{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:25:44Z","timestamp":1793993144083,"version":"4.8.0"},"reference-count":69,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: The global burden of chronic low back pain (CLBP) is a major concern in public health. Several CLBP epidemiological studies have been conducted in high-income-countries (HICs) with little known in low-and-middle-income-countries (LMICs) due to other competing priorities of communicable diseases. The extrapolation of results of studies from HICs for use in LMICs is difficult due to differences in social norms, healthcare systems, and legislations, yet there is urgent need to address this growing burden. It is against this backdrop that we conducted this review to map the current evidence on the distribution of CLBP in Sub-Saharan Africa (SSA). Methods: A comprehensive literature search was conducted from the following databases: PubMed, Google Scholar, Science Direct databases, World Health Organizations library databases, EMBASE, EBSCOhost by searching the following databases within the platform; academic search complete, CINAHL with full text, health sources: nursing\/academic and MEDLINE. The title, abstract and the full text screening phases were performed by two independent reviewers with the third reviewer employed to adjudicate discrepancies. The reference list of all included articles was also searched for eligible articles. This scoping review was reported in accordance with the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation, as well as guided by Arksey and O\u2019Malley\u2019s scoping review framework. A thematic content analysis was used to give a narrative account of the review. Results: The electronic search strategy retrieved 21,189 articles. Title\/abstract and full text screening only identified 11 articles, which were included in this review. The prevalence of CLBP among the general population ranged from 18.1% to 28.2% and from 22.2% to 59.1% among LBP patients. The prevalence of occupation based CLBP ranged from 30.1% to 55.5%. Identified risk factors for CLBP are multifactorial and included biomechanical, psychological, socioeconomic and lifestyle factors, with psychosocial factors playing a significant role. Hypertension, diabetes mellitus, peptic ulcer disease were the most common comorbidities identified. CLBP disability was significantly associated with psychosocial factors. The management of CLBP in primary care follows the traditional biomedical paradigm and primarily involves pain medication and inconsistent with guidelines. Conclusions: There are limited epidemiological data on CLBP in SSA, however, this study concluded that the prevalence and risk factors of CLBP in SSA are comparable to reports in HICs. Considering the projected increase in the burden of CLBP in LMICs extensive research effort is needed to close this knowledge gap.<\/jats:p>","DOI":"10.3390\/ijerph19052964","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T09:24:53Z","timestamp":1646299493000},"page":"2964","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["A Scoping Review on the Epidemiology of Chronic Low Back Pain among Adults in Sub-Saharan Africa"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3669-9768","authenticated-orcid":false,"given":"Morris","family":"Kahere","sequence":"first","affiliation":[{"name":"Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5352-5658","authenticated-orcid":false,"given":"Mbuzeleni","family":"Hlongwa","sequence":"additional","affiliation":[{"name":"Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa"},{"name":"Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9435-3488","authenticated-orcid":false,"given":"Themba G.","family":"Ginindza","sequence":"additional","affiliation":[{"name":"Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3862946","DOI":"10.1155\/2019\/3862946","article-title":"Low Back Pain and Associated Factors among Primary School Teachers in Mekele City, North Ethiopia: A Cross-Sectional Study","volume":"2019","author":"Kebede","year":"2019","journal-title":"Occup. Ther. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.21037\/atm.2020.02.175","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: Estimates from the Global Burden of Disease Study 2017","volume":"8","author":"Wu","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_3","first-page":"49","article-title":"Global, regional and national burden of low back pain 1990\u20132019: A systematic analysis of the Global Burden of Disease study 2019","volume":"32","author":"Chen","year":"2022","journal-title":"J. Orthop. Transl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","article-title":"What low back pain is and why we need to pay attention","volume":"391","author":"Hartvigsen","year":"2018","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1590\/S0034-8910.2015049005874","article-title":"Prevalence of chronic low back pain: Systematic review","volume":"49","author":"Meucci","year":"2015","journal-title":"Rev. De Saude Publica"},{"key":"ref_6","first-page":"777","article-title":"Acute and chronic low back pain","volume":"98","author":"Patrick","year":"2014","journal-title":"Med. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.berh.2010.01.002","article-title":"Exercise therapy for chronic nonspecific low-back pain","volume":"24","author":"Rubinstein","year":"2010","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Amundsen, P.A., Evans, D.W., Rajendran, D., Bright, P., Bj\u00f8rkli, T., Eldridge, S., Buchbinder, R., Underwood, M., and Froud, R. (2018). Inclusion and exclusion criteria used in non-specific low back pain trials: A review of randomised controlled trials published between 2006 and 2012. BMC Musculoskelet. Disord., 19.","DOI":"10.1186\/s12891-018-2034-6"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1741-7015-9-108","article-title":"Barriers and progress in the treatment of low back pain","volume":"9","author":"Foster","year":"2011","journal-title":"BMC Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E668","DOI":"10.1097\/BRS.0b013e318241e5de","article-title":"The burden of chronic low back pain: Clinical comorbidities, treatment patterns, and health care costs in usual care settings","volume":"37","author":"Gore","year":"2012","journal-title":"Spine"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Yang, S., and Chang, M.C. (2019). Chronic pain: Structural and functional changes in brain structures and associated negative affective states. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20133130"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1179\/2049396714Y.0000000094","article-title":"Chronic low back pain among tobacco farmers in southern Brazil","volume":"21","author":"Meucci","year":"2015","journal-title":"Int. J. Occup. Environ. Health"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Louw, Q.A., Morris, L.D., and Grimmer-Somers, K. (2007). The prevalence of low back pain in Africa: A systematic review. BMC Musculoskelet. Disord., 8.","DOI":"10.1186\/1471-2474-8-105"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-018-2075-x","article-title":"An update on the prevalence of low back pain in Africa: A systematic review and meta-analyses","volume":"19","author":"Morris","year":"2018","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_16","first-page":"205","article-title":"The prevalence of low back pain: A systematic review of the literature from 1966 to 1998","volume":"13","author":"Walker","year":"2000","journal-title":"Clin. Spine Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1002\/art.34347","article-title":"A systematic review of the global prevalence of low back pain","volume":"64","author":"Hoy","year":"2012","journal-title":"Arthritis Rheum."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-017-1511-7","article-title":"Prevalence of low back pain in emergency settings: A systematic review and meta-analysis","volume":"18","author":"Edwards","year":"2017","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: Towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"Int. J. Soc. Res. Methodol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: Advancing the methodology","volume":"5","author":"Levac","year":"2010","journal-title":"Implement. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13643-020-01321-w","article-title":"Mapping evidence on the prevalence, incidence, risk factors and cost associated with chronic low back pain among adults in Sub-Saharan Africa: A systematic scoping review protocol","volume":"9","author":"Kahere","year":"2020","journal-title":"Syst. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., and Brennan, S.E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372.","DOI":"10.1136\/bmj.n71"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e000284","DOI":"10.1136\/bmjgh-2017-000284","article-title":"Biopsychosocial factors associated with chronic low back pain disability in rural Nigeria: A population-based cross-sectional study","volume":"2","author":"Coker","year":"2017","journal-title":"BMJ Glob. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4103\/1119-3077.175964","article-title":"Low back pain as seen in orthopedic clinics of a Nigerian Teaching Hospital","volume":"19","author":"Omoke","year":"2016","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"621","DOI":"10.2478\/s13382-013-0135-x","article-title":"Prevalence and impacts of low back pain among peasant farmers in south-west Nigeria","volume":"26","author":"Tella","year":"2013","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Nakua, E.K., Otupiri, E., Dzomeku, V.M., Owusu-Dabo, E., Agyei-Baffour, P., Yawson, A.E., Folson, G., and Hewlett, S. (2015). Gender disparities of chronic musculoskeletal disorder burden in the elderly Ghanaian population: Study on global ageing and adult health (SAGE WAVE 1). BMC Musculoskelet. Disord., 16.","DOI":"10.1186\/s12891-015-0666-3"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6793090","DOI":"10.1155\/2019\/6793090","article-title":"Magnitude and Contributing Factors of Low Back Pain among Long Distance Truck Drivers at Modjo Dry Port, Ethiopia: A Cross-Sectional Study","volume":"2019","author":"Yosef","year":"2019","journal-title":"J. Environ. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1111\/1756-185X.13832","article-title":"Hospital admission and associated factors among individuals presenting to healthcare facilities for low back pain in Ethiopia","volume":"23","author":"Beyera","year":"2020","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kahere, M., and Ginindza, T. (2021). The prevalence and risk factors of chronic low back pain among adults in KwaZulu-Natal, South Africa: An observational cross-sectional hospital-based study. BMC Musculoskelet. Disord., 22.","DOI":"10.1186\/s12891-021-04790-9"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4102\/phcfm.v14i1.3134","article-title":"The prevalence and psychosocial risk factors of chronic low back pain in KwaZulu-Natal","volume":"14","author":"Kahere","year":"2022","journal-title":"Afr. J. Prim. Health Care Fam. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"698","DOI":"10.4314\/ahs.v14i3.28","article-title":"Management of LBP at primary care level in South Africa: Up to standards?","volume":"14","author":"Crous","year":"2014","journal-title":"Afr. Health Sci."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Doualla, M., Aminde, J., Aminde, L.N., Lekpa, F.K., Kwedi, F.M., Yenshu, E.V., and Chichom, A.M. (2019). Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2403-9"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/nhs.12048","article-title":"Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study","volume":"15","author":"Vaismoradi","year":"2013","journal-title":"Nurs. Health Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1111\/hsc.12939","article-title":"Determinants of healthcare utilisation for low back pain: A population-based study in Ethiopia","volume":"28","author":"Beyera","year":"2020","journal-title":"Health Soc. Care Community"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1097\/BRS.0b013e3181ba1531","article-title":"The impact of body mass index on the prevalence of low back pain: The HUNT study","volume":"35","author":"Heuch","year":"2010","journal-title":"Spine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/AJP.0000000000000396","article-title":"Prevalence of chronic neck pain, low back pain, and knee pain and their related factors in community-dwelling adults in Iran","volume":"33","author":"Noormohammadpour","year":"2017","journal-title":"Clin. J. Pain"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"876306","DOI":"10.1155\/2011\/876306","article-title":"The Prevalence of Chronic Pain in Canada","volume":"16","author":"Schopflocher","year":"2011","journal-title":"Pain Res. Manag."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/S0140-6736(11)60610-7","article-title":"Non-specific low back pain","volume":"379","author":"Mannion","year":"2012","journal-title":"Lancet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/j.jpain.2010.07.002","article-title":"The prevalence of chronic pain in United States adults: Results of an Internet-based survey","volume":"11","author":"Johannes","year":"2010","journal-title":"J. Pain"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.gaceta.2011.10.012","article-title":"Prevalence of chronic head, neck and low back pain and associated factors in women residing in the Autonomous Region of Madrid (Spain)","volume":"26","year":"2012","journal-title":"Gac. Sanit."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2581","DOI":"10.1517\/14656560903304063","article-title":"The epidemiology, economic burden, and pharmacological treatment of chronic low back pain in France, Germany, Italy, Spain and the UK: A literature-based review","volume":"10","author":"Juniper","year":"2009","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2474-15-55","article-title":"Prevalence and influencing factors of chronic back pain among staff at special schools with multiple and severely handicapped children in Germany: Results of a cross-sectional study","volume":"15","author":"Claus","year":"2014","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2384","DOI":"10.1016\/S0140-6736(18)30488-4","article-title":"Low back pain: A call for action","volume":"391","author":"Buchbinder","year":"2018","journal-title":"Lancet"},{"key":"ref_45","first-page":"616","article-title":"Prevalence of low back pain among rice farmers in a rural community in Thailand","volume":"94","author":"Taechasubamorn","year":"2011","journal-title":"J. Med. Assoc. Thail."},{"key":"ref_46","first-page":"65","article-title":"Effects of working postures on low back pain","volume":"25","author":"Anannontsak","year":"1996","journal-title":"J. Hum. Ergol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1136\/oem.54.10.741","article-title":"Work environment and low back pain: The influence of occupational activities","volume":"54","author":"Xu","year":"1997","journal-title":"Occup. Environ. Med."},{"key":"ref_48","first-page":"1818","article-title":"Postural Theory of Non-Specific Low Back Pain (NSLBP)","volume":"28","author":"Mafuyai","year":"2013","journal-title":"World Appl. Sci. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/140349488901700211","article-title":"Low back trouble among urban bus drivers in Denmark","volume":"17","author":"Juel","year":"1989","journal-title":"Scand. J. Soc. Med."},{"key":"ref_50","first-page":"180","article-title":"Survey on prevalence of occupational musculoskeletal disorders among workers in a shipyard","volume":"29","author":"Xu","year":"2011","journal-title":"Chin. J. Ind. Hyg. Occup. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s10926-007-9070-7","article-title":"Work-related musculoskeletal disorders in urban bus drivers of Hong Kong","volume":"17","author":"Szeto","year":"2007","journal-title":"J. Occup. Rehabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/occmed\/52.1.4","article-title":"The prevalence of musculoskeletal troubles among car drivers","volume":"52","author":"Porter","year":"2002","journal-title":"Occup. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4103\/0019-5278.183833","article-title":"Comparative cross-sectional study for understanding the burden of low back pain among public bus transport drivers","volume":"20","author":"Jadhav","year":"2016","journal-title":"Indian J. Occup. Environ. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jsv.2004.07.020","article-title":"Whole body vibration and posture as risk factors for low back pain among forklift truck drivers","volume":"284","author":"Hoy","year":"2005","journal-title":"J. Sound Vib."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1002\/acr.22890","article-title":"Epidemiology of chronic low back pain in US adults: Data from the 2009\u20132010 National Health and Nutrition Examination Survey","volume":"68","author":"Shmagel","year":"2016","journal-title":"Arthritis Care Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1007\/s00586-009-1083-9","article-title":"Comparison of risk factors predicting return to work between patients with subacute and chronic non-specific low back pain: Systematic review","volume":"18","author":"Heitz","year":"2009","journal-title":"Eur. Spine J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e919","DOI":"10.1097\/PR9.0000000000000919","article-title":"Prognostic factors for pain chronicity in low back pain: A systematic review","volume":"6","author":"Nieminen","year":"2021","journal-title":"PAIN Rep."},{"key":"ref_58","first-page":"49","article-title":"Low back pain at new working ambient in era of new economy: A systematic review about occupational risk factors","volume":"69","year":"2015","journal-title":"Acta Med. Croat."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Alhowimel, A., AlOtaibi, M., Radford, K., and Coulson, N. (2018). Psychosocial factors associated with change in pain and disability outcomes in chronic low back pain patients treated by physiotherapist: A systematic review. SAGE Open Med., 6.","DOI":"10.1177\/2050312118757387"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1080\/13548500500262945","article-title":"Psychological distress, loneliness and disability in old age","volume":"11","author":"Paul","year":"2006","journal-title":"Psychol. Health Med."},{"key":"ref_61","first-page":"16","article-title":"Disability related to chronic low back pain: Prevalence and associated factors","volume":"46","author":"Pimenta","year":"2012","journal-title":"Rev. Da Esc. De Enferm. Da USP"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"E109","DOI":"10.1097\/00007632-200203010-00017","article-title":"A Systematic Review of Psychological Factors as Predictors of Chronicity\/Disability in Prospective Cohorts of Low Back Pain","volume":"27","author":"Pincus","year":"2002","journal-title":"Spine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/fampra\/cmq072","article-title":"Psychosocial risk factors for chronic low back pain in primary care\u2014A systematic review","volume":"28","author":"Ramond","year":"2011","journal-title":"Fam. Pract."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/j.1445-2197.1996.tb01189.x","article-title":"Psychological aspects of chronic low back pain","volume":"66","author":"Sikorski","year":"1996","journal-title":"Aust. New Zealand J. Surg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"321","DOI":"10.2522\/ptj.20120207","article-title":"The STarT back screening tool and individual psychological measures: Evaluation of prognostic capabilities for low back pain clinical outcomes in outpatient physical therapy settings","volume":"93","author":"Beneciuk","year":"2013","journal-title":"Phys. Ther."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S1836-9553(13)70170-X","article-title":"STarT Back screening tool","volume":"59","author":"Traeger","year":"2013","journal-title":"J. Physiother."},{"key":"ref_67","first-page":"1402","article-title":"Cross-cultural adaptation and validation of the STarT back screening tool in isiZulu","volume":"76","author":"Schmidt","year":"2020","journal-title":"South Afr. J. Physiother."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/1756-185X.12060","article-title":"Risk factors for chronic low back pain in a sample of suburban S ri L ankan adult males","volume":"16","author":"Karunanayake","year":"2013","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_69","unstructured":"Lionel, A. (2014). Risk factors for chronic low back pain. J. Community Med. Health Educ., 4."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2964\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:31:28Z","timestamp":1760135488000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,3]]},"references-count":69,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijerph19052964"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19052964","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,3]]}}}