Back Pain – a high prevalence disease
The lifetime prevalence of low back pain is reported as over 70% in industrialised countries.1, 2 Acute low back pain is usually considered to be self-limiting (recovery rate about 90% in 6 weeks), but 2% – 7% of people develop chronic pain. The high costs associated with low back pain are related to these individuals with chronic back pain.
There are many potentially initiating factors described for low back pain, e.g. heavy lifting, driving motor vehicles, jogging, weaker trunk strength, smoking, poor psychosocial conditions. However, many are difficult to interpret due to the high prevalence of back pain in the general population.
A recent National Health & Wellness Survey involving over 50,000 participants gives insights into the size of the pain problem and who is affected (National Health & Wellness Survey: pain).3 This internet survey of subjects from France, Germany, Italy, Spain, and the UK revealed that 22% of respondents had suffered pain in the past month. Women were slightly more likely than men to experience and report severe pain.
The survey showed that over 70% of those with severe pain had back problems, with other common causes of pain including joint pain, neck pain, arthritis, and neuropathic pain.
Costs of Back Pain
The high prevalence of back pain has major economic and societal consequences. A recent study in Germany reported on the costs of back pain.4 With 12-month prevalence rates of more than 70%, back pain is one of the major health problems for German adults. Based on a survey of over 9,000 respondents and using direct healthcare costs and indirect costs due to back-pain-related production losses, the costs of back pain, expressed in 2005 Euro costs, amounted to 49 billion Euros a year. This represents 2.2% of the gross domestic product. Costs per patient exceeded 1300 Euros, with more than half the costs attributable to indirect costs of back pain.
Similarly high costs of back pain have been reported in other European countries. A report from the UK in 20005 on the cost-of-illness and socio-economic costs of back pain identified that back pain has one of the highest indirect cost burdens of common medical illnesses. The study reported that the direct medical costs of back pain were insignificant when compared with the costs of informal care and the production losses linked with back pain, which amounted to £ 10,668 million per year (in 1998). Back pain was one of the most costly conditions for which an economic analysis has been carried out in the UK.
1 Volinn E. The epidemiology of low back pain in the rest of the world. A review of surveys in low- and middle-income countries. Spine (Phila Pa 1976) 1997;22:1747–54.
2 Juniper M, Le TK, Mladsi D. The epidemiology, economic burden, and pharmacological treatment of chronic low back pain in France, Germany, Italy, Spain and the UK: a literature-based review. Expert Opin Pharmacother 2009;10:2581–92.
3 Kantar Health, Inc. August 2009. National Health And Wellness Survey, 2008 [EU]. Princeton, NJ.
4 Wenig CM et al. Costs of back pain in Germany. Eur J Pain. 2009; 13:280-6.
5 Maniadakis N et al. The economic burden of back pain in the UK. Pain. 2000; 84:95-103.