Multimorbidity among Patients with Back Pain: A Study of Records at a Swedish Primary Health Care Centre

Introduction: Multimorbidity is defined as the simultaneous occurrence of several diseases where none of them is considered as the most important one. In Primary Care a large part of the visits consists of patients with pain disorders. Patients with back pain and diseases related to the spine constitute the largest group of these patients. However, little is known if patients with back pain have a higher degree of multimorbidity than patients without back pain. The aim of this epidemiological study was to investigate which were the most frequent simultaneously concurrent diseases together with back pain. Method: We performed a cross-sectional study of all visits involving back pain to one Primary Health Care Centre in Stockholm, Sweden during the period October 2011 to September 2014. Patients over 20 years of age suffering from back pain were compared, concerning all their diagnoses and number of visits with those who were not diagnosed with back pain. Results: Out of 12,017 adult patients, 971 had back pain; 57% women and 43% men. The patients with back pain had a higher degree of multimorbidity, more primary health care visits and more diagnoses compared to those without back pain. For essentially all of the 20 most common diagnoses the patients with back pain had a higher prevalence ratio. Most evident among these diagnoses was abdominal pain, which had twice as high prevalence among patients with back pain compared to those without. Discussion: Our study showed that patients with back pain had a higher degree of multimorbidity compared to those who did not have back pain. The most frequent concurrent diseases were other pain disorders especially abdominal pain. This finding raises the question if there may be some connection between the innervation from the spine and this concurrent disorder.