Challenge of Back Pain

The Mayo Clinic estimates that a staggering 80% of Americans will experience back pain at some point in their life. In fact, the cost of treating spinal dysfunction has grown to 50 billion dollars in the US annually. As a result, patient, clinicians and third party payers are now demanding less invasive, less expensive, non-phamacological solutions to back pain.

Musculoskeletal conditions are extremely prominent and include more than 150 different diseases and syndromes, which are usually associated with pain and loss of function. It is now recognized that spinal disability, injury and arthritis result in social, psychological and economic burdens to Canadian society.

A Health Canada study revealed that musculoskeletal disorders rank second after cardiovascular disease in terms of the highest cost of burden of illness in Canadian society, at over 16.4 billion dollars or 10.2% of the total (direct and indirect) cost of illness in 1998. In 1998 the morbidity cost due to long term disability from musculoskeletal disorders totalled 12.5 billion dollars, 37.5% or 4.7 billion of which was due to back and spinal disorders alone. This figure is significantly higher than long term disability costs related to all other diagnostic categories, including afflictions of the nervous system (4.1 billion), cardiovascular disease (3.2 billion) and mental disorders (2.2 billion).

The musculoskeletal burden is made more urgent, given Canada’s aging population and the increase of self-reported prevalence of musculoskeletal disorders. Neck pain and back pain are common complaints in seniors, leading to impaired functional ability and decreased independence. A recent cross-sectional study suggests that 10 to 20% of seniors over age 70 reported more than 30 days of neck pain 9r back pain within the past ear with a significant proportion having diminished their physical activities due to neck pain (11%) or back pan (15%) within the past year. Furthermore, back pain and neck pain continue to be common and bothersome complaints even into extreme old age. A nationwide interview/survey of Danish 100 year olds indicate that as many as 29% of women and 17% of men had experienced back pain, and 23% of women and 19% of men had experienced neck pain during the past month. Furthermore, 21% have been bothered by back pain, either when moving, resting or sleeping. Poor overall function, bad rated health and higher depression score were associated with higher prevalence of back and neck pain.