It is well known that lower back pain is a significant problem both in terms of suffering, costs to the individual as well as society at large. What is less well known is exactly how staggeringly large a problem it actually is. This article will review the current status regarding lower back pain.

NUMBER OF PEOPLE WITH BACK PAIN

• In industrialised countries, up to 80% of the population will experience back pain at some stage in their life. During any one year, up to half of the adult population (15%-49%) will have back pain.
• The number of people with back pain increases with advancing age, starting in school children and peaking in adults of 35 to 55 years of age. Back pain is just as common in adolescents as in adults. This will come as a surprise to most people.

RECOVERY FROM BACK PAIN

• Back pain is, in most cases, a self-limiting condition and 90% of people with acute back pain will recover within 6 weeks.
• Up to 7% of people with acute back pain will develop chronic back pain. These chronic patients have considerable discomfort and account for approximately 80% of the social and health care costs.

Health Care and other Costs

In a study carried out by Maniadakis and Gray in 1998 costs were calculated to be £1.6 Billion Pounds. Of this sum, 35% of costs were incurred in the private sector, “With respect to the distribution of cost across different providers, 37% relates to care provided by physiotherapists and allied specialists, 31% is incurred in the hospital sector, 14% relates to primary care, 7% to medication, 6% to community care and 5% to radiology and imaging used for investigation purposes.”

“However, the direct cost of back pain is insignificant compared to the cost of informal care and the production losses related to it, which total £10.6 billion. Overall, back pain is one of the most costly conditions for which an economic analysis has been carried out in the UK and this is in line with findings in other countries.”

Backcare – the Charity

According to Backcare; 

• The National Health Service spends more than £1 billion per year on back pain related costs, this includes:
  £512 million on hospital costs for back pain patients.
  £141 million on GP consultations for back pain.
  £150.6 million on physiotherapy treatments for back pain.
• In the private healthcare sector £565 million is spent on back pain every year.
• This brings the healthcare costs for back pain to a total of £1.6 billion per year.
• In addition there are other (indirect) costs. The Health and Safety Executive estimates that musculoskeletal disorders, which include back pain cost UK employers between £590 million and £624 million per year.
• The total cost of back pain corresponds to between 1% and 2% of gross national product (GDP).
  Other European countries report similar high costs; back pain related costs in The Netherlands in 1991 were more than 4 billion euro. For Sweden in 1995 these were more than 2 billion euro.

These are staggering sums and place lower back pain, its treatment and other related costs such as time off work right at the top of the scale of costs related to any disease.

Summary

As can be read, these sums impact both individuals and society to a significant degree. Research into back pain, its diagnosis, treatment and prevention are really only 20 odd years old. This is likely due to the fact that back pain is not life threatening. The quality of the research is continually improving and important discoveries such as Modic finding and their treatment leave us with hope that we can continue to improve upon the care that we provide as well as developing sound preventative measures.

Dr Alan Jordan, Chiropractor, Phd

Clinic Director