• Ead L
• Wong J
• Hogg-Johnson S
• Mior S
• Plener J
• Côté P

• Affiliation / Canadian Memorial Chiropractic College (CMCC). Division of Clinical Education
• Affiliation / Canadian Memorial Chiropractic College (CMCC). Division of Research and Innovation
• Affiliation / Ontario Tech University. Faculty of Health Sciences
• Affiliation / University of Toronto. Institute of Health Policy, Management and Evaluation
• Canadian Memorial Chiropractic College (CMCC)
• Chiropractors
• Epidemiology
• Low Back Pain
• Open Access Document
• Prevalence
• Students, Chiropractic

Background: Chiropractors and chiropractic students commonly report low back pain (LBP). However, the burden of LBP in this occupational group has not been synthesized in the literature. This systematic review aims to describe the epidemiology of LBP in chiropractors and chiropractic students.

Methods: We searched MEDLINE, Embase, CINAHL, and PsycINFO from inception to May 1, 2023. Eligible studies were cross-sectional, cohort, or case–control studies investigating the prevalence, incidence, associated factors, or risk factors of LBP in chiropractors or chiropractic students. Reviewers independently screened articles and assessed risk of bias using the appropriate JBI Checklists for the observational study design. We descriptively synthesized studies that were rated as low or moderate risk of bias.

Results: Of 2012 citations screened, we included 2 cross-sectional studies in the evidence synthesis (1 study rated as moderate risk of bias on chiropractors, and 1 rated as low risk of bias on chiropractic students). For chiropractors, the 12-month prevalence of work-related overuse injuries to the low back was 35.6% (95% CI 29.1, 42.0) in women and 22.4% (95% CI 16.3, 29.6) in men. The 12-month prevalence of work-related acute physical injuries to the low back in chiropractors were 3.4% (95% CI 1.6, 6.8) for women and 0.7% (95% CI 0.1, 3.7) for men. Among chiropractic students, the 1-week prevalence of LBP was 69% (95% CI 64.8, 73.0). This was higher among female students (72.5%, 95% CI 67.1, 77.4) and lower among male students (64%, 95% CI 57.0, 70.6).

Conclusion: There is limited high-quality evidence on the epidemiology of LBP in chiropractors and chiropractic students. Our systematic review provides a synthesis of the body of literature, highlighting that chiropractors and chiropractic students commonly report LBP. Future high-quality research is needed to address the incidence, associated factors, and risk factors of LBP. 

Author keywords: Chiropractors - Chiropractic students - Low back pain - Epidemiology - Prevalence

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