About back problems and associated comorbidities


People with back problems often have other chronic diseases and long-term conditions. These are referred to as 'comorbidities'—two or more health problems occurring at the same time. Comorbidities often share common risk factors, and are increasingly seen as acting together to determine the health status of individuals.

As people age, they are more likely to develop more than one chronic condition. Various studies show that cardiovascular diseases [1,2] arthritis [3], mental health problems [4,5] and respiratory conditions [6] are common comorbidities with back problems.

Treatment and management

Compared with people without chronic low back pain, people with chronic low back pain make greater use of pain-related medications and health care resources [4].

Pain is the main symptom of most back problems and treatment can be complex. This can be complicated by the existence of other comorbidities. As pain treatment is given at the same time as other treatments, serious drug interactions can be an issue [7].

Some general treatment strategies for chronic diseases can benefit people with back problems. For example, lifestyle modifications such as diet, exercise, weight control, and reducing smoking have been shown to be beneficial [8].


  1. Ha IH, Lee J, Kim MR, Kim H & Shin JS 2014. The association between the history of cardiovascular diseases and chronic low back pain in South Koreans: a cross-sectional study. PLOS ONE 9(4):e93671.
  2. Schofield DJ, Callander EJ, Shrestha RN, Passey ME, Percival R & Kelly SJ 2012. Association between comorbidities and labour force participation amongst persons with back problems. Pain 153:2058–2072.
  3. Bollegala D, Perruccio AV & Badley EM 2011. Combined impact of concomitant arthritis and back problems on health status: Results from a nationally representative health survey. Arthritis Care & Research 63(11):1584–1591.
  4. Gore M, Sadosky A, Stacey BR, Tai KS & Leslie D 2012. The burden of chronic low back pain: clinical comorbidities, treatment patterns, and health care costs in usual care settings. Spine (Phila Pa 1976) 37(11):E668–E677.
  5. Gerhardt A, Hartmann M, Schuller-Roma B, Blumenstiel K, Bieber C, Eich W et al. 2011. The prevalence and type of Axis-I and Axis-II mental disorders in subjects with non-specific chronic back pain: results from a population-based study. Pain Medicine 12:1231–1240.
  6. Bartholomeeusen S, Van Zundert J, Truyers C, Buntinx F & Paulus D 2012. Higher incidence of common diagnoses in patients with low back pain in primary care. Pain Practice 12:1–6.
  7. Kozma CM, Provenzano DA, Slaton TL, Patal AA & Benson CJ 2014. Complexity of pain management among patients with nociceptive or neuropathic neck, back, or osteoarthritis diagnoses. Journal of Managed Care & Speciality Pharmacy 20(5):455–466b.
  8. Bauer UE, Briss PA, Goodman RA & Bowman BA 2014. Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. Lancet 384:45–52.