Prevalence of chronic low back pain: systematic review

OBJECTIVE To estimate worldwide prevalence of chronic low back pain according to age and sex. METHODS We consulted Medline (PubMed), LILACS and EMBASE electronic databases. The search strategy used the following descriptors and combinations: back pain, prevalence, musculoskeletal diseases, chronic musculoskeletal pain, rheumatic, low back pain, musculoskeletal disorders and chronic low back pain. We selected cross-sectional population-based or cohort studies that assessed chronic low back pain as an outcome. We also assessed the quality of the selected studies as well as the chronic low back pain prevalence according to age and sex. RESULTS The review included 28 studies. Based on our qualitative evaluation, around one third of the studies had low scores, mainly due to high non-response rates. Chronic low back pain prevalence was 4.2% in individuals aged between 24 and 39 years old and 19.6% in those aged between 20 and 59. Of nine studies with individuals aged 18 and above, six reported chronic low back pain between 3.9% and 10.2% and three, prevalence between 13.1% and 20.3%. In the Brazilian older population, chronic low back pain prevalence was 25.4%. CONCLUSIONS Chronic low back pain prevalence increases linearly from the third decade of life on, until the 60 years of age, being more prevalent in women. Methodological approaches aiming to reduce high heterogeneity in case definitions of chronic low back pain are essential to consistency and comparative analysis between studies. A standard chronic low back pain definition should include the precise description of the anatomical area, pain duration and limitation level.

研究目的：本研究旨在按年龄与性别划分，评估慢性腰背痛（chronic low back pain）的全球患病率。
研究方法：我们检索了Medline（PubMed）、LILACS及EMBASE电子数据库。检索策略采用以下主题词及组合：背痛、患病率、肌肉骨骼疾病、慢性肌肉骨骼疼痛、风湿性疾病、腰背痛、肌肉骨骼疾患及慢性腰背痛。我们筛选了以慢性腰背痛为结局指标的以人群为基础的横断面研究或队列研究。此外，我们对纳入研究的方法学质量进行了评估，并按年龄与性别统计慢性腰背痛的患病率。
研究结果：本综述共纳入28项研究。经定性评估，约三分之一的研究方法学质量评分较低，主要原因是无应答率过高。24~39岁人群的慢性腰背痛患病率为4.2%，20~59岁人群为19.6%。在9项纳入18岁及以上人群的研究中，6项报告的慢性腰背痛患病率介于3.9%~10.2%，其余3项介于13.1%~20.3%。在巴西老年人群中，慢性腰背痛患病率为25.4%。
研究结论：慢性腰背痛患病率自人生第三个十年起呈线性增长，直至60岁，且女性患病率更高。针对慢性腰背痛病例定义存在的高度异质性问题，采用标准化方法以提升不同研究间结果的一致性与可比性至关重要。标准化的慢性腰背痛定义应精准包含解剖部位、疼痛持续时长及功能受限程度的描述。