INTRODUCTION

Lumbar pain is a musculoskeletal injury considered a public health problem, causing a social and economic impact on the population. There are different ergonomic, postural, emotional factors, etc., which could lead to a functional limitation affecting the individual's quality of life. Likewise, if the person has chronic lumbar pain, they have a higher risk of suffering a higher level of disability^1,2.

Lumbar pain is usually nonspecific or mechanical when intrinsically from the spinal column (the intervertebral discs or surrounding soft tissues). On the other hand, non-mechanical lumbar pain includes a progressive motor or sensory loss, new urinary retention or overflow incontinence, history of cancer, recent invasive spinal procedure, and significant age-related trauma³.

People of active working age are subject to a series of physical factors, typical of daily life activities⁴. For many years, lumbar pain has been the leading cause of absence from work as the ultimate indication for medical rehabilitation due to disability^5,6.

On the other hand, common psychological problems are significantly associated with musculoskeletal disorder patterns⁷. Likewise, the comorbidity of anxiety and depression is related to pain intensity, pain-related disability, and health-related quality of life⁸.

In addition, epidemiological studies found some psychiatric disorders found more commonly among people with chronic pain, such as headache, back pain, than those without chronic pain. Some psychiatric disorders, such as depression, increase the risk of chronic pain and its persistence. These clinical studies suggest that chronic pain is not common comorbidity among people with other psychiatric disorders, such as dementia and schizophrenia. It is not clear if this is a consequence of some specific biological mechanism or methodology problems in the studies⁹.

The functions of the National Police of Peru are an organism of the Peruvian state in charge of guaranteeing, maintaining, and reestablishing internal order, providing protection and assistance to people and the community, and ensuring compliance with the security laws of the public and private assets¹⁰.

Most of these police officers have a level of psychosocial exposure unfavorable to their health in terms of insecurity, occupational stressors, such as organization (for example, staff shortages, inconsistent leadership styles), and operational elements (for example, work by turns, public scrutiny). A working schedule is 3-5 times a week, and they cannot choose their time off. Regarding physical exposure, their work demands to be standing during the entire shift of their work. This is a negative factor in terms of the posture of which it has generated some kidney problems, varicose veins, and the most common is swelling of feet. Most of the officers are unaware of active breaks; therefore, they do not take them^11,12. The present objective is to determine the association of lumbar pain with anxiety and depression in police officers from a Lima police station.

METHODS

RESULTS

Of the total of 110 participants, 93.6% were men and 6.4% women. 50.9% of the participants declared to be married, 46.4% were single, 1.8% were divorced, and 0.9% were widowed. The average age of the participants was 38.3, with an age range of 21 to 60 years. The sociodemographic characteristics of the study sample were shown inTable 1.

Regarding the participants’ lumbar pain, it was obtained that 75.5% had lumbar pain while 15.5 % did not present lumbar pain. Regarding the anxiety of the participants, it was obtained that 84.5% presented a normal degree of anxiety, 13.6% showed a degree of anxiety from minimal to moderate, and 1.8% presented a degree of anxiety from marked to severe. Regarding the depression of the participants, it was obtained that 80% did not present depression, while 20% presented mild to moderate depression.Table 2shows the results obtained from the measurement instruments applied to the population that participated in the study.

When performing the bivariate analysis on the relationship between anxiety and depression with lumbar pain, it was found that 63.6% of those surveyed with lumbar pain had a normal degree of anxiety, while 11.8% of those surveyed with lumbar pain. Lumbar pain presented a degree of minimal to moderate anxiety (p = 0.028). In addition, 60.9% of those surveyed with lumbar pain did not present depression, while 14.5% of those surveyed with lumbar pain presented mild to moderate depression (p = 0.740). The other data for analysis are found inTable 2.

Regarding the clinical characteristics of the participants’ lumbar pain, it was found that 46.4% were chronic, 34.5 % was of moderate-intensity, 50% sometimes presented pain, 17.3% pain was puncture type and 30% presented pain on both sides.Table 3details the results obtained from the measurement instrument applied to the population that participated in the study.

DISCUSSION

Musculoskeletal disorders are considered a major problem affecting the health and well-being of active-duty police. Discomfort from wearing mandatory equipment and sitting for long periods in fleet vehicles are workload factors related to musculoskeletal disorders in the police¹³.

Regarding lumbar pain, 75.5% of police officers present lumbar pain. This agrees with several previous reports Cardoso E¹⁴, Brown JJ¹⁵, Gruevski KM¹⁶. This problem is severe and frequent in police personnel¹⁷. While it is true, the police’s activity is exposed to a series of factors that could affect their health and produce physical disability. Some carry out internal functions such as administrative activities, others patrol, standing for many hours, and carrying heavy equipment. Adding the working conditions, can lead to an overload of the column¹⁸.

Regarding anxiety and its relationship with lumbar pain (p = 0.028), studies such as Douma NB¹⁹. This agrees with several previous reports Santiago C²⁰, Barreda E²¹. Likewise, anxiety and depression disorders are increasingly affecting society. Anxiety disorders are the most common psychiatric disorders, and depressive disorders are increasing in society globally. Lumbar pain is one of the common health problems experienced by 50-80% of adults at some point in their lives²².

Regarding depression, a study by Jara JA²³. People with symptoms of depression are at higher risk of developing an episode of lumbar pain in the future, with the risk being higher in patients with more severe levels of depression²⁴. Anxious manifestations accompany this high proportion of depressive disorders, and these frequently present with pain. Likewise, these painful manifestations cause or worsen depressive and anxious symptoms²⁵.

On the other hand, the individual’s psychological aspects are important in the development and progression of lumbar pain. It is important to consider that the official personnel, in the presence of pain, rest, and take medications prescribed by the specialist, similar to a study mentioned by Anderson G²⁶. Likewise, back pain is a factor to increase the probability of depression²⁷.

This type of Investigation in police personnel is of utmost importance, because of the characteristics demanded by their work in the development of their functions. They are exposed to physical and functional injury, and in their emotional state, problems could hinder missions. Early detection could avoid any kind of subsequent consequences.

Despite the present research, which was supported by the participants. It had limitations, including the little and scarce national background information about lumbar pain publications in police personnel. Likewise, he may have had a recall or memory bias when completing the questionnaire alternatives, to recall experiences accurately.

CONCLUSION

Lumbar pain is associated with anxiety in police officers at a police station in Lima. Likewise, a high percentage of police officers who suffer from lumbar pain consider it a public health problem, which could lead to some type of disability in the future, affecting their quality of life.