Mapping Comorbidities in Patients With Low Back Pain-A Systematic Review.

Only nine observational studies met the inclusion criteria, so the overview is narrow. The studies used different countries, age groups, healthcare systems, and comorbidity lists, so their results cannot be pooled into one clear picture. The definition of comorbidity was not consistent. Some studies may have recorded symptoms or questionnaire cutoffs rather than diagnosed conditions. Prevalence estimates changed based on whether comorbidities came from patient reports, registries, or both. Three studies were rated very low certainty, four low certainty, and two moderate certainty for prevalence estimates. Most studies were from high-income countries, so findings may not apply everywhere. The review was not pre-registered. Because the included studies were observational, the review cannot show that comorbidities cause low back pain or that treating them changes outcomes.

The authors declare no conflicts of interest.

Do not read the 49% to 92% range as one prevalence rate, and do not read the common comorbidities as proof that treating them improves low back pain. The review only mapped what other conditions were reported in observational studies, and the estimates varied by study population, age, comorbidity definition, and data source.