Medical Student UCSF School of Medicine San Francisco, California, United States
Objectives: Low back pain (LBP) is a leading disability in the United States (US) that prevents people from working and participating in everyday activities. LBP burden is disproportionate amongst Black and Hispanic patients with these patients reporting greater pain intensity, being recommended fewer diagnostic tests, receiving less spine-related care, and reporting less functional improvement. The objective is to investigate disparities, including LBP intensity, in US Black and Hispanic patients through systematic review.
Design: Systematic review was performed utilizing PRISMA guidelines and databases included MEDLINE, Embase, and Web of Science. Article criteria included peer-reviewed journal, patients at least 18 years, and methodology assessing for comparative differences in LBP intensity in US Black and Hispanic patients compared to other populations. Extracted data compared article methodology and conclusions.
Results: Of 777 publications found through search, 4 were identified that fit criteria, consisting of a total of 98 Hispanic and 1092 Black patients. The one study that included Hispanic patients did not separately present pain intensity scores for the Hispanic patients. All 4 publications demonstrated significantly greater pain intensity scores for Black patients as compared to White patients though the measures utilized differed in each study, ranging from numerical rating scales based on 10 versus 11 points over a duration of 24 hours versus 7 days, focusing on average pain versus averaging worst, least and usual pain intensity over time.
Conclusions: Limited studies have focused on characterizing disparities in LBP intensity in US Black and Hispanic patients with none having presented comparisons of Hispanic to non-Hispanic patients. Of these 4 identified studies comparing LBP intensity of Black versus White patients, heterogenous pain intensity measures were used, limiting ability to draw conclusions across studies. More standardized comparisons following larger groups and examination of disparity etiology are needed to elucidate racial disparities in LBP intensity.
