Socio-Demographic Factors and Levels of Pain and Disability in Patients with Somatic and Neurogenic Low Back Pain at Mbagathi Sub-County Hospital in Nairobi City County, Kenya

Abstract

Low Back Pain (LBP) is a problem of public health importance in developed countries as well as developing ones including Kenya. It is sub-categorized into neurogenic and somatic pain. Low back pain causes suffering, discomfort, and disability whose levels remain unknown. The main objective of this study was to determine the levels of pain and disability and their association with selected socio-demographic characteristics in patients with neurogenic and somatic LBP at Mbagathi Sub-county Hospital. This was a cross-sectional study design where 176 patients of 18 years and above were sampled using systematic random sampling. A Semi-structured questionnaire, adapted Oswestry Disability Index (ODI) and Self- complete Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) were administered by research assistants to study subjects. The questionnaire captured information on selected socio-demographic characteristics and adapted S-LANSS information on pain intensity and type/category while the adapted ODI was used to measure levels of disability. Ethical considerations in regard to approval of the study, privacy of participants, confidentiality of information and voluntary participation by participants was observed. Majority (72.7%) suffered from somatic LBP compared to 27.3% that had neurogenic LBP. Out of 176 participants, females were more (63.1%) than males (36.9%). The mean age was 41.1(12.6) SD, median age in years was 40 and IQR 32-48. On Visual Analogue Scale (VAS), 55.7 %( n=98) reported moderate pain and severe pain was 44.3 % (n=78). On ODI, 60.8% had minimal disability, 33.5% moderate disability and 5.7% had severe disability. Chi-square test of association showed no relationship between levels of pain and disability and selected socio-demographics (P>0.05). Multivariate logistic regression showed significant association between severe pain and moderate and severe disability (P<0.001, OR=7.2, 95% CI, 2.6-20.2). Neurogenic pain was also significantly associated with severe and moderate disability (P=0.006, OR=14.1, 95% CI, 2.2-92.5). From the study it was found that patients with neurogenic LBP had a higher risk of severe and moderate disability compared to somatic LBP. Therefore special attention is required in LBP diagnosis to identify this sub-category to be able to effectively address the severe and moderate disability.