Low Back Pain and Effect on Productivity

In the industrialized world, low back pain is second only to headache as a cause of pain. It is the leading cause of expenditure as a cause of pain. It is the leading cause of expenditure for workers' compensation. Although it is often a self-limiting symptom, it costs at least $16 billion a year and disables 5.4 million Americans.

According to estimates of the US Census Bureau, 1.8 million Americans were unable to work at some time during 1984 to 1985 because of low back pain. One study reported that 2% of all U.S. workers have a compensable back injury each year.

Another study suggested that 24 million Americans lost one or more days of work annually because of low back pain. About 2% of workers each year submit claims for disability due to low back pain.

Low back pain is a symptom that can be caused by various disease entities and can be affected by various psychosocial factors. Furthermore, in the absence of specific anatomical and pathological findings, the pain is not objectively verifiable. Thus, the application of the science of Epidemiology to the subject of low back pain is difficult.

The available survey studies have to be analyzed with attention to several factors, including the presence of absence of specific anatomical change or pathological process, whether the pain is severe or trivial.

50% to 80% of adults will have low back pain at some time in their lives. In 1985, the Nuprin Pain Report, conducted through telephone interview of 1254 Americans, revealed that 56% of the adult population had some low back pain in the year preceding the survey, and 3% of them had had low back pain for more than 1 month.

The U.S. population in 1985 was approximately 180 million, and one can conclude from this study that approximately 100 million persons had some low back pain and 6 million had low back pain for more than 1 month during that year.

In a study conducted in Finland, about 75% of both men and women reported having had at least one episode of low back pain, 45% recalled at least six episodes of low back pain, and 18% reported having low back pain in the previous month.