Comorbidity and impact of chronic spinal pain in Nigeria

Study Design. A cross-sectional survey of households selected using multistage stratified sampling. Objective. This paper investigates the prevalence of chronic spinal pain, its profile of comorbidity, and its impact on role disability in Nigeria. Summary of Background Data. Study was conducted in 21 states representing 57% of the national population. A probability sample (n = 2143) was interviewed. Methods. Self-reports of chronic spinal pain, other pain conditions, as well as comorbid medical conditions were obtained. Composite International Diagnostic Interview, version 3, was used to evaluate mood, anxiety, and substance use disorders. Functional role impairment was assessed with questions about days out of role. Results. Chronic spinal pain was present in 16.4% (95% confidence interval, 14.5%-18.5%) of the sample. Prevalence increased with age of respondents, with 1 in 3 persons 60 years of age and older reporting chronic spinal pain. Persons with chronic spinal pain were at elevated risk to have chronic pain at other anatomic sites, to have a range of medical comorbidities, and to have mood and substance use disorders. Even though about one third of the decrement in functional role performance associated with chronic pain condition was attributable to demographics and comorbid conditions, chronic spinal pain was independently associated with significant role impairment. Conclusion. Chronic spinal pain is a common problem in the Nigerian community, and persons 60 years of age and older may be at particularly elevated risk. Chronic spinal pain is associated with increased probability of comorbid physical and mental disorders. These comorbid conditions partly but do not fully explain the disability associated with chronic spinal pain, which therefore constitutes a substantial health burden on the society.