Back Pain

Backache or back pain is a common symptom and affects up to 85% of individuals in their lifetime {"Back Pain"}. In most cases (80%), there is no clear diagnosis or anatomic finding to account for the pain {Perina}. By contrast to general back pain, low back pain often has specific causes: 70% of cases by simple strains and sprains; 10% by age-related changes; 4% by disc herniations; another 4% by compression fractures from osteoporosis; and 3% from narrowing (stenosis) around the spinal nerve roots {Hills}.

In most cases, general back pain is of non life-threatening (benign) mechanical origins. However, spinal complaints may also involve disease such as tumor (rare); be caused by a fracture; be referred from the shoulder, hip, or internal organs (e.g., appendix, kidneys, bladder, ovaries); or represent physical manifestations of a psychiatric or emotional disorder.

See Low Back Pain, Thoracic Spine Pain, and Intervertebral Disc Disorders for additional information.

Risk Risk factors that increase the likelihood of back pain include aging, poor general health, physically demanding occupations, participation in sports that involve twisting the back, a sedentary lifestyle that includes lack of participation in sports activities or regular exercise, previous back injury, depression, pregnancy, smoking, obesity, poor posture, and bone or joint disease, including infectious disease.

Incidence and Prevalence Overall, 4 out of 5 people (80%) will experience nonspecific back pain during their lifetime, 15% to 20% will experience prolonged periods of pain, and up to 8% will have chronic pain {Wheeler}. Nearly half will have at least one recurrence {Fraser}.

The incidence of back pain is highest for those aged 30 to 50 {Perina, Wheeler}. Annual incidence of low back pain in the general population is 18.4% {Jacob}. In a group of outpatient veterans, three-year incidence of new low back pain was 67% {Jarvik}.

Annual incidence of temporary disability from back pain is 3% to 4%, with 1% of the workforce developing permanent disability {Wheeler}.

In Europe, yearly prevalence of low back pain is 25% to 45% {Wheeler}.

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