Biopsychosocial factors associated with chronic low back pain disability in rural Nigeria: A population-based crosssectional study

Chinonso Nwamaka Igwesi-Chidobe*, Bolaji Coker, Chika N. Onwasigwe, Isaac O. Sorinola, Emma L. Godfrey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

51 Citations (Scopus)
338 Downloads (Pure)

Abstract

Introduction Many people in Nigeria are living withdisability due to chronic low back pain (CLBP), with thegreatest burden accounted for by people living in ruralNigeria. However, factors associated with disability in ruralNigeria have not yet been established. We investigatedthe biomechanical and psychosocial predictors of CLBPdisability in a rural Nigerian population.Methods A cross-sectional study of adults with nonspecificCLBP recruited from rural communities in EnuguState, South-eastern Nigeria. Measures of self-reportedand performance-based disability, pain intensity, anxietyand depression, coping strategies, social support,occupational biomechanical factors, illness perceptionsand fear avoidance beliefs were collected by trainedcommunity health workers. We used univariate andmultivariate analyses. Results 200 individuals were recruited. Psychosocialfactors were the most important factors associated withCLBP disability, and accounted for 62.5% and 49.1% of thevariance in self-reported and performance-based disability,respectively. The significant predictors of self-reporteddisability were: illness perceptions (β=0.289; p<0.0005),pain intensity (β=0.230; p<0.0005), catastrophising(β=0.210; p=0.001), fear avoidance beliefs (β=0.198;p=0.001) and anxiety (β=0.154; p=0.023). The significantpredictors of performance-based disability were: illnessperceptions (β=0.366; p<0.0005), social support(β=0.290; p<0.0005), fear avoidance beliefs (β=0.189;p<0.01) and female gender (β=0.184; p<0.01). Illnessconcern was the most salient dimension of illnessperceptions predicting self-reported and performance baseddisability. Conclusions These results provide evidence which can beused to inform the development of interventions to reduceCLBP disability in rural Nigeria, and may have relevance inother rural African contexts.
Original languageEnglish
Article numbere000284
JournalBMJ Global Health
Volume2
Issue number3
Early online date15 Sept 2017
DOIs
Publication statusPublished - Sept 2017

Keywords

  • arthritis
  • community-based survey
  • cross-sectional survey
  • epidemiology
  • other diagnostic or tools

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