is an underlying increase in the occurrence of low back pain in the general population. The prevalence rate of low back pain has been continually estimated over the last 40 years, but are the studies sufficiently homogeneous to allow pooling of data?

Methods: Twenty-six population-based epidemiologic surveys on the occurrence of low back pain in the Nordic countries were assessed for the following criteria: quality of the report according to a checklist related to the representativeness of the study sample, quality of data, and definition of low back pain; study design (study population, definition of low back pain, and recall periods); probability of data, taking into account the quality of the report, the definition of low back pain, type of population, age, and sex.

Results: Only 10 studies fulfilled a minimum of 75% of the methodologic criteria. There were large differences between studies regarding study design, and the poolability of data was limited to a few studies, none of which fulfilled all of the above criteria.

Conclusion: A more stringent, systematic, and uniform methodologic approach to studying the prevalence (or incidence) of back pain is needed.