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Behavior-Related Factors Associated With Low Back Pain in the US Adult Population

Yang, Haiou, PhD; Haldeman, Scott, DC, MD, PhD†,‡

doi: 10.1097/BRS.0000000000001665

Study Design. This study is based on data from the 2009–2012 National Health Interview Survey (NHIS) of the civilian population of the United States. The NHIS focuses on a number of health conditions, including low back pain.

Objective. The objective of this study is to explore behavior-related factors associated with low back pain in the US adult population, including leisure-time physical activity, alcohol use, tobacco use, sleep duration, and obesity.

Summary of Background Data. Low back pain is a prevalent musculoskeletal health disorder with profound impact on individuals, business, and society. Addressing behavior-related factors holds the potential to reduce the burden of low back pain on a societal basis.

Methods. To account for the complex sampling design of the NHIS, the Taylor linearized variance estimation methods were used to conduct weighted descriptive statistics and multivariate logistic regression analyses in exploring the relationships between low back pain and a set of behavior-related risk factors.

Results. This study shows associations between self-reported lower back pain and reported leisure-time physical inactivity, current or former smoking, current or former alcohol drinking, short sleep duration, and obesity.

Conclusion. This study identified a number of behavior-related factors that appear to have a significant relationship with low back pain. Public health policy makers and clinicians should consider these factors to reduce the burden of low back pain. This study supports the need for longitudinal study design in future research.

Level of Evidence: 2

Center for Occupational and Environmental Health, University of California, Irvine

Department of Neurology, University of California, Irvine

Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA.

Address correspondence and reprint requests to Haiou Yang, PhD, Center for Occupational and Environmental Health, University of California, Irvine, CA 92612; E-mail:

Received 17 September, 2015

Revised 31 March, 2016

Accepted 14 April, 2016

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

Relevant financial activities outside the submitted work: grants.

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