STUDY OBJECTIVE--The aim was to assess the geographical variation in low back pain and associated disability in Britain. DESIGN--This was a cross sectional survey with information collected by postal questionnaire. SETTING--General practices in seven British towns and one rural district. SUBJECTS--1172 men and 1495 women aged 20-59 years were selected from the age-sex registers of 136 general practitioners in the study areas. MAIN RESULTS--The overall lifetime and one year period prevalences of low back pain were 58.3% and 36.1%. Rates in men and women were similar. Symptoms were more common in men with manual occupations than in those with non-manual jobs, but in women there was no clear trend in relation to social class. Geographical differences in prevalence were small, but the threshold for consulting general practitioners about symptoms varied markedly from place to place. After allowance for age, sex, social class, and severity of symptoms, subjects in the northern towns of Arbroath and Peterlee who had suffered from low back pain in the past year were three to four times as likely to have consulted their doctor about the problem as those living in the southern towns of St Austell and Dorking. Consultation rates in the Midlands were intermediate. CONCLUSIONS--Geographical variation in rates of general practice consultation for low back pain in Britain is due largely to differences in patient behaviour once symptoms have developed. The distribution of important causes of low back back pain across the country is probably fairly uniform.
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