THE EPIDEMIOLOGY OF BACK PAIN

Environmental Health 5700UG

The Back Basics

The epidemiology of back pain varies by occupational, ethnic, and gender groups.

> 75% of general population has suffered from low back pain at one time or another (approximately 5%-10% will become chronic),

Point prevalence of low back pain is about 15%-20% in the general population

•Back pain has a Back pain has a high recurrence high recurrence rate, 20%-25% of rate, 20%-25% of cases recur within cases recur within the first year the first year

The point prevalence of The point prevalence of low back pain is about low back pain is about 15%-20% in the 15%-20% in the general populationgeneral population

Approximately 1% of all back injuries will require surgical intervention, e.g., disk herniation is most common condition

About 10% of back pain patients are out of work for more than 6 months, and these cases can be very expensive.

Direct and indirect medical costs are estimated as high as $100 billion annually

How to Measure the Epidemiology of Back Pain?

Frequency Duration Intensity Effect on daily activities Cost

Increased Risk Factors?

Previous history of back injury Younger age (« 30 years) Male gender Smoking Height (taller = greater risk)

More Risk Factors

Anatomical defects {e.g., spinal curvature)

Occupation {e.g., physical labor) Availability of insurance benefits

{e.g., Workman's Compensation)

Risk Factors Associated with Chronicity of Back Pain Previous history of back pain Older age (> 30 years) Female gender Occupation (e.g., physical labor) Insurance benefits (e.g.,

Workman's Compensation) Initial diagnosis (e.g., "labelling" by

physician)

Ergonomic Factors Associated with Back Pain Risk

Posture (e.g., quality and duration) Level of physical effort (e.g.,

intensity, frequency, duration) Vibration level (e .g. , partial or

total body) Subjective perception of physical

demand to perform a given task

Psychosocial Factors Associated with Back Pain

Depression Job satisfaction Substance abuse Ethnicity

Assessment of Back Pain

Diagnostics (e.g., x-rays, etc.) Symptoms Range of motion Strength Psychosocial measures (e.g.,

McGill and/or Quebec Pain Scales)

Intervention

Most cases (after rule out of other problems) respond well to NSAIDs and as much normal activity as possible

Saline injections found to be just as effective as corticosteroid injections

Assess occupational and psychosocial factors for problem areas