Differences in physical and psychological health in patients with chronic low back pain: a national survey in general Spanish population



To estimate the prevalence of diagnosed and undiagnosed chronic low back pain (CLBP-D and CLBP-UD, respectively) in the general adult population in Spain and to compare the characteristics of these two groups with subjects without CLBP symptoms (No-CLBP). To establish CLBP-D patient sub-groups according to their self-perceived health status, mental health, level of pain and the impact of their pain on daily activities.


Data were obtained from the National Health Survey of Spain 2017 with a sample of 23,089 adults. Three groups were defined: CLBP-D, CLBP-UD and No-CLBP. In the CLBP-D group, a cluster analysis was performed to identify sub-groups. A multinomial regression model was constructed to determine the factors associated with each of the sub-groups identified.


The prevalence of CLBP-D was 22% (95% CI 21.5–22.5) and that of CLBP-UD was 1.4% (95% CI 1.2–1.5). CLBP-D was more common in middle-aged females with a low educational level. They have a worse perceived health status, report more comorbidities, have worse mental health and more limitations in comparison with the populations without CLBP and with CLBP-UD. Three sub-groups of CLBP-D subjects were identified. Women and older subjects with a lower educational level, more occupational stress, less social support and with more physical limitations were the most likely subjects to be included in the group worst-affected.


There is a high prevalence of CLBP among the adult population in Spain. Occupational stress and a lack of social support are common factors among subjects’ worst-affected of CLBP-D and identifying the subjects with these risks is therefore a recommended strategy for improving the healthcare provided to CLBP patients.

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This work was supported by a collaboration between the University of Cádiz and the Grünenthal Foundation. The Grünenthal Foundation is a private, non-profit organization that promotes the dissemination of scientific knowledge and supports research.

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Dueñas, M., Moral-Munoz, J.A., Palomo-Osuna, J. et al. Differences in physical and psychological health in patients with chronic low back pain: a national survey in general Spanish population. Qual Life Res (2020). https://doi.org/10.1007/s11136-020-02553-y

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  • Low back pain
  • Mental health
  • Chronic pain
  • Stress
  • Social support