A person’s backbone, or spine is made up of 33 bone discs called vertebrae. These vertebrae perform the vital functions of protecting the spinal cord and allowing a person to stand and bend. The major regions of the spine are typically categorized as cervical, or neck; thoracic or upper back; and, lumbar or lower back. The vertebral column also contains the sacrum, made up of five fused vertebrae (S1-S5), which form a strong and large triangularly shaped structure connecting the spine to the hip bones to form the pelvis and support the weight of the upper body. The lowest segment of the spinal column is the coccyx, or tailbone. While considered a vestigial structure, the coccyx helps with balance while sitting and is an attachment site for tendons, ligaments and even muscles.
The majority of patients with back pain have benign conditions and can be treated with rehabilitation and back care, once the presence of a serious diagnosis is ruled out.
Back Pain
Back pain can be sudden, chronic, extremely painful and debilitating, drastically affecting a person’s quality of life. In most cases, back pain does not arise from disease but rather a group of symptoms marked by acute, sub-acute or chronic pain.
Back pain is usually categorized by the region affected, such as lower (lumbar) back pain (LBP), upper (thoracic) back pain and neck (cervical) pain. Pain in each region typically stems from different underlying causes and may require different treatments.
Globally, back pain is on the rise for a few reasons. Humans have eradicated many life-threatening illnesses and we are also much better at managing diseases and infections that were often fatal in the past. People are generally living longer—life expectancy is higher than ever before. The world’s population is aging and this longevity, while wonderful, is contributing to a global rise in back pain.
There is great variation from country to country and clinical study to study on the occurrence, or prevalence, of neck pain, upper back pain and lower back pain.
Neck Pain (NP)
Neck pain is widely considered a major global public health issue when analyzing personal health, general wellbeing and indirect expense (costs). On average, women report more neck pain than men according to a study that reviewed global databases and clinical papers.1 According to another study, the global occurrence of neck pain reveals a very large range from 16.7% to 75.1%. What most agree upon is that neck pain is a common condition that may cause substantial disability.2
Thoracic Spine Pain (TSP) Global Statistics
Thoracic spine pain studies vary greatly as do the characteristics associated with upper back pain. This area of spinal pain is not as well documented as neck and lower back pain. It is thought that anywhere between 15-19% of people suffer from chronic, or lifetime upper back pain.3
Lumbar Back Pain (LBP) Global Statistics
The lifetime prevalence of ‘common’ low back pain is estimated at 60% to 70% in industrialized countries. The prevalence of back pain that lasts for a year varies widely from 15% to 45%.4 Of equal concern, lower back pain causes more global disability than any other condition, which is also referred to as ‘years lived with disability’ (YLDs) and because back pain is not associated with mortality, it is also referred to as ‘disability-adjusted life years’ (DALYs).5
A 2009 study published in the Archives of Internal Medicine produced some alarming statistics about back pain in the United States. Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and conducted by researchers at the University of North Carolina at Chapel Hill, the study noted that not only is lower back pain the second most common cause of disability in the United States and a common reason for missing work, but that 80 percent of Americans will experience an episode of lower back pain at some time in their lives and that total costs of the condition are estimated at greater than $100 billion annually, with two-thirds of that due to decreased wages and productivity.6
1 Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. European Spine Journal. 2006;15(6):834-848. doi:10.1007/s00586-004-0864-4.
2 Genebra CVDS, Maciel NM, Bento TPF, Simeão SFAP, Vitta AD. Prevalence and factors associated with neck pain: a population-based study. Brazilian Journal of Physical Therapy. 2017;21(4):274-280. doi:10.1016/j.bjpt.2017.05.005.
3 Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskeletal Disorders. 2009;10:77. doi:10.1186/1471-2474-10-77.
4 World Health Organization
5 Hoy D, March L, Brooks P, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases 2014;73:968-974.
6 Freburger, JK, Holmes, GM, Agans, RP, et al. The Rising Prevalence of Chronic Low Back Pain. Archives of internal medicine. 2009;169(3):251-258. doi:10.1001/archinternmed.2008.543.
