Back pain in men. A prospective study over twenty years

Sammanfattning: The initial objective of this thesis was to design a method in order to identify individuals, with a back pain which was in risk of deteriorating during the military service. Those who enlisted during a six-month period answered questions about back pain, and a sub-group was also clinically examined. Follow-ups have been undertaken by postal questionnaires, 10 and 20 years later (at 20-years including a self-administered test). At the age of 18, 37% had experienced back pain some time over the last two years. Twenty years later 84% experienced more or less back- and/or neck pain, 39% reported frequent pain (often or always). Experiencing both back- and neck pain was more common than either one or the other.Having experienced pain already at enlistment presented an increased risk of frequent pain problems at follow-up, but for those who had reported pain, which had a great influence on their daily activities, there was an even higher statistical risk.The pain showed a correlation to the work environment, 33% among those with a sitting job at enlistment and 53% of those with heavy jobs, reported frequent pain at follow-up.At time of the 20-year follow-up, both physically heavy work, and the report of a poor psychosocial work environment correlated to frequent pain.Those with overweight (BMI>25) had increased from around 10% to 50% twenty years later, BMI > 25 at enlistment also meant a significantly increased risk of frequent pain at follow-up. Smoking > 10 cigarettes/day at enlistment presented a significantly increased risk for back/neck pain at follow-up. The number of smokers had, however, decreased.The only clinical tests at enlistment that correlated with frequent pain at follow-up were pain during cervical provocation tests and lumbar "springing" test. There was an indication that both the workrelated stress and the amount of hours worked had increased between the first and the second follow-up.Conclusions: Back pain was rather common already among young men, and most men had some experience of back- and/or neck pain at the 20-year follow-up.Back pain that at enlistment had affected daily activities, heavy work, overweight and smoking were associated with an increased risk of frequent pain twenty years later.