{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:48:44Z","timestamp":1792259324399,"version":"4.4.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"7-8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Physical and medical readiness have emerged as a top priority in the army over the last decade. With this emphasis on deployment readiness, it is important to understand key risk factors attributed to common medical problems that arise in our soldiers, including low back pain. The purpose of this study is to elucidate demographic and lifestyle risk factors which would result in seeking medical care for musculoskeletal low back pain among active duty army personnel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A cross-sectional retrospective study investigating all active duty soldiers between October 1, 2016 and September 30, 2018 was performed using the existing Military Health System Data Repository to retrospectively review administrative claims data. Our study queried 39 unique International Classification of Disease codes, 10th Revision codes for low back pain to determine a positive case. We compared those with and without back pain across all variables using a chi-square analysis in SAS. Multivariate logistic analysis was performed to adjust for confounding within any single proposed risk factor and the six other proposed risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six hundred fifty seven thousand and six thirty soldiers met inclusion criteria; 228,184 of whom had a medical encounter for low back pain (34.7%). All of the proposed risk factors included statistically significant unadjusted and adjusted odds ratios (ORs) with age conferring the greatest risk in soldiers aged 50\u201359 with an OR of 2.89 (2.73\u20133.05) compared to those aged 20\u201329. Obesity-adjusted OR was 1.77 (1.74\u20131.80) compared to those who were normal weight. Senior Enlisted status\u2013adjusted OR was 1.34 (1.32\u20131.36). Females were 66% more likely to have low back pain compared to males with an OR of 1.66 (1.63\u20131.68).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Disease burden for low back pain tends to be high in the U.S. Army with 34.7% of service members experiencing low back pain. Older age, obesity, and being an enlisted, female service member are risk factors for these musculoskeletal injuries, which is in agreement with previously reported literature on the topic. To mitigate the burden of low back pain, policies and incentives to encourage healthy body mass index and lifestyle are needed. The results of this work inform future studies aimed at further delineating the risk factors found in this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usab217","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T23:19:36Z","timestamp":1624403976000},"page":"e814-e820","source":"Crossref","is-referenced-by-count":31,"title":["Prevalence and Risk Factors for Musculoskeletal Back Injury Among U.S. Army Personnel"],"prefix":"10.1093","volume":"187","author":[{"given":"Baris K","family":"Gun","sequence":"first","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Banaag","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc , Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munziba","family":"Khan","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc , Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey Perez","family":"Koehlmoos","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"issue":"4","key":"2022070112171284400_R1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/wvn.12301","article-title":"Headache in the active duty military population: an integrative review","volume":"15","author":"Bader","year":"2018","journal-title":"Worldviews Evid Based Nurs"},{"issue":"1","key":"2022070112171284400_R2","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.1016\/j.amepre.2009.10.014","article-title":"Medical surveillance of injuries in the U.S. Military descriptive epidemiology and recommendations for improvement","volume":"38","author":"Jones","year":"2010","journal-title":"Am J Prev Med"},{"key":"2022070112171284400_R3","article-title":"Returning from Iraq and Afghanistan: the long-term costs of providing veterans medical care and disability benefits","volume-title":"John F. Kennedy School of Government - Harvard University","author":"Soldiers","year":"2007"},{"issue":"9\u201310","key":"2022070112171284400_R4","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1093\/milmed\/usz032","article-title":"Body mass index effect on health service utilization among active duty male United States army soldiers","volume":"184","author":"Shiozawa","year":"2019","journal-title":"Mil Med"},{"issue":"6","key":"2022070112171284400_R5","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1097\/00005768-200106000-00014","article-title":"Risk factors for training-related injuries among men and women in basic combat training","volume":"33","author":"Knapik","year":"2001","journal-title":"Med Sci Sports Exerc"},{"issue":"8","key":"2022070112171284400_R6","first-page":"434","article-title":"Aerobic capacity. Differences between smokers and non-smokers. Effects of withdrawal","volume":"193","author":"Aparici","year":"1003","journal-title":"Rev Clin Esp"},{"issue":"10","key":"2022070112171284400_R7","first-page":"1351","article-title":"Low back pain in military basic trainees","volume":"18","author":"O\u2019Connor","year":"1993","journal-title":"A Pilot Study Spine"},{"issue":"4","key":"2022070112171284400_R8","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.spinee.2013.06.029","article-title":"Occupational driving as a risk factor for low back pain in active-duty military service members","volume":"14","author":"Knox","year":"2014","journal-title":"Spine"},{"issue":"1","key":"2022070112171284400_R9","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-019-2421-7","article-title":"Prevalence and potential risk factors of flight-related neck, shoulder and low back pain among helicopter pilots and crewmembers: a questionnaire-based study","volume":"20","author":"Posch","year":"2019","journal-title":"Musculoskelet Disord"},{"issue":"5\u20136","key":"2022070112171284400_R10","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.1093\/milmed\/usx095","article-title":"Non-modifiable risk factors associated with sternoclavicular joint dislocations in the U.S. Military","volume":"183","author":"Gun","year":"2018","journal-title":"Mil Med"},{"issue":"1\u20132","key":"2022070112171284400_R11","first-page":"e178","article-title":"Non-modifiable risk factors associated with avascular necrosis in the US Military","volume":"185","author":"Gun","year":"2020","journal-title":"Mil Med"},{"issue":"10","key":"2022070112171284400_R12","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.7205\/MILMED-D-15-00571","article-title":"Epidemiology of lower extremity stress fractures in the United States Military","volume":"181","author":"Waterman","year":"2016","journal-title":"Mil Med"},{"key":"2022070112171284400_R13","article-title":"About the military health system","author":"Defense Health Agency"},{"key":"2022070112171284400_R14","article-title":"Military health system basics","author":"Funk"},{"issue":"8","key":"2022070112171284400_R15","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1377\/hlthaff.2019.00252","article-title":"Assessing low-value health care services in the military health system","volume":"38","author":"Koehlmoos","year":"2019","journal-title":"Health Aff"},{"key":"2022070112171284400_R16","article-title":"Defense primer: military health system","author":"Congressional Research Service"},{"issue":"12","key":"2022070112171284400_R17","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.1007\/s11999-017-5229-5","article-title":"Is there variation in procedural utilization for lumbar spine disorders between a fee-for-service and salaried healthcare system?","volume":"475","author":"Schoenfeld","year":"2017","journal-title":"Clin Orthop Relat Res"},{"key":"2022070112171284400_R18","article-title":"Risk factors for musculoskeletal back injury among US Navy and Marine Corps personnel, 2009-2015","author":"Mullinax"},{"key":"2022070112171284400_R19","article-title":"DoD 1312. 1-1. Occupational Conversion Index: enlisted\/officer\/civilian","author":"Defense of Defense Office of the Undersecretary of Defense Personnel and Readiness.","year":"2001"},{"issue":"12","key":"2022070112171284400_R20","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1097\/00005768-199912000-00017","article-title":"Gender differences in musculoskeletal injury rates: a function of symptom reporting?","volume":"31","author":"Almeida","year":"1999","journal-title":"Med Sci Sports Exerc"},{"issue":"3","key":"2022070112171284400_R21","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S0749-3797(99)00173-7","article-title":"High injury rates among female army trainees: a function of gender?","volume":"18","author":"Bell","year":"2000","journal-title":"Am J Prev Med"},{"key":"2022070112171284400_R22","article-title":"Women in the U.S. Military: growing share, distinctive profile","volume-title":"PEW Soc & Dem Trends","author":"Patten"},{"issue":"11","key":"2022070112171284400_R23","doi-asserted-by":"crossref","first-page":"S654","DOI":"10.1249\/MSS.0b013e3181893f30","article-title":"Differences in physical fitness of male and female recruits in gender-integrated army basic training","volume":"40","author":"Yanovich","year":"2008","journal-title":"Med Sci Sports Exerc"},{"issue":"2","key":"2022070112171284400_R24","article-title":"2015 Department of Defense Health Related Behaviors Survey (HRBS)","volume":"8","author":"Meadows","year":"2018","journal-title":"Rand Health Q"},{"key":"2022070112171284400_R25","article-title":"Medical services: medical readiness","author":"Defense Do. AR 40-502"},{"issue":"21","key":"2022070112171284400_R26","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1001\/jama.2016.6458","article-title":"Trends in obesity among adults in the United States, 2005 to 2014","volume":"315","author":"Flegal","year":"2016","journal-title":"JAMA"},{"issue":"4","key":"2022070112171284400_R27","doi-asserted-by":"crossref","first-page":"699","DOI":"10.3233\/BMR-140572","article-title":"Efficacy of core muscle strengthening exercise in chronic low back pain patients","volume":"28","author":"Kumar","year":"2015","journal-title":"J Back Musculoskelet Rehabil"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/187\/7-8\/e814\/44369942\/usab217.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/187\/7-8\/e814\/44369942\/usab217.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T08:19:09Z","timestamp":1656663549000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/187\/7-8\/e814\/6308094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,23]]},"references-count":27,"journal-issue":{"issue":"7-8","published-online":{"date-parts":[[2021,6,23]]},"published-print":{"date-parts":[[2022,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usab217","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,7,1]]},"published":{"date-parts":[[2021,6,23]]}}}