The Impact of Body Weight and Depression on Low Back Pain in a Representative Population Sample

Objective Low back pain ( LBP ), obesity, and depression are highly prevalent health conditions. We assessed the relative impact of body weight and depression on different types of LBP in a representative population sample. Design This is a cross‐sectional study. Setting and Patients Two thousand five hundred ten subjects aged 14–90 years were randomly selected from the G erman general population in 2012. Measures Pain sites and duration of pain were assessed by the W idespread P ain I ndex( WPI ), depression by the B eck D epression I nventory P rimary C are Q uestionnaire, disability by the E uropean O rganization for R esearch and T reatment of C ancer questionnaire, and current body mass index ( BMI , kg/m 2 ) by self‐reported body weight and height. Widespread pain was defined by ≥7/19 pain sites in the WPI . Hierarchical logistic regression analyses were performed with different types of LBP as the dependent variable, and age, gender, lifetime employment status as a worker, number of pain sites, BMI , and depression as independent variables. Results One thousand six hundred eighty‐seven (67.1%) of participants reported no pain. Five hundred six (20.2%) reported chronic LBP and 84 (3.3%) reported disabling chronic LBP . Age (odds ratio [ OR ] 1.05 [95% confidence interval { CI } 1.04–1.06]), BMI ( OR 1.08 [95% CI 1.05.–1.11]), and depression ( OR 1.38 [95% CI 1.30–1.49]) independently predicted chronic LPB compared with persons without pain. Age ( OR 1.07 [95% CI 1.05–1.09]), BMI ( OR 1.07 [95% CI 1.03–1.13]), and depression ( OR 1.71 [95% CI 1.55–1.88]) independently predicted disabling chronic LPB compared with persons without pain. Age ( OR 1.03 [95% CI 1.01–1.05]), widespread pain ( OR 5.23 [95% CI 3.04–9.00), and depression ( OR 1.34 [95% CI 1.16–1.55]) independently predicted disabling chronic LPB compared with persons with nondisabling chronic LBP . Conclusion BMI and depression are modifiable risk indicators for chronic disabling LBP .