Low back pain causes more disability around the globe than any other condition, reveals research published online in the Annals of the Rheumatic Diseases.
As world population growth gathers pace, and the proportion of elderly rises, the problem is set to worsen over coming decades, warn the authors, who urge governments and health services to take the issue far more seriously than they have done so far.
The authors base their findings on data for the Global Burden of Disease 2010 study, which assesses ill health/disability arising from all conditions in 187 countries – grouped into 21 regions – for 1990, 2005, and 2010.
They looked at the prevalence, incidence, remission, duration, and risk of death associated with low back pain in 117 published studies covering 47 countries and 16 of the 21 Global Disease world regions; plus surveys in five countries about the impact of acute and severe chronic low back pain with and without leg pain; and data from national health surveys in many countries.
The authors then assessed the toll taken by low back pain in terms of disability adjusted life years (DALYs). These are worked out, by combining the number of years of life lost as a result of early death, and the number of years lived with disability.
Results and Discussion:
Out of all 291 conditions studied in the Global Burden of Disease 2010 study, low back pain came top of the league table in terms of years lost to disability, and sixth in terms of DALYs.
It was ranked as the greatest contributor to disability in 12 of the 21 world regions, and the greatest contributor to overall burden in Western Europe and Australasia.
Almost one in 10 people (9.4%) had low back pain, with the number of DALYs rising from 58.2 million in 1990 to 83 million in 2010. The prevalence of low back pain was highest in Western Europe, followed by North Africa and the Middle East, and lowest in the Caribbean and Latin America.
The prevalence and the overall impact of the condition increased with age. “With ageing populations throughout the world, but especially in low and middle income countries, the number of people living with low back pain will increase substantially over coming decades,” conclude the authors.
“Governments, health service and research providers and donors need to pay far greater attention to the burden that low back pain causes than what they had done previously,” they add.
Hoy D, March L, Brooks P, et al. Ann Rheum. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014;0:1–7. doi:10.1136/annrheumdis-2013-204428
Link to paper: http://www.ard.bmj.com/lookup/doi/10.1136/annrheumdis-2013-204428
Dr Rachelle Buchbinder, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Tel: + 61 41 810 5043
Dr Tony Woolf, Department of Rheumatology, Royal Cornwall Hospital, Truro, Cornwall, UK.
Tel: +44 (0)7836 623 725
Dr Lyn March, Department of Rheumatology, University of Sydney Institute of Bone and Joint Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
Tel: + 61 41 186 4062
Notes for editors:
The Annals of the Rheumatic Diseases is one of more than 50 specialist journals published by BMJ. The title is co-owned with the European League against Rheumatism (EULAR). www.ard.bmj.com
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