Low back pain is the leading cause of disability in the world, with more than 600 million people living with the condition. This is one of the main conclusions of our June 2023 study published in the journal Lancet Rheumatology.
Our systematic analysis synthesized data from approximately 500 studies worldwide over 30 years to estimate the global burden of low back pain, broken down by country, year, age, sex, and severity. “Load” refers to a combination of how common low back pain is and how much health toll it causes. We measured low back pain in people aged five years and over.
Low back pain has been ranked first among the causes of disability for the last three decades. Back pain, however, is unavoidable, even though it can feel that way at times.
The findings are part of a larger project called the Global Burden of Disease Study, which aims to measure all health costs globally.
Our study found that if people could directly address three major risk factors — obesity, smoking, and workplace ergonomics — it could reduce the burden of low back pain by up to 39 percent.
Smoking has previously been linked to microcirculatory damage to spinal structures, such as discs and joints, as well as bone weakening. But researchers also know that smoking is often associated with other lifestyle factors, including physical inactivity, obesity, and lack of sleep, all of which are associated with an increased risk of low back pain.
Similarly, obesity is associated with other unhealthy lifestyle factors, all of which can increase the risk of low back pain. Obesity is also associated with an increased burden on spinal structures, which makes them susceptible to injury and a systemic inflammatory response.
Why is it important
Low back pain is influenced by many factors, including biological, social, and psychological factors. The complexity of human spinal anatomy means that, in many cases, simple structural causes, such as a single joint or muscle, cannot be identified, even with sophisticated diagnostic imaging.
This means that the diagnosis is made largely on the basis of reported symptoms. And while most cases of low back pain are short-lived, with relief experienced within the first six weeks of pain onset, one-third of cases will be persistent and can last for years. This persistence contributes to the significant burden of this condition.
As part of this work, we estimated how many people would experience low back pain over the next 30 years if little changed. We estimate that 843 million people worldwide will live with the condition. The problem of low back pain will not go away unless policymakers step in.
Although a person’s gender does not directly determine the risk of low back pain, this condition is more common in women. Our study found a global total of 395 million women reporting back pain, compared with 225 million men.
This disparity can be explained by differences in care-seeking behavior, as well as access to health care, between men and women.
The level of occurrence of low back pain also differs depending on your age. It’s a common myth that low back pain is most common in working-age adults, but in fact, rates are highest for people in their 80s. Older adults are often neglected when it comes to care.
Older adults with low back pain have limited access to evidence-based treatments that promote healthy lifestyles and recovery, such as those that support patients to manage their symptoms on their own. They are also less likely than their younger counterparts to recover from severe pain and disability, more prone to developing persistent long-term symptoms, and at higher risk of falls.
What is still unknown
For people with low back pain, a better and more effective way to deal with it is needed. Studies show that many current treatments are either unsuccessful or do very little. This treatment includes pain relief and several surgical procedures.
Given our findings that hundreds of millions of people are living with low back pain, it is clear that more research is needed to identify effective prevention strategies.
This article was originally published in The Conversation by Jaimie Steinmetz at the University of Washington and Manuela Ferreira at the University of Sydney. Read the original article here.
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