EC Neurology

Background: Low back pain (LBP) is a common health issue among healthcare workers and is more common in nurses. It negatively impacts nurses’ productivity, leading to low-quality care.

Objectives: To investigate the prevalence and risk factors of LBP among nurses in Abha, Kingdom of Saudi Arabia (KSA).

Design: Cross-sectional analytic study with multistage random and clustered sampling techniques.

Setting: This study was performed among nurses working at three government hospitals and three primary healthcare centers (PHCCs) in Abha, KSA. Cluster sampling was used for five PHCCs located in the northern, central, southern, eastern, and western areas of Abha.

Patients and Methods: A self-administered questionnaire comprising four parts (a sociodemographic, work-related, and medical factors questionnaire; the Nordic musculoskeletal questionnaire; the perceived stress scale; and the Oswestry LBP disability questionnaire) was distributed to nurses from the selected institutions.

Main Outcome Measures: Prevalence and risk factors for LBP.

Sample Size: With a population size of 1,900, a sample of 152 participants was required; however, to accommodate non-respondents, the sample size was increased to 175 participants.

Results: Overall, 166 of the 175 nurses participated. Multiple regression analysis for factors that are independently associated with LBP revealed that nurses who were Saudi (adjusted odds ratio [aOR] = 3.32; 95% confidence interval [CI]: 1.44 - 7.65), were married (aOR = 4.21; 95% CI: 1.59 - 11.14), lifted and assisted patients manually (aOR = 5.42; 95% CI: 1.53 - 19.19), had increased stress scores (aOR = 1.09; 95% CI: 1.01 - 1.18), and worked more than 8 h/day (aOR = 3.33; 95% CI: 1.41 - 7.82) were more likely to experience LBP.

Conclusion: The LBP prevalence in the study population was high; the cumulative, annual, and weekly LBP prevalence rates were 65.0%, 89.8%, and 56.7%, respectively. Risk factors significantly associated with LBP in nurses included being Saudi, being married, lifting and assisting patients manually, stress, and working more than 8 h/day.

Limitations: First, we were unable to determine any causal relationships between exposure (such as perceived stress) and LBP. Second, self-reported questionnaires can be affected by a participant’s feelings. Third, due to the small number of male nurses, it was difficult to determine whether there was an association between sex and LBP.

 Keywords: Low Back Pain; Prevalence; Risk Factors; Nurses

1. Hoy D., et al. “Measuring the global burden of low back pain”. Best Practice and Research: Clinical Rheumatology2 (2010): 155-165.
2. Wu A., et al. “Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017”. The Annals of Translational Medicine's6 (2020): 299.
3. Al-Arfaj AS., et al. “How common is back pain in Al-Qaseem region”. Saudi Medical Journal2 (2003): 170-173.
4. Stewart WF., et al. “Lost productive time and cost due to common pain conditions in the US workforce”. The Journal of the American Medical Association18 (2003): 2443-2454.
5. Skela-Savič B., et al. “Low back pain among nurses in Slovenian hospitals: cross-sectional study”. International Nursing Review4 (2017): 544-551.
6. Attar SM. “Frequency and risk factors of musculoskeletal pain in nurses at a Tertiary Centre in Jeddah, Saudi Arabia: A cross sectional study”. BMC Research Notes1 (2014): 61.
7. Azizpour Y., et al. “Prevalence of low back pain in Iranian nurses: A systematic review and meta-analysis”. BMC Nursing1 (2017): 50.
8. Alnaami I., et al. “Prevalence and factors associated with low back pain among health care workers in southwestern Saudi Arabia”. BMC Musculoskeletal Disorders1 (2019): 56.
9. Almaghrabi A and Alsharif F. “Prevalence of low back pain and associated risk factors among nurses at King Abdulaziz University Hospital”. International Journal of Environmental Research and Public Health4 (2021): 1567.
10. Alshahrani A. “Prevalence of low back pain among nursing staff in Najran, Saudi Arabia: A cross-sectional study”. Medical Sciences4 (2020): 45.
11. Jradi H., et al. “Psychosocial and occupational factors associated with low back pain among nurses in Saudi Arabia”. Journal of Occupational Health1 (2020): e12126.
12. Sang S., et al. “Prevalence of low back pain among intensive care nurses: A meta-analysis”. Nursing in Critical Care6 (2021): 476-484.
13. Abuzeid Atta Elmannan A., et al. “Non-specific low back pain among nurses in Qassim, Saudi Arabia”. Cureus11 (2021): e19594.
14. Corrêa Pinto RN., et al. “Low back pain prevalence and associated factors in nurses from Brazilian primary health units”. Work1 (2021): 279-285.
15. Lorusso A., et al. “A review of low back pain and musculoskeletal disorders among Italian nursing personnel”. Industrial Health5 (2007): 637-644.
16. Kasa AS., et al. “Low back pain among nurses working in clinical settings of Africa: Systematic review and meta-analysis of 19 years of studies”. BMC Musculoskeletal Disorders1 (2020): 310.
17. Gilchrist A and Pokorná A. “Prevalence of musculoskeletal low back pain among registered nurses: results of an online survey”. Journal of Clinical Nursing11-12 (2021): 1675-1683.
18. Al-Eisa E and Al-Abbad H. “Occupational back pain among rehabilitation nurses in Saudi Arabia: The influence of knowledge and awareness”. Workplace Health and Safety9 (2013): 401-407.
19. Gaowgzeh RAM. “Low back pain among nursing professionals in Jeddah, Saudi Arabia: prevalence and risk factors”. Journal of Back and Musculoskeletal Rehabilitation4 (2019): 555-560.
20. Al Amer HS. “Low back pain prevalence and risk factors among health workers in Saudi Arabia: A systematic review and meta-analysis”. Journal of Occupational Health1 (2020): e12155.
21. Sun W., et al. “The factors of non-specific chronic low back pain in nurses: A meta-analysis”. Journal of Back and Musculoskeletal Rehabilitation3 (2021): 343-353.
22. Tefera BZ., et al. “Magnitude and associated factors of low back pain among nurses working at intensive care unit of public hospitals in Amhara region, Ethiopia”. PLoS One12 (2021): e0260361.
23. Tan BK., et al. “Low back pain beliefs are associated to age, location of work, education and pain-related disability in Chinese healthcare professionals working in China: A cross sectional survey”. BMC Musculoskeletal Disorders1 (2014): 255.
24. Khawaja RA., et al. “Medically certified sickness absence among health care workers”. Journal of Pakistan Medical Association9 (2012): 900-904.
25. Bejia I., et al. “Prevalence and factors associated to low back pain among hospital staff”. Joint Bone Spine3 (2005): 254-259.
26. Şimşek Ş., et al. “Prevalence of and risk factors for low back pain among healthcare workers in Denizli”. Agri2 (2017): 71-78.
27. Hignett S. “Work-related back pain in nurses”. Journal of Advanced Nursing6 (1996): 1238-1246.
28. Shieh SH., et al. “Increased low back pain risk in nurses with high workload for patient care: A questionnaire survey”. Taiwanese Journal of Obstetrics and Gynecology4 (2016): 525-529.
29. Linton SJ. “Occupational psychological factors increase the risk for back pain: A systematic review”. The Journal of Occupational Rehabilitation1 (2001): 53-66.
30. Vinstrup J., et al. “Perceived stress and low-back pain among healthcare workers: A multi-center prospective cohort study”. Frontiers in Public Health 8 (2020): 297.
31. Bin Homaid MB., et al. “Prevalence and risk factors of low back pain among operation room staff at a Tertiary Care Center, Makkah, Saudi Arabia: A cross-sectional study”. Annals of Occupational and Environmental Medicine 28 (2016): 1.
32. Tsuboi Y., et al. “The association between perceived stress and low back pain among eldercare workers in Japan”. Journal of Occupational and Environmental Medicine8 (2017): 765-767.