Title: Prevalence of low back pain in the general population in France in 2008–2009, 2015 and 2022, comparison with other common chronic conditions, and estimation of its relative contribution to limitations in ADL and IADL
Research structure: Centre de Recherche en Épidémiologie et Statistiques (CRESS), UMR 1153, Inserm – Université Paris Cité
Team: Équipe EpiAgeing (Epidemiology of Ageing & Neurodegenerative diseases)
Location: Université Paris Cité, Inserm, UMR 1153, 10, avenue de Verdun, 75010 Paris
Director’s team: Pre Archana SINGH-MANOUX / Dre Séverine SABIA
Supervisors: Dr Louis JACOB, MCU-PH en médecine physique et de réadaptation, Hôpital Lariboisière – Fernand-Widal, Paris
Topic :
Low back pain is a major cause of disability worldwide, affecting 619 million people in 2020 [1]. In France, population-based surveys have documented its prevalence and the contribution of musculoskeletal conditions to activity limitations [2–4]. Activities of daily living (ADL), such as bathing or dressing, and instrumental activities of daily living (IADL), such as shopping or preparing meals, help characterize its impact on independent living.
Low back pain frequently follows a recurrent course, and its impact depends on physical, psychological and social factors [5]. In France, lower educational attainment is associated with a higher prevalence of low back pain, an association largely explained by physical occupational exposures [6]. Chronic back pain is also associated with poorer quality of life in a French general population survey [7]. These findings highlight the value of complementing prevalence estimates with an assessment of limitations in daily activities.
This research master’s internship in epidemiology aims to estimate the prevalence of low back pain in France in 2008–2009, 2015 and 2022, compare it with other common chronic conditions, including diabetes and hypertension, and quantify its relative contribution to ADL and IADL limitations. It will provide updated evidence on the functional burden of low back pain and examine changes over time in comparable populations, accounting for coexisting conditions.
The project will use the cross-sectional Disability-Health (2008–2009), CARE-Households (2015) and Autonomy-Households (2022) surveys conducted by DREES and INSEE [8–10]. Disability-Health includes a household component in 2008 and an institutional component in 2009. CARE-Households covers people aged 60 years or older; comparisons across all three periods will therefore focus on this age group living in private households in metropolitan France. Estimates for all adults will be produced for 2008 and 2022, depending on variable availability; institutional data from 2009 will be examined separately if available. An initial harmonization step will establish the definitions of low back pain and ADL and IADL limitations used in the analyses. Comparisons across surveys will focus on indicators with comparable wording, reference periods and difficulty thresholds.
Prevalence estimates and 95% confidence intervals will account for sampling weights and survey designs, with age and sex standardization for temporal comparisons. ADL and IADL limitations will be analyzed separately. Multivariable models will include sociodemographic characteristics and coexisting conditions; average attributable fractions will estimate the relative contribution of low back pain while accounting for multimorbidity [3]. These estimates will be interpreted as statistical contributions, without causal conclusions from cross-sectional data. Sensitivity analyses will examine definitions and missing data. The internship will include a literature review, data harmonization, analyses in R and preparation of the master’s dissertation, with a view to publication. Strong epidemiology and biostatistics skills and very good proficiency in R are required.
Please apply to Dr Louis Jacob (louis.jacob@aphp.fr) by sending a motivation letter, a detailed curriculum vitae (including modules in epidemiology and statistics) and your most recent academic transcripts.
Références :
- 1. GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5: e316–e329. doi:10.1016/S2665-9913(23)00098-X
- 2. Gourmelen J, Chastang J-F, Ozguler A, Lanoë J-L, Ravaud J-F, Leclerc A. Frequency of low back pain among men and women aged 30 to 64 years in France. Results of two national surveys. Ann Readapt Med Phys. 2007;50: 640–644, 633–639. doi:10.1016/j.annrmp.2007.05.009
- 3. Palazzo C, Ravaud J-F, Trinquart L, Dalichampt M, Ravaud P, Poiraudeau S. Respective contribution of chronic conditions to disability in France: results from the national Disability-Health Survey. PLoS One. 2012;7: e44994. doi:10.1371/journal.pone.0044994
- 4. Palazzo C, Ravaud J-F, Papelard A, Ravaud P, Poiraudeau S. The burden of musculoskeletal conditions. PLoS One. 2014;9: e90633. doi:10.1371/journal.pone.0090633
- 5. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391: 2356–2367. doi:10.1016/S0140-6736(18)30480-X
- 6. Leclerc A, Gourmelen J, Chastang J-F, Plouvier S, Niedhammer I, Lanoë J-L. Level of education and back pain in France: the role of demographic, lifestyle and physical work factors. Int Arch Occup Environ Health. 2009;82: 643–652. doi:10.1007/s00420-008-0375-4
- 7. Husky MM, Ferdous Farin F, Compagnone P, Fermanian C, Kovess-Masfety V. Chronic back pain and its association with quality of life in a large French population survey. Health Qual Life Outcomes. 2018;16: 195. doi:10.1186/s12955-018-1018-4
- 8. DREES. Les enquêtes Handicap-Santé. https://drees.solidarites-sante.gouv.fr/sources-outils-et-enquetes/02-les-enquetes-handicap-sante (consulté le 30 septembre 2026).
- 9. DREES. Les personnes âgées dépendantes vivant à domicile en 2015. Premiers résultats de l’enquête CARE « ménages ». Études et Résultats. 2017;1029. https://drees.solidarites-sante.gouv.fr/sites/default/files/er_1029.pdf
- 10. DREES. Le dispositif d’enquêtes « Autonomie » (2021-2025). https://www.drees.solidarites-sante.gouv.fr/sources-outils-et-enquetes/le-dispositif-denquetes-autonomie-2021-2025 (consulté le 30 septembre 2026).
