Unequal Burdens: Disparities In Baseline Low Back Pain At An Academic Health System

Abstract

There is a growing need to assess the prevalence of disparities in low back pain (LBP). The purpose of this study was to evaluate the association between demographic characteristics (race/ethnicity, age, gender, and median income of patients' zip code) and pain and function in patients (n = 15,954) seeking care for LBP at an Academic Medical Center. Demographic characteristics and PROMIS Pain Interference and Physical Function T-Scores were measured at baseline. ANOVA and post hoc tests were performed to evaluate the relationship in pain/physical function and demographic characteristics. Black patients reported worse physical function compared to Hispanic (mean difference [md] = 0.97) and Caucasian (md = 0.42) patients and worse pain interference than Hispanic (md = 0.93) and Caucasian (md = 2.08) patients. All racial/ethnic disparities were statistically significant at p < 0.05. Patients aged 65+ experienced worse physical function (md = 3.10) compared to patients aged 18-44. Additionally, patients living in poorer zip codes reported worse physical function (md = 4.02) and worse pain interference (md = 3.03) than patients living in wealthier zip codes. Female patients reported worse function (md = 1.87) and worse pain interference (md = 0.40) than male patients. Study findings highlight several detrimental disparities in baseline pain and function of low back pain. Future research is needed to evaluate whether these disparities are associated with poorer outcomes from treatments for low back pain.