Last updated: Mon, Aug 12, 2024
Each year about 5% of adults will consult a physician because of a new episode of low back pain1 This is just a fraction of those who experience lower back pain (LBP) each year, a proportion that is estimated at between 18 and 50%2 of the population. Between 58 and 84% of people will experience an episode at some time in their lives.3 LBP is more common among women than among men after age 29, and is more common with increasing age up to about age 60 for both men and women. It is the most common of the musculoskeletal regional pain syndromes. “Low back pain,” like “chronic pain,” doesn't have a precise definition. It is generally considered to include pain lower than the lowest pair of ribs and above the fold of skin at the base of the buttocks. However, leg pain that is believed to arise from problems in the lower back is usually considered to be part of the low back pain, wherever it is felt.
Low back pain is often said to be self-limiting, meaning that it usually clears up without medical intervention. However, although 90% of patients who consult a primary-care physician for LBP cease to consult them after three months, only 21% of the patients report complete recovery at that time.4 One study reported that 39% of LBP patients continue to have “persistent disabling pain” three months after first consulting a physician.5 LBP is often recurrent. It has been reported that 5-10% of LBP patients become chronic low back pain patients,6 although in light of a broad definition of “chronic pain,” the 39% referred to previously might be a better estimate.
The statistics that are given about the costs of LBP are quite impressive. In the United Kingdom, LBP is the third-leading cause of “certified” work loss (I presume this means “excused by a doctor”), after respiratory illness and mental illness. Loss of work time because of LBP often leads to more lost time in the future, and the subsequent losses tend to be longer.7 The National Academy of Sciences and the Institute of Medicine in 2001 estimated $50 billion per year as the financial impact of LBP in the U.S. This includes productivity losses, lost wages, lost household services, social security benefits, and lost tax revenues, so it is a very broad measure.8 The health care costs of LBP in the United Kingdom in 1998 were about $US 1.63 billion, only slightly less than the annual costs of care for coronary heart disease. The cost in terms of human suffering doesn't convert well into dollars.