[What do we know about the symptoms of back pain? Epidemiological results on prevalence, incidence, progression and risk factors]

Abstract

Aims: This paper provides an overview of epidemiological findings concerning the prevalence and incidence of back pain, the underlying risk factors and health care utilization due to back pain.

Methods: Besides epidemiological studies, data from health care statistics and cost-of-illness studies were included in the systematic search. Relevant publications were identified using electronic literature databases (in particular Medline).

Results: Back-related disorders, classified according to the ICD-10 M40-M54 key are the major cause for receiving disability benefits. While back pain leads to a frequent demand for medical services, loss of production because of temporal sick leave is the major economic factor. In total, the estimated annual costs caused by back pain range between 16 and 22 billion euros. The life-time prevalence corresponds to the immense costs: 80 % report having ever experienced back pain. The point prevalence lies between 30 and 40 %. Approximately one-fourth to one-third of those affected suffer from clinically significant back pain. Recurrent as well as incident back pain is best predicted by prior back pain. The wide spectrum of other risk factors (depression, psychosocial distress, somatization, catastrophizing, dissatisfaction at work and sociodemographic as well as socioeconomic variables) underscores the multifaceted etiology of this symptom.

Conclusion: Back pain belongs to the major individual and societal health problems in Germany. While extensive epidemiological evidence exists for the prevalence of back pain, its severity, course and associated risk factors, little systematic knowledge is available about the medical treatment of back pain.