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A variety of back problems are managed in Australian hospitals.

In 2010-11, there were 93,564 hospitalisations with a principal diagnosis of back problems according to the National Hospital Morbidity Database (NHMD). The common reasons for hospitalisations were:

  • low back pain (27.7% of hospitalisations for back problems)
  • narrowing of the spinal canal (spinal stenosis) (14.1%)
  • pain including tingling, numbness and weakness in the legs that starts from the lower back (sciatica) (13.8%).

Depending on the cause and symptoms, back problems are managed in a variety of ways. In hospitals they may include:

  • patient education and support to help patients understand the problems and make lifestyle modifications for effective management of the condition
  • rehabilitation for lost or reduced functions
  • pain management including medication
  • spinal surgery.

Spinal surgery is usually the last resort in the treatment of back problems and has been considered to be moderately better than other common treatments. It may include:

  • relieving of pressure from spinal cord and nerve roots (segment of spinal nerve attached to the spinal cord)
  • removal of an intervertebral disc
  • replacement of an intervertebral disc
  • spinal fusion surgery (joining of two vertebrae to stop movement between them).

According to the NHMD in 2010-11:

  • more females (407 per 100,000 population) than males (383 per 100,000 population) had their back problems managed in hospitals - as admitted patients
  • the rate of back problems managed in hospitals increased with increasing age.

These data contrast with the prevalence data (from the 2007-08 National Health Survey), which suggests that after the age of 34 the prevalence does not vary greatly with age. This may suggest that the severity or type of the condition worsens with age even if the prevalence does not. 

Figure 1: Rate of hospitalisation for back problems by sex and age, 2010–11

 Bar chart shows rate of hospitalisation for back problems by sex and age. Rate tends to increase by age - the highest rate of hospitalisations for back problems was for females aged 80-84.

Source: AIHW National Hospital Morbidity Database. Source data

The hospitalisation rate for back problems among Australians aged 45 and over increased from 746 per 100,000 in 2001-02 to 818 per 100,000 in 2010-11. The hospitalisation rate increased similarly for males and females during this period.

Figure 2: Rate of hospitalisation for back problems, people aged 45 and over, 2001–02 to 2010–11

 Line graph shows rate of hospitalisation for back problems by sex, for people aged 45 and over. There is a slight increase over 2001-02 to 2010-11. The rate of females hospitalised for back problems was consistently higher than that for males.

Source: AIHW National Hospital Morbidity Database. Source data

While the hospitalisation rate for back problems increased over the 10 years from 2001–02 to 2010–11, the average patient days for hospitalisations where back problems were the principal diagnosis decreased from 4.1 days in 2001–02 to 3.7 days in 2010–11.

This trend is consistent with an overall decline in the average patients days (from 3.7 to 3.0) for admitted patients in hospitals over the same period.

Figure 3: Average patient days for back problems in admitted hospital care, people aged 45 and over, 2000–01 to 2010–11

 Line graph shows the average patient days for back problems in admitted hospital care in people aged 45 and over. There is an overall decrease, from 4.1 bed days in 2001-02 to 3.7 days in 2010-11.

Source: AIHW National Hospital Morbidity Database. Source data

Source tables

Table 1: Hospitalisation rates for back problems by sex and age, 2010–11
Age group Males   Females   Persons
Number (a) Per cent (n=43,426) Rate (b) Number Per cent (n=50,138) Rate Number  Per cent (n=93,564) Rate
0–4 28 0.1 4   25 0.0 3   53 0.1 4
5–9 24 0.1 3   42 0.1 6   66 0.1 5
10–14 60 0.1 8   95 0.2 14   155 0.2 11
15–19 228 0.5 30   370 0.7 51   598 0.6 40
20–24 654 1.5 77   798 1.6 100   1,452 1.6 88
25–29 1,354 3.1 159   1,201 2.4 145   2,555 2.7 152
30–34 2,022 4.7 260   1,840 3.7 238   3,862 4.1 249
35–39 3,264 7.5 410   2,848 5.7 353   6,112 6.5 381
40–44 3,680 8.5 471   3,480 6.9 440   7,160 7.7 455
45–49 4,092 9.4 525   4,244 8.5 536   8,336 8.9 531
50–54 4,145 9.5 565   4,463 8.9 594   8,608 9.2 580
55–59 4,224 9.7 638   4,564 9.1 675   8,788 9.4 657
60–64 4,685 10.8 766   5,005 10.0 810   9,690 10.4 788
65–69 4,087 9.4 886   4,549 9.1 968   8,636 9.2 927
70–74 3,547 8.2 1,016   4,426 8.8 1,191   7,973 8.5 1,106
75–79 3,075 7.1 1,193   4,222 8.4 1,423   7,297 7.8 1,316
80–84 2,329 5.4 1,224   4,120 8.2 1,646   6,449 6.9 1,463
85+ 1,928 4.4 1,345   3,846 7.7

1,450

   5,774 6.2 1,413
All 43,426 100.0 383    50,138 100.0 407   93,564  100.0  396 

(a) Refers to the number of hospitalisations where back problems were the principal diagnosis.
(b) Rate = age standardised rate per 100,000 population. For each sex, the age-specific rates are obtained by dividing the number of hospitalisations for each of the age groups by the population for that age group in December 2010.

Notes
1. Back problems were classified according to the ICD-10-AM, 6th edition (NCCH 2008) codes M46.9, M47, M48.0, M48.1, M48.2, M48.8, M48.9, M50, M51, M53 and M54.
2. Excludes one hospital separation where sex of the patient was not recorded.
3. Hospital separations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.

Source AIHW National Hospital Morbidity Database.

Table 2: Hospitalisation rates and and average patient days for back problems, people aged 45 and over, 2001–02 to 2010–11 
Year Males: ASR Females: ASR Persons: ASR Average bed
days (persons)
2001–02 700 789 746 4.1
2002–03 686 785 737 4.0
2003–04 704 805 755 3.9
2004–05 718 823 772 3.8
2005–06 725 832 782 3.7
2006–07 731 823 780 3.7
2007–08 732 830 783 3.7
2008–09 734 841 791 3.5
2009–10 762 855 811 3.6
2010–11 774 857 818 3.7

(a) ASR = age standardised rate per 100,000 population. Rates were age standardised to the Australian population as at 30 June 2001.

Notes
1. Although hospitalisations with a principal diagnosis of back problems occur for younger Australians, the majority of those hospitalisations are for people aged 45 and over. For this reason, this analysis excluded people younger than 45 years of age.
2. Back problems were classified according to ICD-10-AM, 6th edition for 2008-09 and 2010-11, and earlier editions used for the years 2000-01 to 2007-08. In all editions of the ICD-10-AM, codes for back problems were M46.9, M48.0, M48.1, M48.2, M48.8, M48.9, M50, M51, M53 and M54.
3. Hospitalisations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.
4. Changes in the number of hospitalisations for back problems may be due to changes in the severity and prevalence of the disease in the community and/or the effectiveness of disease management. The use of hospital care for the management of back problems may also be influenced by the relative accessibility of hospital services and of alternative services such as general practitioners. Changes in admission criteria and administrative policies also affect hospital usage data.

Source: AIHW National Hospital Morbidity Database.