Low back pain as seen in orthopedic clinics of a Nigerian Teaching Hospital

Abstract

Background: Low back pain is not a specific disease though a common health concern worldwide. There is regional variation in its etiology and patterns of presentation. In West African sub‑region, there are very limited data on this important aspect of low back pain.
Objective: We aimed to determine the etiology and pattern of presentation of low back pain among patients seen in our orthopedic outpatient clinics.
Materials and Methods: This was a retrospective review of database of all new patients with low back pain seen at the orthopedics clinics of Federal Teaching Hospital, Abakaliki between 2003 and 2013.
Results: There were 2914 new patients seen in the orthopedic clinics –291 (10%) of them presented with low back pain. The female to male ratio was 1:1.04 and the mean age was 45.8 ± 1.67 years. The mechanical low back pain was involved in 82.1% of the patients, and the incidence was significantly higher in females than males (53.1% vs. 46.9%, P < 0.003). The males were significantly more afflicted than females by pain from spinal infections (58.3% vs. 41.7%) and tumors (92.3% vs. 7.7% P < 0.003). Low back pain associated with radiculopathy was observed in 75 (25.7%) patients and the incidence was significantly higher in the married than the singles (30.2% vs. 13.9%, P < 0.005). Lifting of heavy object was the most common predisposing factor of low back pain. Hypertension and peptic ulcer disease were two top medical co‑morbidities while osteoarthritis of hip and knee was the most common associated musculoskeletal disorders.
Conclusion: Low back pain of mechanical origin (recurrent and chronic in a significant proportion of patients) is predominant in our environment. This pattern calls for prevention as well as the early and appropriate care of the patient with low back pain.

Key words: Disc prolapse, low back, mechanical, Nigeria, pain, radiculopathy, spondylosis