PSYCHOSOCIAL DETERMINANTS OF BACKACHE IN FEMALES

Backache is subjective perception of pain in low back buttocks or legs. It is a frustrating cause of chronic physical impairment in females. Backache in females is a substantial problem.

Objectives:To identify the following psycho social factors associated with backache in females i.e. Pregnancy, Obesity, Aging, High heel shoes, Major Depressive Disorder, Malnutrition, Work overload(profession), Awkward working posture, Excessive household work, Unsuitable sleeping conditions, Sedentary lifestyle, Menopause, Domestic violence, Fibromyalgia Rheumatica, Somatization disorder, Oral contraceptives. This association between backache and these psychosocial determinants was found by a case control study in a period of 3 months (1^st July to 30^th September).

Design: Population based Case Control study.

Place And Duration: Urban Lahore from January 1^st to March 31^st 2017.

Subjects and Methods: A population-based case-control study with 1:1 case to control ratio was conducted. A total of 100 persons (50 cases and 50 controls) were recruited in the study. Selection was made on laid down criteria from adult population living in Urban Lahore after taking due consent. Interviews were conducted through a pretested questionnaire by a group of trained medical doctors of the Department of Community Medicine, King Edward Medical University, Pakistan.

Results: Our research included females of age group 18-55 years. It was found that backache is more in females above 36 years of age (65%) who were working women (60%) and married (61%).  In Bivariate Analysis backache was found to be significantly associated with Major Depressive Disorder (OR:16.00 ,CI:3.483-73.408) Excessive household work(OR:14.462 ,CI: 3.972-52.656) Awkward working posture( OR: 7.319, CI: 3.025-17.705) Obesity (OR:6.143, CI: 2.323-16.242) Fibromyalgia Rhuematica (OR: 5.156,CI:1.86-16.3444) Somatization disorder (OR:5.505,CI: 1.460-20.755) High heel shoes (OR:5.412,CI: 1.660-17.646) Work overload (OR:4.472,CI: 1.355-14.755) Malnutrition (R:4,448,CI:1.675-11.811) Unstable Sleeping Conditions (OR:4.125 CI: 1.473-11.555)Pregnancy (OR: 3.841 ,CI: 1.610-9.161) Domestic Voilence (OR: 3.019,CI: 1.315-6.929) Marital status (OR: 2.279,CI: 1.017-5.108). However in multivariate analysis while controlling all other risk factors; Major Depressive Disorder (OR: 20.891, CI: 2.07-2113.007) High heel shoes (OR:7.777, CI:1.28-466.376) and Fibromyalgia rheumatica (OR:4.757 ,CI:2.5-921.082) were found to be significantly associated with backache in females.

Conclusion: Backache was significantly associated with Major Depressive Disorder, High heel shoes and Fibromyalgia Rheumatica.

Key words: Psychosocial, determinants, backache, pregnancy, obesity, fibromyalgia rheumatica, depression.