Transitions in chronic low back pain in Japanese older adults: a sociomedical perspective.

This study examines the patterns and determinants of chronic low back pain over a three-year period among older adults in Japan. We tested our model based on a sociomedical perspective, using a two-wave national probability sample survey of persons aged 60 and older (N = 2,200) conducted in 1987 and 1990 in Japan. At baseline, the prevalence of chronic low back pain was 18 percent. Among those who were free of back pain at baseline, the probabilities of onset, death, and nonresponse were 13 percent, 7 percent, and 10 percent. Among those who had back pain at baseline, the probabilities of recovery, death, and nonresponse were 43 percent, 8 percent, and 9 percent, respectively. Our multinomial logistic regression analysis supports our thesis that societal factors (age, gender, education, and social relationships) affect transitions in chronic back pain not only directly, but also indirectly through mediating health and health behavior factors. The results suggest that social relationships have both favorable and unfavorable effects on chronic low back pain.