Mapping Comorbidities in Patients With Low Back Pain—A Systematic Review
Jacob S. Gandløse, Caroline W. M. Sørensen, Cecilie T. Hemmingsen, Kasper W. Larsen, Þorvaldur Skúli Pálsson
Abstract
BACKGROUND AND PURPOSE: Low back pain (LBP) frequently co-occurs with other health conditions, but there is no clear consensus on which comorbidities are most prevalent. This limits understanding of the broader burden and challenges clinical practice. METHODS: Systematic searches were conducted in seven databases, including PubMed, Embase, CINAHL, PsycINFO, PEDro, Rehabilitation and Sports Medicine Source, and Cochrane Library. Observational studies on adults (≥ 16 years) with nonspecific LBP and at least three comorbidities were included. Data were extracted, tabulated, and quality assessed using CASP checklists and GRADE classifications. RESULTS: Nine peer-reviewed studies were included. The prevalence of at least one comorbidity ranged from 49% to 92%, with hypertension, osteoarthritis, and chronic pain elsewhere in the body being the most proportionally prevalent comorbidities in individual study populations. Across all studies, hypertension, diabetes, osteoarthritis, asthma, and depression were the most frequently reported comorbidities. Comorbidity assessment, population characteristics, and prevalence varied significantly. Certainty in the prevalence of comorbidities varied from "very low" to "moderate." DISCUSSION: Comorbidities are highly prevalent in adults with LBP. The included studies varied considerably in comorbidity assessment, reporting, and study populations, where sociodemographic factors like sex, age, marital status, education, and employment likely influenced comorbidity prevalence and types. Findings emphasize the need for standardized assessment methods and tailored physiotherapy approaches to address the diverse needs of this population.