Growing global low back pain cases pose healthcare crisis, calls for urgent action

An analysis of more than 30 years of data reveals a concerning trend: the number of low back pain cases is steadily increasing worldwide.

Researchers predict that by 2050, a staggering 843 million individuals will be affected by this condition. This surge is primarily attributed to population growth and the aging of populations. The lack of a consistent approach to back pain treatment and limited treatment options further exacerbate concerns, as low back pain currently stands as the leading cause of disability globally.

Global Impact and Shifting Landscape

The study’s findings indicate that Australia is expected to witness a nearly 50 per cent increase in low back pain cases by 2050. However, the most significant rises in cases are projected to occur in Asia and Africa. The implications of this analysis underscore the immense strain it will place on healthcare systems worldwide. Lead author Professor Manuela Ferreira from Sydney Musculoskeletal Health emphasises the urgent need for a national, research-informed approach to managing low back pain.

Professor Ferreira highlights that the current response to back pain has been primarily reactive, necessitating a shift towards proactive prevention. With Australia being a global leader in back pain research, there is an opportunity to set an example by focusing on prevention rather than simply treating the symptoms. Professor Ferreira, based at Sydney’s Kolling Institute, calls for proactive initiatives to tackle back pain prevention.

Key Findings and Risk Factors

The study reveals significant milestones in the prevalence of back pain cases. As of 2017, the number of low back pain cases surpassed half a billion people, reaching approximately 619 million cases in 2020. Occupational factors, smoking and being overweight contribute to at least one-third of the disability burden associated with back pain.

Contrary to a common misconception, low back pain affects older individuals more frequently than adults of working age. Additionally, females experienced higher rates of low back pain compared to males, confirming the study’s findings.

This research represents the most comprehensive and up-to-date data available, including global projections and an assessment of the impact of risk factors on low back pain. The collaborative efforts of The University of Sydney, the Institute for Health Metrics and Evaluation (IHME), and the Global Alliance for Musculoskeletal Health made this study possible.

Senior author Professor Lyn March from Sydney Musculoskeletal Health and the Kolling Institute notes that the available data primarily originates from high-income countries. As a result, it may be challenging to fully interpret these results for low to mid-income countries. Therefore, there is an urgent need for more population-based data on back pain and musculoskeletal conditions from these regions.

The Way Forward

The study analysed Global Burden of Disease (GBD) data from 1990 to 2020 across 204 countries and territories, offering a comprehensive overview of the back pain landscape over time. Additionally, it employed modelling techniques to project future prevalence. The urgent response required to address the growing burden of low back pain is emphasised by Professor Anthony Woolf, co-chair of the Global Alliance for Musculoskeletal Health. Ministries of health must prioritise musculoskeletal conditions, including low back pain, considering their substantial social and economic consequences.

National guidelines will serve as the foundation for back pain prevention strategies. Independent experts had previously voiced concerns and recommendations in The Lancet in 2018, emphasising the need for global policy changes regarding the prevention and management of low back pain. Unfortunately, little progress has been made since then. Commonly recommended treatments for low back pain have proven to be ineffective or of unknown effectiveness, including certain surgeries and opioid prescriptions.

Professor Ferreira underscores the lack of consistency in how health professionals manage back pain cases, urging the healthcare system to adapt. Notably, clinical guidelines often fail to provide specific recommendations for older individuals, who tend to have more complex medical histories. To avoid negative impacts on their function and quality of life, including potential interference with existing medications, the guidelines must be updated accordingly.

Ritchelle Drilon

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Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.

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