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Low back pain is a leading cause of disability worldwide, with more than 600 million people living with low back pain. This is one of the key points of a June 2023 study published in the journal The Lancet Rheumatology.
Our systematic analysis integrates data from nearly 500 studies worldwide over 30 years to estimate the global burden of low back pain, broken down by country, year, age, gender, and severity. “Burden” refers to the combination of the frequency of back pain and the degree of health loss it causes. We measured low back pain in people aged 5 years and older.
For the past 30 years, low back pain has ranked number one among causes of disability. However, back pain is not inevitable, even though it may feel like it.
These findings are part of a larger project called the Global Burden of Disease Study, which aims to quantify all the world’s health losses.
Our research shows that the burden of back pain could be reduced by 39% if society directly addressed three key risk factors: obesity, smoking, and workplace ergonomics.
Smoking has previously been associated with weakening of bones as well as damage to the microcirculation of spinal structures such as intervertebral discs and joints. But researchers also know that smoking is often associated with other lifestyle factors, such as physical inactivity, obesity, and lack of sleep, all of which are associated with an increased risk of back pain.
Similarly, obesity is associated with other unhealthy lifestyle factors, all of which can increase your risk of back pain. Obesity is also associated with increased loading on spinal structures, making them more susceptible to injury and systemic inflammatory responses.
Symptoms in older adults are often overlooked due to a common misconception that back pain primarily affects middle-aged workers. DjelicS/E+ (via Getty Images)
why is it important
Low back pain is influenced by many factors, including biological, social, and psychological. Because of the anatomical complexity of the human spine, even advanced imaging tests often cannot identify simple structural causes, such as a single joint or muscle.
This means that diagnosis is primarily based on reported symptoms. Also, while most cases of low back pain are short-lived and resolve within the first six weeks after the pain begins, one-third of cases can become persistent and last for years. This persistence contributes to the significant burden of this condition.
As part of this study, we estimated how many people could experience back pain over the next 30 years if little changes. We estimate that as many as 843 million people worldwide will live with this condition. The problem of low back pain will not go away unless policy makers intervene.
Although a person’s gender does not directly determine the risk of back pain, this condition is much more common in women. Our research found that a total of 395 million women worldwide report back pain, compared to 225 million men.
This disparity may be explained by differences in care-seeking behavior and access to health care between men and women.
The incidence of low back pain also varies depending on age. It is a common belief that lower back pain is most common among working-age adults, but in reality, lower back pain rates are highest among people in their 80s. Elderly people are often overlooked when providing care.
Older adults with low back pain have limited access to evidence-based treatments that promote healthy lifestyles and recovery, including helping patients manage their symptoms on their own. They are also less likely to recover from severe pain and disability than younger generations, more likely to develop long-term persistent symptoms, and more likely to fall.
What is not yet known?
For people with lower back pain, there is a need for more effective and better ways to manage lower back pain. Research shows that many current treatments are ineffective or have little effect. These treatments include painkillers and some surgeries.
Considering research shows that hundreds of millions of people live with low back pain, it is clear that more research is needed to identify effective prevention strategies.
This article is republished from The Conversation, a nonprofit, independent news organization that provides facts and trusted analysis to help you make sense of our complex world. Author: Jamie Steinmetz, University of Washington and Manuela Ferreira, University of Sydney.
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The Global Burden of Disease Study is funded by the Bill & Melinda Gates Foundation.
Manuela Ferreira receives funding from the Australian National Health and Medical Research Council, Medibank Research Foundation, NIHR-UK, and the Finnish Academy of Sciences.
