Combined impact of concomitant arthritis and back problems on health status: Results from a nationally representative health survey

Abstract

Objective. To investigate whether people who report both arthritis and back problems report poorer health outcomes than those who have either condition alone. Methods. We performed an analysis of the 2005 Canadian Community Health Survey (n ‫؍‬ 126,049, age >15 years). Respondents were asked about long-term chronic health conditions diagnosed by a health professional and lasting 6 months or more. The risks of reporting 4 health outcomes (activity limitation, fair/poor self-rated overall health, fair/poor self-rated mental health, and >4 doctor consultations in the previous 12 months) were estimated using log Poisson regression analysis adjusting for sociodemographic and lifestyle factors for 5 analytic groups (arthritis and back problems, arthritis only, back problems only, any other chronic condition, and no chronic condition). Results. Arthritis and back problems were reported by 6% of the population (10.5% arthritis only and 13% back problems only). The arthritis and back problems and arthritis only groups had a higher prevalence in women, those of older age, and those who were overweight or obese. For all health outcomes, prevalence ratios showed higher risks of poor outcome for the arthritis and back problem group than for arthritis only or back problems only groups, which had similar risk. Risks were lowest for the any other chronic conditions group and the no chronic conditions group. Conclusion. Chronic back problems were reported by one-third of people with arthritis, who had increased risks of activity limitation, poorer self-rated overall and mental health, and higher health care use. The findings suggest that concomitant back problems are a major contributor to a range of health outcomes in arthritis.

Chronic back problems and labor force participation in a national population survey: impact of comorbid arthritis

“…Our findings extend previous analyses which showed that the combination of back problems and arthritis was more highly associated with pain and activity limitation and having poor self-rated heath than either condition alone, even after controlling for the effect of other chronic health conditions [29]. It is likely that these higher levels of pain and disability are contributory reasons for the increased risk for individuals with both back problems and arthritis of not being employed or being out of the labor force.…”

“…While it is not clear what the back problems and arthritis group represents, the similarity to the arthritis only group in terms of risks of not being in the labor force as well as the profile of socio-demographic and lifestyle characteristics tentatively suggests that a portion of the back problems and arthritis group might represent a contribution from arthritis with spinal involvement, such as osteoarthritis [29,41]. The profile of characteristics of the back problems only group is similar to that for chronic non-specific low back pain [25].…”

“…It was found that individuals who reported both conditions had significantly higher risks of reporting activity limitation, fair/poor self-rated health and self-rated mental health, and having more than three doctor consultations in the previous month compared to individuals who reported having arthritis only or back problems only [29]. Building on these findings, we hypothesized that having co-morbid back problems and arthritis would also negatively impact labor force participation over and above the effect of having each condition on its own.…”

Risk Factors for Restricting Back Pain in Older Persons

“…A greater number of comorbid conditions and higher illness burden may lead to greater physical, emotional, psychological and social vulnerability that renders an older individual prone to suffering from restricting back pain. One study from Canada reported an increased risk of activity limitation, poorer self-rated overall and mental health, and higher health care use among individuals with concomitant back pain and arthritis compared with those having either condition alone (43). Future studies should evaluate the impact of multimorbidity and combinations of chronic conditions (including other sites of pain (44) and arthritis (18)) on outcomes in older persons with back pain.…”

Identification of common content between the questionnaire of the Health Survey (ISA-SP) and the International Classification of Functionality, Disability, and Health

“…Cross-sectional population-based studies have been widely used to determine prevalence and for diagnosis in health for both national [35][36][37][38][39] and international levels [40][41][42] . In the case of the surveys that address the issue of disability, the incorporation of the concepts advocated by the WHO, through the ICF, is crucial for the estimation of the prevalence of disabilities not to be impaired, and that the results are not biased.…”