Unpacking the Pain: Understanding Barriers and Unmet Needs of Adults with Low Back Pain in a Southern Nigeria Outpatient Clinic
Article Sidebar
Page Numbers:
75-87
Digital Object Identifier:
10.58578/ajmsphr.v2i1.4610
Viewed: 367 times
Downloaded: 159 times
LYAS Publisher cordially invites qualified professionals to serve as Editors or Reviewers. Your expertise will make an important contribution to maintaining and strengthening the academic quality of our publications. Interested applicants are kindly requested to complete the application form at the following link: Editors & Reviewers
Please feel free to contact us if you need any further information about the submission process or if you have any additional questions.
Authors:
Obianuju Iheomamere Muoghallu1, Akaninyene Mark2, Tensaba Andes Akafa3, Gloria Omonefe Oladele4, Kingsley Iyoko Iseko5 
Copyright :
Authors retain copyright and grant the journal right of first publication.
Main Article Content
Abstract
Background: Low back pain (LBP) is a prevalent health issue leading to functional disability in adults. This study aimed to evaluate the barriers to care and unmet needs of adults with LBP and functional disability attending the General Out-Patient Clinic (GOPC) at the University of Uyo Teaching Hospital, Akwa Ibom State. The goal is to enhance quality of life by reducing disability and LBP burden through prevention, addressing barriers, and fulfilling unmet needs. Key barriers identified include limited access to healthcare, high out-of-pocket costs, inadequate insurance coverage, and a lack of understanding of LBP and self-management strategies. Methodology: Conducted at the GOPC, this cross-sectional analytical study involved 370 adult patients (18+ years) using systematic sampling. Data collection spanned two months, employing an interviewer-administered semi-structured Oswestry lumbar disability questionnaire. Analysis utilized IBM SPSS version 27, with frequency tables for pain patterns and chi-square tests to assess associations between body mass index (BMI) and LBP severity. Results: The mean age of respondents was 40.2 years. LBP was significantly linked to low function, with the association strengthening over time. Most respondents were classified as obese (BMI 25.0-29.9 kg/m²), and 56.7% reported high pain intensity. Activities like lifting weights and sitting exacerbated pain for 70.3% and 66.2% of respondents, respectively. The median pain score was 52, with significant differences noted (p<0.001). Alcohol consumption was reported by 39.6% (p=0.005), while 72.2% did not smoke. Respondents with LBP were 1.70 times more likely to experience functional disability compared to those without. Conclusion: LBP is strongly associated with functional disability among adults. Unmet needs include limited rehabilitation access, inadequate education on LBP, and insufficient support for self-management. Addressing risk factors, implementing multi-modal pain management strategies, and enhancing health education are essential for preventing functional disability.
Article Details
References
2. Waddell G. The Back Pain Revolution 2022. 2nd ed. Edinburgh: Churchill Livingstone
3. Vlaeyen JW, Morley S, Linton SJ, Boersma K, de Jong J. Pain-Related Fear: 2021. Exposure-Based Treatment for Chronic Pain. Seattle, WA: IASP Press;
4. Chou R, Qaseem A, Snow V, et al. 2017. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med.;147(7):478-491. doi: 10.7326/0003-4819-147-7-200710020-00006
5. Yokota J, Fukutani N, Nin K, et al. 2019. Association of low back pain with presenteeism in hospital nursing staff. J Occup Health.;61:219–26.
6. Sakai K, Nagata T, Nagata M, et al. Relationship between impaired work function and coping behaviors in workers with low back pain. J Occup Health. 2021;63:e12272.
7. Reid MC, Williams CS, Gill TM. Back pain and decline in lower extremity physical function among community-dwelling older persons. J Gerontol A Biol Sci Med Sci. 2005;60:793–7.
8. Rudy TE, Weiner DK, Lieber SJ, et al. The impact of chronic low back pain on older adults: a comparative study of patients and controls. Pain. 2007;131:293–301.
9. Coyle PC, Knox PJ, Pohlig RT, et al. Hip range of motion and strength predict 12-month physical function outcomes in older adults with chronic low back pain: the Delaware spine studies. ACR Open Rheumatol. 2021;3:850–9.
10. Leveille SG, Guralnik JM, Hochberg M, et al. Low back pain and disability in older women: independent association with difficulty but not inability to perform daily activities. J Gerontol A Biol Sci Med Sci. 1999;54:M487–93.
11. Chou CH, Hwang CL, Wu YT. Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: a meta-analysis. Arch Phys Med Rehabil. 2012;93:237–4
12. Bernetti A, Agostini F, de Sire A, et al. Neuropathic pain and rehabilitation: a systematic review of international guidelines. Diagnostics (Basel). 2021;11:74
13. Bernetti A, La Russa R, de Sire A, et al. Cervical spine manipulations: role of diagnostic procedures, effectiveness, and safety from a rehabilitation and forensic medicine perspective: a systematic review. Diagnostics (Basel). 2022;12:1056.
14. Tomata Y, Suzuki Y, Kawado M, et al. Long-term impact of the 2011 great East Japan earthquake and tsunami on functional disability among older people: a 3-year longitudinal comparison of disability prevalence among Japanese municipalities. Soc Sci Med. 2015;147:296–9.
15. Kuroda Y, Iwasa H, Orui M, et al. Risk factor for incident functional disability and the effect of a preventive exercise program: a 4-year prospective cohort study of older survivors from the great East Japan earthquake and nuclear disaster. Int J Environ Res Public Health.
16. Greiner C, Ono K, Otoguro C, et al. 2016. Intervention for the maintenance and improvement of physical function and quality of life among elderly disaster victims of the great East Japan earthquake and tsunami. Appl Nurs Res.;31:154–9.
17. Tanji F, Sugawara Y, Tomata Y, et al. 2017. Psychological distress and the incident risk of functional disability in elderly survivors after the great East Japan earthquake. J Affect Disord.;221:145–50.
18. Tsubota-Utsugi M, Yonekura Y, Tanno K, et al. 2018. Association between health risks and frailty in relation to the degree of housing damage among eldery survivors of the great East Japan earthquake. BMC Geriatr.;18:133.