Prevalence of low back pain and associated factors among military personnel attending the orthopedic clinic of the General Military Hospital Bombo

Abstract

Background: Low back pain (LBP) is a significant medical and social problem among military personnel, contributing to high health care costs, reduced productivity and disability. However, in Uganda there is generally paucity of literature on the prevalence and factors associated with LBP amongst this special group of people despite their occupational exposure. This study aimed to determine the prevalence of LBP and its associated factors amongst military personnel. Methods: This was a cross-sectional study conducted at the Orthopedic clinic of the General Military Hospital Bombo, targeting military personnel. LBP was assessed using a modified Nordic Musculoskeletal Questionnaire. Data on the sociodemographic, psychosocial and occupational exposure were collected through an interviewer-administered structured questionnaire. Factors associated with LBP were identified using Modified Poisson regression analysis, with statistical significance set at p < 0.05. Data were analysed using STATA version 15. Results: The study enrolled 327 military personnel, with a mean age of 36.0 ± 9.3 years and a predominance of males (n= 244), (74.6%). The overall prevalence of LBP was 61.5% (n=201), with an age standardized prevalence of 64.1%. The prevalence of LBP was highest in participants aged more than 50 years (85.3%), the Senior Commissioned Officers (87.5%), the Recruits/Cadets (81.0%) and those working in the artillery unit (87.0%) and the service unit (68.8%). Pain was predominantly sharp and shooting in character (49.3%), with the majority of affected personnel reporting radiation to the thigh (27.4%), buttocks (19.9%), and foot (11.9%), alongside burning sensations (28.4%) and muscle spasms (28.9%). This pattern of neuropathic-quality pain with dermatomal radiation is consistent with nerve root irritation. LBP was found to be significantly associated with few years of service [1–5 years] (aPRR 0.5 [0.268 - 0.891], p=0.02) or 6–10 years (aPRR 0.5 [0.258 - 0.844], p=0.012) and engaging in physical activity for only 0–5 hours per week (aPRR 1.4 [1.055 - 2.073], p=0.048) as compared to those who had served the military for over 20 years or engage in physical activity for more than 16 hours respectively. Conclusion: LBP is highly prevalent among military personnel (64.1%) and has substantial functional impact. Early-career personnel and those with lower levels of physical activity are at increased risk. Strengthening preventive strategies, including structured physical conditioning, ergonomic interventions, and early rehabilitation programs, is recommended to reduce the burden of LBP and maintain operational readiness within the Uganda People’s Defense Forces.