Back facts

 Back pain costs the country billons

1. Back pain is the nation's leading cause of disability, with 1.1 million people disabled by it.
2. In 1997.8, over 119 million days a year were lost due to registered disability caused by back problems. This figure includes only people who claimed benefits as a result of their bad backs, so the total estimate, including short spells, could be nearer 180 million lost working days.
3. One in eight (13%) unemployed people say that back pain is the reason they are not working.
4. On average, each person with back pain and related conditions takes 13 days off work.
5. The most recent information available suggests that the NHS currently spends about £480 million a year on services used by people with back pain. This includes about 14 million GP consultations, seven million physical therapy sessions and 800,000 in-patient bed-days.
6. Back problems cost the nation about £6 billion a year, almost two thirds of it is due to time lost from work. (most recent estimate, 1993) 7. A typical GP practice with 5 GPs and 10,000 patients spends an average of £88,000 a year on patients with back pain.(most recent estimate, 1993)

Cost of back problems to the economy 

Who is at risk? 

1. Back pain is spread fairly evenly across the community in terms of age, sex and geography, but occupation makes a difference, over 1 million people have work-related back pain or upper limb disorders. Manual workers are, not surprisingly, more likely to have back problems than white-collar workers since their work is more likely to involve heavy lifting. 10% of all employee major injuries take place while handling, lifting or carrying.

2. You are more likely to suffer a serious back injury at work (involving a fracture or hospital admission for more than 24 hours) if you work in

• agriculture 

• construction
• mining 
• transport and communications 

3. You are most likely to sprain or strain your back so that you have to take more than three days off work if you work in 

• the postal or telecommunications business 
• transport support services 
• food, drink or tobacco manufacturing 
• the water supply industry  

4. Some occupations can cause back problems without involving injury. Among these are 

• driving a motor vehicle. A recent study found that people driving over 25,000 miles a year averaged just over 22 days a year off work with a bad back, compared with just over 3 days for low mileage drivers 
• driving a train. Train drivers are twice as likely as HGV drivers to report back pain
• work involving intensive use of the telephone without headsets. A survey of London office workers showed that half of office workers who use a telephone for at least two hours a day and also use a computer report neck pain and 31% lower back pain
• being a supermarket cashier - 57% experience lower back pain in a year.

Treating back pain 

1. Based on an extensive review of the research into the effectiveness of different treatments for back pain, the treatment currently recommended for an acute attack of low back pain which has no danger signs is 

• painkillers 
• continuing with normal activities 
• returning to work as soon as possible 

Bed rest is not recommended - it actually makes things worse and should be avoided. Despite this, GPs are still recommending bed rest to one in four of the people who consult them about back pain.   

2. The longer someone is off work with back pain, the lower the chances of their returning to work. Patients who return to normal activities feel healthier, take fewer painkillers and are less distressed than those who limit their activities.  

3. In two out of three cases, back pain clears up spontaneously and quickly - in less than a month - but for an unfortunate minority, it becomes chronic. Chronic back pain is often associated with psychological or social factors - in fact these are more important risk factors for developing chronic pain than physical symptoms and signs. For this reason, purely physical treatment has a low success rate with chronic back pain sufferers.  

4. Other factors associated with chronic back pain are 

• smoking 
• heart disease 
• depression 
• poor working conditions

Although more than 16 million people will suffer from back pain in the course of a year, fewer than half will consult their GP. About one in ten will receive hospital outpatient treatment, one in 165 will undergo inpatient treatment and only one in just under 700 will need surgery.

 We are indebted to BackCare for the information they have provided for this section.

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