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Back problems are a range of conditions related to the bones, joints, connective tissue, muscles and nerves of the back. Back problems are a significant cause of disability and lost productivity.
1 in 6 Australians (16%) reported back problems in 2014–15. That’s 3.7 million people
3rd leading cause of disease burden in Australia in 2011
4 in 5 people with disability and back problems had difficulty with mobility, communication or self-care in 2012
Risk factors increase the chance of developing a chronic condition. Back problems share a number of risk factors with other chronic diseases, such as:
Non-modifiable risk factors
Modifiable risk factors
Other factors such as exposure to whole body vibration  and mechanical exposures (such as placing unequal stress on the spine by twisting while lifting heavy objects or poor posture during work activities)  may increase the risk of developing back problems, in particular low back pain.
Risk factors can also affect quality of life, and often complicate treatment and management options . Managing these risk factors helps to manage the progression and health burden of back problems, and can reduce the risk of developing further complications and other chronic diseases.
Risk factors are defined in Box 1.
According to the 2014–15 NHS, people with back problems are more likely to be current daily smokers (although the difference is not statistically significant) and more likely to be physically inactive and obese, compared to those without back problems (see Figure 1 and Table 1).
Note: The thin vertical lines attached at the end of each bar are 95% confidence intervals. We can be 95% confident that the true value is within this confidence interval.
Source: ABS National Health Survey, 2014–15 (see Data table).
People with back problems were more likely to be or have been a smoker:
Current smoking is associated with:
People with back problems were slightly less likely than people without back problems to report engaging in the recommended levels of moderate or vigorous physical activity. For adults with back problems, 57.8% reported being physically inactive (this includes people who are inactive and insufficiently active) compared to 53.7% of those without back problems.
Exercise and physical activity are important for the prevention and management of back problems. The relationship between physical activity and back problems is affected by the nature and intensity of the physical activities undertaken. Both too little and too much activity increases the risk of chronic lower back pain . Moderate to strong risk factors for lower back pain include heavy manual workload and repetitive lifting, with stronger associations for flexed, rotated or awkward positions of the spine .
For people with back problems, the prevalence of risk factors varies by age.
The prevalence of smoking in people with back problems decreased with age. Younger people (aged 18–44) with back problems were more likely to report smoking (22.7%) than those aged 45–64 (19.0%) or 65 and over (7.5%).
There was an increase with age in the prevalence of physical inactivity or overweight and obesity for people with back problems. Physical inactivity increased from 51.1% at age 18–44 to 58.9% at age 45–64 to 66.6% at age 65 and over, although the increase was not significant. Overweight and obesity increased significantly from 58.5% at age 18–44 to 75.9% at ages 45–64 and 65 and over.
A similar pattern is observed in the prevalence of smoking and physical inactivity for people without back problems. In contrast, the prevalence of overweight and obesity for people without back problems increased up to the age of 45–64 but declined for people aged 65 and over, although this decline is not significant.
Note: The thin horizontal lines attached at the end of each bar are 95% confidence intervals. We can be 95% confident that the true value is within this confidence interval.
Risk factors analysis is based on people aged 18 and over. This age group was selected due to the available data in the ABS National Health Survey (NHS) and to ensure consistency with other AIHW risk factor reports [8, 9].
The risk factor data are presented here at one point in time, based on self-reported data from the NHS. When interpreting self-reported data, it is important to recognise that it relies on respondents providing accurate information.
It is not possible to attribute cause and effect to self-reported risk factors and back problems. Risk factors present at the time of the survey may or may not have contributed to the presence of back problems. Similarly, the presence of back problems may not be directly related to the number of risk factors a person has.
Smoker status is defined by the extent of regular smoking of tobacco at the time of interview. This includes manufactured (packet) cigarettes, roll-your-own cigarettes, cigars and pipes, at time of interview. It excludes chewing tobacco and smoking of non-tobacco products. The categories are:
According to the Australian Physical Activity and Sedentary Behaviour Guidelines, physical activity is defined as any bodily movement that requires energy expenditure . This includes walking (for transport, fitness, recreation, or sport). The categories include:
Not achieving the recommended amounts of physical activity of 150 minutes per week over at least five days. The analysis includes categories of inactive and insufficiently active.
Based on body mass. Categories of body mass were derived from the body mass index (BMI)—calculated by dividing a person's weight in kilograms by the square of their height in metres (kg/m2). The standard recommended by the World Health Organization to measure BMI for adults aged 18 and over is:
Source: ABS 2014 .
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