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Janet K. Freburger, PT, PhD; George M. Holmes, PhD; Robert P. Agans, PhD; Anne M. Jackman, MSW; Jane D. Darter, BA; Andrea S. Wallace, RN, PhD; Liana D. Castel, PhD; William D. Kalsbeek, PhD; Timothy S. Carey, MD, MPH

Arch Intern Med. 2009;169(3):251-258.

Background  National or state-level estimates on trends in the prevalence of chronic low back pain (LBP) are lacking. The objective of this study was to determine whether the prevalence of chronic LBP and the demographic, health-related, and health care–seeking characteristics of individuals with the condition have changed over the last 14 years.

Methods  A cross-sectional, telephone survey of a representative sample of North Carolina households was conducted in 1992 and repeated in 2006. A total of 4437 households were contacted in 1992 and 5357 households in 2006 to identify noninstitutionalized adults 21 years or older with chronic (>3 months), impairing LBP or neck pain that limits daily activities. These individuals were interviewed in more detail about their health and health care seeking.

Results  The prevalence of chronic, impairing LBP rose significantly over the 14-year interval, from 3.9% (95% confidence interval [CI], 3.4%-4.4%) in 1992 to 10.2% (95% CI, 9.3%-11.0%) in 2006. Increases were seen for all adult age strata, in men and women, and in white and black races. Symptom severity and general health were similar for both years. The proportion of individuals who sought care from a health care provider in the past year increased from 73.1% (95% CI, 65.2%-79.8%) to 84.0% (95% CI, 80.8%-86.8%), while the mean number of visits to all health care providers were similar (19.5 [1992] vs 19.4 [2006]).

Conclusions  The prevalence of chronic, impairing LBP has risen significantly in North Carolina, with continuing high levels of disability and health care use. A substantial portion of the rise in LBP care costs over the past 2 decades may be related to this rising prevalence.

Author Affiliations: Cecil G. Sheps Center for Health Services Research (Drs Freburger, Holmes, and Carey and Mss Jackman and Darter), Division of Physical Therapy (Dr Freburger), Survey Research Unit (Drs Agans and Kalsbeek), Department of Biostatistics (Drs Agans and Kalsbeek), and Department of Medicine (Dr Carey), University of North Carolina at Chapel Hill; College of Nursing, University of New Mexico, Albuquerque (Dr Wallace); and Department of General Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Castel).

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