Prevalence of non-communicable diseases, multimorbidity, and their impact on activity limitations among adults with chronic back pain: a national population-based study in a middle-income country

Abstract

BACKGROUND: Patients with chronic back pain who also have comorbidities are more likely to report severe symptoms and receive inappropriate care. It is still unclear which types of comorbidity are associated with more disabling symptoms. OBJECTIVE: To compare the prevalence of chronic non-communicable disease between adults with and without chronic back pain, estimate the prevalence of multimorbidity in adults with chronic back pain, and identify comorbidities that are associated with activity limitations. METHODS: Data from adults who participated in the 2019 National Health Survey were used to collect information about chronic non-communicable diseases, chronic back pain, and activity limitations. Multimorbidity was defined as the presence of one or more comorbidities in addition to chronic back pain. Difference in proportion and ordinal logistic regression were used in the analyses. RESULTS: Of the total sample size (n = 87,678), 21.6 % (n = 18,930) reported having chronic back pain. The prevalence rates of all non-communicable conditions were higher in people with chronic back pain compared to those without chronic back pain. Multimorbidity was reported by 62.1 % (95 %CI: 61.1, 63.6) of the adults with chronic back pain. The odds of a participant with comorbidities reporting a worse activity limitation level were 2.1 (95 %CI:1.9, 2.4) for arthritis or rheumatism, 1.6 (95 %CI: 1.4, 1.8) for depression, and 1.5 (95 %CI: 1.3, 1.6) for cardiovascular disease compared to participants without this specific comorbidity. CONCLUSION: Non-communicable diseases and multimorbidity were prevalent in adults with chronic back pain. Cardiovascular disease, arthritis or rheumatism, and depression, were associated with higher activity limitations due to back pain.