From ncoa.org
Back pain affects millions of Americans of all ages each year and costs billions of dollars in expenses. Read on to learn more about this condition, its impact on daily life, and potential treatments.
Key Takeaways
- Nearly 620 million people dealt with back pain globally in 2020.
- Adults 65 and older are more likely to experience back pain than any other age group.
- U.S. workers lose roughly 83 million work days yearly due to back pain.
- Lower back pain is more common than upper back pain.
- Back pain costs billions of dollars in health care each year, with low back pain costing roughly $50 billion alone.
Most of us have experienced back pain at one point in our lives. It’s a prevalent condition that affects roughly 39% of U.S, adults, with data showing it impacts 619 million people globally. We experience back pain as acute or chronic:
- Acute back pain occurs suddenly, typically due to a specific injury, and can resolve within a few days but may persist for up to six weeks.
- Chronic back pain develops gradually and may worsen over time. It’s characterized by pain lasting at least three months or recurring occasionally over approximately six months.
“Back pain is a generic term used to describe uncomfortable sensations from the neck to the sacrum, either in the midline or in the muscles adjacent to the spine (paraspinal musculature). The vast majority of back pain is considered ‘nonspecific,’ with no clear structural cause for the symptoms,” said Simon Harris, a spine and orthopaedic surgeon in Toronto.
In this article, we’ll discuss data on the different types of back pain, its prevalence, who is at risk of developing it, and potential treatments.
Back pain types and causes
According to Harris, lower back pain is typically more common than neck or upper back pain. Upper back pain, or pain that can be felt in the neck, is typically characterized by feelings of tightness, aching, or shooting pains in the thoracic region (the 12 vertebrae attached to the ribs). According to recent research, 15%–35% of adults worldwide experience thoracic back pain throughout their lifetime.
Upper back pain can occur from trauma, strain, poor posture, and even illness. A few specific symptoms to be aware of if you’re experiencing upper back pain are fever, chills, and upset stomach, which may indicate an underlying condition such as shingles. Shingles is a virus that can cause a rash and pain, potentially leading to long-term nerve pain in the back, also known as post-herpetic neuralgia. This is especially important for older adults to rule out since adults over 70 are 70% more likely to have ongoing pain from shingles than those under 70. The two-dose shingles vaccine is recommended for adults age 50 and older.
Thoracic pain may also radiate to your arms as feelings of tingling, numbness, or overall weakness. “If there is impingement of the spinal nerves, it can cause pain to radiate into the arms or legs. If the pain shoots into the buttock and posterior thigh into the leg below the knee, this is commonly referred to as sciatica,” said Harris.
Sciatica is a type of pain that originates in the lower back and is caused by pressure placed on the sciatic nerve. While sciatica can cause pain in the lower back, the sciatic nerve runs down the leg and can cause pain in the hips, legs, and even feet. Sciatica makes up 10% of the cases of lower back pain, and it is most common in people over age 40. Some of the best mattresses for sciatica may help ease sciatica symptoms.
The causes of back pain vary widely, but most back pain is considered “mechanical.” This means it originates from the spinal structure, which includes the bones, ligaments, discs, joints, and nerves.
Common causes of back pain include:
- Inflammatory conditions, like arthritis
- Herniated discs
- Muscle strains and injury
- Osteoporosis
- Fibromyalgia
- Kidney stones or infections
- Endometriosis
- Pregnancy
- Scoliosis
- Degenerative disc disease
- Pinched or compressed nerves
- Narrowing of the spinal canal (spinal stenosis)
- Vertebral fractures
- Tumours
Mechanical back pain makes up more than 90% of back pain cases. Getting to the root cause of your back pain ensures you get the proper treatment, so it’s important to tell your health care provider about all your symptoms.
Back pain statistics by age
Research shows that back pain is less prevalent in children than in adults. One study showed that only 1% of 12-year-olds experienced back pain, and only 5% of 15-year-olds experienced it. But as age increases, so does the likelihood of experiencing back pain. The same study showed that 50% of people experienced back pain at least once by age 18 (females) and 20 (males).
The Centres for Disease Control and Prevention (CDC) reported that adults over 65 are more likely to experience back pain. Here’s the breakdown by age:
- 30–44: 35.2%
- 45–64: 44.3%
- 65 and older: 45.6%
Managing back pain is different for children than for adults. It’s important to rule out any pre-existing conditions before getting diagnosed with acute back pain. If there’s no serious condition, a doctor will likely advise older patients to avoid any activity that worsens pain and educate them about prevention and management techniques. Doctors will also want to rule out any pre-existing conditions for any adult with chronic back pain. If none exist, the doctor may recommend exercise or cognitive behavioural therapy to help manage symptoms. Other treatment options include massage, acupuncture, yoga, and other rehabilitation techniques.
Back pain statistics by gender
The CDC reported women experience back pain more often than men: 40.6% of women over the age of 18 are likely to experience back pain compared to 37.2% of men over the age of 18.
Harris, a spine and orthopaedic surgeon, noted a lower bone mineral density, the physical changes associated with pregnancy, and the hormonal changes of menopause as possible contributing factors to the increased incidence of low back pain in women.
Physiological differences between the sexes may also contribute to women experiencing more back pain than men. One such difference is the structure of the sacroiliac joints (the joints that link the pelvis and lower spine), which are more flexible in women than men. Research shows that because this joint is more flexible in women, the stress load they put on it is higher, which can lead to more strain and, eventually, lower back pain.
Back pain statistics by activity level
Back pain can be caused or triggered by certain everyday activities, and knowing which ones to avoid can help you avoid potential pain. Examples include sitting at a desk all day, gardening, poor exercise posture, and inactivity. According to Harvard Health, here are some other potential triggers of back pain:
- Desk jobs: While you may think of sitting at a desk as a low-risk activity, it can actually cause or worsen back pain. A survey conducted by BrandWatch said back pain was the second most common complaint during the pandemic, with nearly 1 million people posting about their back pain on online forums between March 2020 and January 2021. While poor work-from-home posture is a possible contributing factor, a general lack of movement and sitting (even on the couch) for a long time can also lead to back pain.
When you’re sitting for extended periods of time, pressure is being placed on the spine and the discs between your vertebrae. While posture can be adjusted to reduce pressure, it’s not a cure-all if you sit for more than six consecutive hours each day. Getting up to stand or walk every hour and maintaining a healthy posture can help reduce the risk of back pain.
- Heavy lifting: Because heavy objects place more strain on your back, it’s important to use the right posture. Before picking up a heavy object, get as close to it as you can. Engage your core and keep your stomach muscles tight to support your spine. Also, be sure to pivot your entire body if you need to turn (move your feet) instead of twisting your back. Lastly, always be sure to lift with your legs, meaning don’t use your back muscles to stand. Instead, use your leg muscles to propel you up. Keep the object close to your chest as you carry it.
- Leading an inactive lifestyle: Although you may think laying low would be a good way to avoid back pain, experts say the opposite may be true. Physical activity, such as walking, exercising, and regularly stretching your hip and back muscles, can help you maintain strength. It can also increase blood flow to the back, which may help reduce pain symptoms.
- Improper exercise habits: Before getting off the couch and heading to the gym, know how to exercise properly to avoid injury or trigger back pain. Overextending the spine when working out is one of the leading causes of back pain, as is working out for too long or too intensely. If you’re just starting your exercise routine at the gym, talk to a professional to ensure you have proper form.
Occupational back pain statistics
Back pain and work are closely linked. Statistics from Georgetown University show that back pain is the No. 1 cause of missed work in the United States, with 83 million days of work lost per year due to back pain.
Because back pain affects working-age people, it significantly impacts the workforce and employment levels. Data published in The Lancet Rheumatology show that back pain may lead to some people retiring early, which can create a loss of income and lower total wealth compared to people employed full-time.
According to the CDC, back pain is also linked with family income. Data reveal that 44.8% of adults with an income below the federal poverty level (which, as of 2024, was $15,060 a year for a single person) experience back pain compared to 37% of adults who live above the poverty level.
According to a study published in the Annals of Internal Medicine, the type of work someone does may also influence the likelihood of back pain. For example, data show that people who work in construction have a high likelihood of experiencing back pain, with roughly 32% of workers in this field reporting any type of lower back pain and 9.9% reporting frequent and severe low back pain. Health care practitioners and technical workers also reported a high level of back pain, with roughly 29% saying they experienced back pain of any type and 7.5% saying they experienced severe low back pain.
The Annals of Internal Medicine shares other industries that reported high levels of back pain, including:
- Building and grounds cleaning and maintenance: 30% reported general back pain.
- Personal care and service: 30% reported general back pain.
- Office and administrative support: 29% reported general back pain.
- Installation, maintenance, and repair: 30% reported general back pain.
- Transportation and material moving: 29% reported general back pain.
- People in the legal profession: 26% reported general back pain.
The study also reported that workers ages 45–64 are 5% more likely to experience back pain than workers ages 30–44 and 10% more likely than workers ages 18–29.
The Annals of Internal Medicine also reported that 20% of workers with back pain were told by health professionals that their back pain was work-related. The data also revealed that up to 10% of workers either quit work, switched jobs, or made major changes in their work due to back pain. Some of the reasons for work-related back pain include inadequate supervision on the job and general job dissatisfaction.
Unfortunately, back pain can impact your income. The Georgetown University Health Policy Institute reported that people who have difficulties at work due to back pain earn less than those who don’t. People who reported having limitations at work due to back pain have an average annual earnings of $18,480, while people who don’t have limitations due to back pain earn an average of $24,480 per year.
Working directly with a supervisor and developing a back pain prevention strategy may help curb work-related back pain issues.
Back pain and sleep statistics
Waking up from a poor night’s sleep with an achy back is all too common. According to Harris, this is usually due to your position rather than a health-related issue.
“These symptoms usually resolve with some simple stretches and a warm shower. However, if they persist, it may be of value to review your sleeping posture. Side sleeping in the foetal position tends to offload strain on the low back. Sleeping on your back with a pillow beneath the knees is often recommended to allow your lumbar spine to rest in its neutral position. On the other hand, prone sleeping with a soft mattress may lead to hyperlordosis [a condition where the lower spine curves too far inward] of the lumbar spine and contribute to early morning low back pain,” said Harris.
It’s also worth noting that your sleep can influence your back pain, and vice versa—poor sleeping conditions can lead to back pain, which can cause sleep disturbances. Research shows poor sleep quality is commonly observed in people with lower back pain. And people who don’t sleep well due to discomfort or insomnia are more likely to develop chronic pain.
If you experience back pain, finding the best mattress for back pain may help manage your symptoms. Many mattresses today are designed to help relieve pressure and reduce pain, and some are specifically designed for people who experience back pain. Side sleeping may also help offset back pain, so finding the best mattress for side sleepers may help as well.
Back pain treatment statistics
Having back pain can be costly in several ways. Loss of work days, early retirement, and the cost of treatment all add up to millions of dollars in losses and expenses. Data show that approximately 30 million people in the United States are treated professionally for back pain annually.
Nationally, the average yearly indirect and direct costs of back pain are $100–200 billion, while the costs per patient range from $9,231–$10,143. To treat chronic back pain, people may need to consider chiropractic treatment, physical therapy, or visiting their general physician, all of which can be costly. Surgery is also a potential treatment for people dealing with back pain, which is another high expense.
“However, surgery is usually reserved for patients with a structural spine problem, MRI evidence of nerve root compression, and leg or arm dominant symptoms (i.e., the leg pain is more severe than the back pain),” Harris said. “Even though the back pain can be very severe and incapacitating at times, it is usually brief and responds to conservative management such as short-term rest, graduated physiotherapy-guided exercises, oral pain killers, and topical treatments.”
The American Society of Anesthesiologists reported that some potential reasons to get back surgery may include herniated or ruptured discs, spinal stenosis, vertebral fractures as a result of injury or osteoporosis, and degenerative disk disease.
The Lancet Rheumatology reported the high cost of treating back pain is a major concern worldwide and that prescription medications are on the rise, particularly opioids. Because there’s a link between opioids and other negative health consequences, such as addiction and overdoses, there are secondary costs of back pain associated with treating the side effects of these drugs.
Chiropractic care may effectively reduce back pain. One study that evaluated military personnel who complained of back pain compared two different types of care. One group received typical care that included medication, physical therapy, and self-care. The other half received the same typical care and also went to a chiropractor. The group that received chiropractic care noticed an overall decrease in the intensity of their pain, higher satisfaction with their treatment, and the need for less pain medication after six weeks.
In general, adults with back pain spend more money on health care treatments than those who don’t have back pain. Data from the Health Policy Institute shows that 83% of people with back pain in the United States visited a general physician within the preceding year. People with back pain also see physical and occupational therapists, representing even more economic investment.
Here’s a breakdown of the investments put toward back pain care in the United States, according to the Health Policy Institute at Georgetown University:
- $275 million is spent annually on hospital visits related to back pain.
- $203 million is spent on non-physician visits for back pain.
- $367 million is spent on prescription drugs for back pain.
Bottom line
Back pain is a serious issue that affects millions of people and costs billions of dollars each year (roughly $100-200 billion for low back pain alone). The causes of back pain are wide and varied, and treatment options range from self-care techniques to surgery, depending on the severity of the back pain.
Taking preventive measures, such as exercising, maintaining proper posture at work, not sitting for extended periods of time, and sleeping on the right mattress, are just a few ways to help reduce the likelihood of back pain.
If you’re dealing with acute or chronic back pain, visit your physician. They can develop a treatment plan or refer you to a chiropractor or physical or occupational therapist to ensure proper recovery.
https://www.ncoa.org/adviser/sleep/back-pain-statistics/
